scholarly journals Pullout strength of all suture anchors in the repair of rotator cuff tears: a biomechanical study

2013 ◽  
Vol 37 (10) ◽  
pp. 2017-2023 ◽  
Author(s):  
Alexandre Galland ◽  
Stéphane Airaudi ◽  
Renaud Gravier ◽  
Sophie Le Cann ◽  
Patrick Chabrand ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biomechanical Study ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Pullout Strength

Design and Mechanical Evaluation of Sutureless Implants for the Surgery Treatment of Rotator Cuff Tears

2021 ◽  
Author(s):  
Marcília Valéria Guimarães ◽  
Elton Bonifácio ◽  
Thiago Carmo ◽  
Cleudmar Araújo
Keyword(s):  
Rotator Cuff ◽  
Mechanical Behavior ◽  
Functional Disability ◽  
Statistical Significance ◽  
Testing Machine ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Pullout Strength ◽  
Rigid Foam ◽  
Pullout Tests

Abstract Rotator cuff (RC) tears cause pain and functional disability of the shoulder. Despite advances in suture anchors, there are still reports about the incidence of surgical-related injuries to RC mainly associated with sutures. The purpose of this study was to design and evaluate the mechanical behavior of sutureless implants to repair RC tears. We hypothesized that the implants present mechanical characteristics suitable for the surgical treatment of RC tears as suture anchors. Three different implants (T1,T2,T3) were designed and fabricated with titanium: T1 has two rods and rectangular head; T2 has two rods with a small opening and enlarged rectangular head and T3 has three rods and a circular head. The implants were fixed in rigid polyurethane foam blocks by a series of blows, and the applied mechanical loads along with the number of blows were quantified. Pullout tests using tapes fixed between the implant head and testing machine grip were conducted until implant failure. The maximum pullout strength and displacement of the implant relative to the rigid foam block were computed. Statistical significance was set at p < 0.05. Owing to its geometric configuration, implant T2 presented the best characteristics related to stability, strength, and ease of insertion. Implant T2 confirms our hypothesis that its mechanical behavior is compatible with that of suture anchors which could lead to the reduction of RC repair failures and simplify the arthroscopic procedure.

Pullout strength of suture anchors in comparison with transosseous sutures for rotator cuff repair

2008 ◽  
Vol 16 (5) ◽  
pp. 504-510 ◽  
Author(s):  
Matthias F. Pietschmann ◽  
Valerie Fröhlich ◽  
Andreas Ficklscherer ◽  
Jörg Hausdorf ◽  
Sandra Utzschneider ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchors ◽  
Pullout Strength ◽  
Cuff Repair

Relationship Between Deltoid and Rotator Cuff Muscles During Dynamic Shoulder Abduction: A Biomechanical Study of Rotator Cuff Tear Progression

2018 ◽  
Vol 46 (8) ◽  
pp. 1919-1926 ◽  
Author(s):  
Felix Dyrna ◽  
Neil S. Kumar ◽  
Elifho Obopilwe ◽  
Bastian Scheiderer ◽  
Brendan Comer ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Dynamic Testing ◽  
Correlation Coefficients ◽  
Biomechanical Study ◽  
Rotator Cuff Tears ◽  
Shoulder Abduction ◽  
Mean Values ◽  
Critical Shoulder Angle ◽  
Anterior Deltoid ◽  
Shoulder Angle

