Pullout Strength of All-Suture Anchors: Effect of the Insertion and Traction Angle—A Biomechanical Study

2018 ◽  
Vol 34 (10) ◽  
pp. 2784-2795 ◽  
Author(s):  
Joo Han Oh ◽  
Hyeon Jang Jeong ◽  
Seok Hoon Yang ◽  
Sung Min Rhee ◽  
Yasuo Itami ◽  
...  
Keyword(s):  
Biomechanical Study ◽  
Suture Anchors ◽  
Pullout Strength

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

scholarly journals Interference Screw Versus Suture Anchors for Femoral Fixation in Medial Patellofemoral Ligament Reconstruction: A Biomechanical Study

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198928
Author(s):  
Heath P. Gould ◽  
Nicholas R. Delaney ◽  
Brent G. Parks ◽  
Roshan T. Melvani ◽  
Richard Y. Hinton
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Interference Screw ◽  
Biomechanical Study ◽  
Graft Fixation ◽  
Mpfl Reconstruction ◽  
Suture Anchors ◽  
Femoral Fixation ◽  
Significant Difference ◽  
Load To Failure ◽  
The Mean

Background: Femoral-sided graft fixation in medial patellofemoral ligament (MPFL) reconstruction is commonly performed using an interference screw (IS). However, the IS method is associated with several clinical disadvantages that may be ameliorated by the use of suture anchors (SAs) for femoral fixation. Purpose: To compare the load to failure and stiffness of SAs versus an IS for the femoral fixation of a semitendinosus autograft in MPFL reconstruction. Study Design: Controlled laboratory study. Methods: Based on a priori power analysis, a total of 6 matched pairs of cadaveric knees were included. Specimens in each pair were randomly assigned to receive either SA or IS fixation. After an appropriate reconstruction procedure, the looped end of the MPFL graft was pulled laterally at a rate of 6 mm/s until construct failure. The best-fit slope of the load-displacement curve was then used to calculate the stiffness (N/mm) in a post hoc fashion. A paired t test was used to compare the mean load to failure and the mean stiffness between groups. Results: No significant difference in load to failure was observed between the IS and the SA fixation groups (294.0 ± 61.1 vs 250.0 ± 55.9; P = .352), although the mean stiffness was significantly higher in IS specimens (34.5 ± 9.6 vs 14.7 ± 1.2; P = .004). All IS reconstructions failed by graft pullout from the femoral tunnel, whereas 5 of the 6 SA reconstructions failed by anchor pullout. Conclusion: In this biomechanical study using a cadaveric model of MPFL reconstruction, SA femoral fixation was not significantly different from IS fixation in terms of load to failure. The mean load-to-failure values for both reconstruction techniques were greater than the literature-reported values for the native MPFL. Clinical Relevance: These results suggest that SAs are a biomechanically viable alternative for femoral-sided graft fixation in MPFL reconstruction.

scholarly journals Mapping of the Inferior Glenohumeral Ligament for Suture Pullout Strength: A Biomechanical Analysis

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712096964
Author(s):  
Sumit Raniga ◽  
Joseph Cadman ◽  
Danè Dabirrahmani ◽  
David Bui ◽  
Richard Appleyard ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Biomechanical Study ◽  
Labral Repair ◽  
Pullout Strength ◽  
Recurrent Instability ◽  
Glenohumeral Ligament ◽  
Time Zero ◽  
Capsular Plication ◽  
Inferior Glenohumeral Ligament ◽  
The Impact

Background: Suture pullout during rehabilitation may result in loss of tension in the inferior glenohumeral ligament (IGHL) and contribute to recurrent instability after capsular plication, performed with or without labral repair. To date, the suture pullout strength in the IGHL is not well-documented. This may contribute to recurrent instability. Purpose/Hypothesis: A cadaveric biomechanical study was designed to investigate the suture pullout strength of sutures in the IGHL. We hypothesized that there would be no significant variability of suture pullout strength between specimens and zones. Additionally, we sought to determine the impact of early mobilization on sutures in the IGHL at time zero. We hypothesized that capsular plication sutures would fail under low load. Study Design: Descriptive laboratory study. Methods: Seven fresh-frozen cadaveric shoulders were dissected to isolate the IGHL complex, which was then divided into 18 zones. Sutures in these zones were attached to a linear actuator, and the resistance to suture pullout was recorded. A suture pullout strength map of the IGHL was constructed. These loads were used to calculate the load applied at the hand that would initiate suture pullout in the IGHL. Results: Mean suture pullout strength for all specimens was 61.6 ± 26.1 N. The maximum load found to cause suture pullout through tissue was found to be low, regardless of zone of the IGHL. Calculations suggest that an external rotation force applied to the hand of only 9.6 N may be sufficient to tear capsular sutures at time zero. Conclusion: This study did not provide clear evidence of desirable locations for fixation in the IGHL. However, given the low magnitude of failure loads, the results suggest the timetable for initiation of range-of-motion exercises should be reconsidered to prevent suture pullout through the IGHL. Clinical Relevance: From this biomechanical study, the magnitude of force required to cause suture pullout through the IGHL is met or surpassed by normal postoperative early range-of-motion protocols.

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.

The Influence of Trabecular Microstructure on Mechanical Properties and the Pullout Strength of Suture Anchors

2010 ◽  
Author(s):  
Mariya Poukalova ◽  
Christopher M. Yakacki ◽  
Robert E. Guldberg ◽  
Angela Lin ◽  
Ken Gall
Keyword(s):  
Mechanical Properties ◽  
Bone Mineral Density ◽  
Suture Anchor ◽  
Common Type ◽  
Tissue Fixation ◽  
Suture Anchors ◽  
Pullout Strength ◽  
Mineral Density ◽  
Trabecular Microstructure ◽  
Type Of Surgery

Suture anchors provide soft-tissue fixation, often tendons and ligaments