Background: Previous biomechanical studies regarding deltoid function during glenohumeral abduction have primarily used static testing protocols. Hypotheses: (1) Deltoid forces required for scapular plane abduction increase as simulated rotator cuff tears become larger, and (2) maximal abduction decreases despite increased deltoid forces. Study Design: Controlled laboratory study. Methods: Twelve fresh-frozen cadaveric shoulders with a mean age of 67 years (range, 64-74 years) were used. The supraspinatus and anterior, middle, and posterior deltoid tendons were attached to individual shoulder simulator actuators. Deltoid forces and maximum abduction were recorded for the following tear patterns: intact, isolated subscapularis (SSC), isolated supraspinatus (SSP), anterosuperior (SSP + SSC), posterosuperior (infraspinatus [ISP] + SSP), and massive (SSC + SSP + ISP). Optical triads tracked 3-dimensional motion during dynamic testing. Fluoroscopy and computed tomography were used to measure critical shoulder angle, acromial index, and superior humeral head migration with massive tears. Mean values for maximum glenohumeral abduction and deltoid forces were determined. Linear mixed-effects regression examined changes in motion and forces over time. Pearson product-moment correlation coefficients ( r) among deltoid forces, critical shoulder angles, and acromial indices were calculated. Results: Shoulders with an intact cuff required 193.8 N (95% CI, 125.5 to 262.1) total deltoid force to achieve 79.8° (95% CI, 66.4° to 93.2°) of maximum glenohumeral abduction. Compared with native shoulders, abduction decreased after simulated SSP (–27.2%; 95% CI, –43.3% to –11.1%, P = .04), anterosuperior (–51.5%; 95% CI, –70.2% to –32.8%, P < .01), and massive (–48.4%; 95% CI, –65.2% to –31.5%, P < .01) cuff tears. Increased total deltoid forces were required for simulated anterosuperior (+108.1%; 95% CI, 68.7% to 147.5%, P < .01) and massive (+57.2%; 95% CI, 19.6% to 94.7%, P = .05) cuff tears. Anterior deltoid forces were significantly greater in anterosuperior ( P < .01) and massive ( P = .03) tears. Middle deltoid forces were greater with anterosuperior tears ( P = .03). Posterior deltoid forces were greater with anterosuperior ( P = .02) and posterosuperior ( P = .04) tears. Anterior deltoid force was negatively correlated ( r = −0.89, P = .01) with critical shoulder angle (34.3°; 95% CI, 32.0° to 36.6°). Deltoid forces had no statistical correlation with acromial index (0.55; 95% CI, 0.48 to 0.61). Superior migration was 8.3 mm (95% CI, 5.5 to 11.1 mm) during testing of massive rotator cuff tears. Conclusion: Shoulders with rotator cuff tears require considerable compensatory deltoid function to prevent abduction motion loss. Anterosuperior tears resulted in the largest motion loss despite the greatest increase in deltoid force. Clinical Relevance: Rotator cuff tears place more strain on the deltoid to prevent abduction motion loss. Fatigue or injury to the deltoid may result in a precipitous decline in abduction, regardless of tear size.

Effect of biceps rerouting technique to restore glenohumeral joint stability for large irreparable rotator cuff tears: a cadaveric biomechanical study

2020 ◽  
Vol 29 (7) ◽  
pp. 1425-1434 ◽  
Author(s):  
Sang-Yup Han ◽  
Thay Q. Lee ◽  
David J. Wright ◽  
Il-Jung Park ◽  
Maniglio Mauro ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Glenohumeral Joint ◽  
Biomechanical Study ◽  
Rotator Cuff Tears ◽  
Joint Stability

scholarly journals Biomechanical testing of trans-humeral all-suture anchors for rotator cuff repair

2018 ◽  
Vol 11 (1_suppl) ◽  
pp. 77-85
Author(s):  
Mikel Aramberri-Gutiérrez ◽  
Amaia Martínez-Menduiña ◽  
Simon Boyle ◽  
Maria Valencia
Keyword(s):  
Rotator Cuff ◽  
Proximal Humerus ◽  
Biomechanical Testing ◽  
Tensile Load ◽  
Biomechanical Properties ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Load To Failure ◽  
Insertion Sites ◽  
Number Of Cycles

Background Rotator cuff tears are one of the most common causes of shoulder pain. All-suture anchors are increasingly being used in the arthroscopic repair of rotator cuff tears. The purpose of this experimental study is to evaluate the biomechanical properties of all-suture anchors at different insertion sites in the proximal humerus relevant to rotator cuff repairs and the remplissage procedure. Methods Sixteen cadaveric shoulders were used for the study. Four all-suture anchors were inserted in each proximal humerus at common anchor insertion sites on the rotator cuff footprint and a simulated Hill–Sachs defect. Cyclic loading and load-to-failure tests were undertaken. The number of cycles, load to failure and nature of failure were recorded. Results The all-suture anchors placed in the cuff footprint using a transosseous technique displayed superior biomechanical properties. Sutures sited in this way demonstrated a maximum tensile load to failure of 542 N as well as a highest mean load to failure and the maximum number of cycles before anchor failure. In descending order, all-suture anchors placed in the lateral footprint were significantly superior to those located in the medial row and in a simulated Hill–Sachs defect. Discussion Anchors placed in the rotator cuff footprint exceeded the physiological isometric abduction forces for the supraspinatus and infraspinatus. Data obtained from our study suggest that all-suture anchors are strong enough to be used for the repair of rotator cuff tears.

Cement augmentation of suture anchors in the proximal humerus during rotator cuff repair improves pullout strength: a systematic review

2021 ◽  
pp. jisakos-2020-000603
Author(s):  
Jeff S Kimball ◽  
Anirudh K Gowd ◽  
Brian R Waterman ◽  
Seth L Sherman ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Proximal Humerus ◽  
Cement Augmentation ◽  
Suture Anchors ◽  
Inclusion Criteria ◽  
Pullout Strength ◽  
Pullout Force ◽  
Cuff Repair

ImportanceRotator cuff pathology is a growing concern in the ageing population. If cement augmentation of suture anchors improves pullout strength, its application can potentially be applied in cases of poor bone quality to prevent anchor failure.ObjectiveTo evaluate the biomechanical benefits and fixation strength of cement-augmented versus non-augmented suture anchors in the proximal humerus during rotator cuff repair (RCR).Evidence reviewA systematic review of PubMed, Embase and Cochrane Library was performed to identify all published articles reporting on biomechanical analysis of suture anchors in the shoulder in a cadaveric model. Inclusion criteria required fresh-frozen specimens, placement in the footprint of the proximal humerus, and comparative assessment of fixation constructs with or without polymethylmethacrylate (PMMA) or bioabsorbable composite cement augmentation. Biomechanical testing procedure, cement augmentation method and pullout force were assessed.FindingsAfter review of 105 abstracts, seven full manuscripts met inclusion criteria. Six of seven studies reported statistically significant differences in mean pullout force between augmented (three PMMAs, three composites, one PMMA vs composite) and non-augmented anchors. Of two studies evaluating cycles to failure, both found a significant increase in the augmented versus non-augmented anchors. Of two studies stratifying by anchor position, both investigations identified significant differences in mean pullout strength between augmented and non-augmented anchors at the posteromedial and anterolateral anchor positions.Conclusions and relevanceCement augmentation of suture anchors in cadaveric humeri for RCR improves pullout strength regardless of cement type used or anchor position. Cement augmentation may provide a viable option for future clinical application.Level of evidenceIV, systematic review.

scholarly journals The Arthroscopic Intra-Articular Stabilization of the Shoulder for Irreparable Rotator Cuff Tear: A New Technique Proposal

2021 ◽  
Vol 8 ◽  
Author(s):  
Pierfrancesco Luciani ◽  
Luca Farinelli ◽  
Luca De Berardinis ◽  
Antonio Gigante
Keyword(s):  
Rotator Cuff ◽  
Humeral Head ◽  
Biceps Tendon ◽  
Reverse Shoulder Arthroplasty ◽  
Supraspinatus Tendon ◽  
Biomechanical Study ◽  
Rotator Cuff Tears ◽  
Rotator Cuff Injuries ◽  
Superior Capsular Reconstruction ◽  
Significant Difference

Background: Superior capsular reconstruction (SCR) has shown good results in the management of irreparable rotator cuff tears due to the depressive effect on the humeral head, but it is a technically demanding and expensive procedure.Purpose: We hypothesized that an intra-articular neoligament that prevents the superior translation of the humeral head could give similar results in terms of the superior translation of humerus (STH) and range of motion (ROM).Study Design: To compare our proposed technique and the SCR, we conducted a biomechanical study on 10 porcine shoulders in a custom shoulder testing system.Methods: STH and total rotational ROM were quantified in the following four scenarios: (1) when the rotator cuff was intact, (2) after cutting the supraspinatus tendon, (3) after the reconstruction of the superior capsule by long head of the biceps tendon (LHB), and (4) after an arthroscopic intra-articular stabilization by an intra-articular graft. Our proposed technique provides the creation of a humeral and glenoid tunnel, the passage of a graft through these tunnels under arthroscopic guidance, and the graft fixation in the two tunnels. We analyzed the STH and total ROM in each scenario.Results: With respect to the STH, we reported that the present proposed technique is characterized by a significant reduction of superior translation at 0 and 45° compared to scenario 2. In addition, the comparison between our proposed technique and SCR showed a significant difference of the STH at 0° of abduction. Total rotational ROMs of the two tenchinques were similar to scenario 2. Therefore, the use of an intra-articular ligament that prevents the STH can restore shoulder stability in irreparable rotator cuff injuries at both 0 and 45° of glenohumeral abduction without apparently limiting the total rotational ROM.Conclusion: Our proposed technique could be an important treatment option in irreparable rotator cuff tears, especially in patients under 65 years in whom reverse shoulder arthroplasty (RSA) has shown poor results and many complications.

Sign in / Sign up

Export Citation Format

Share Document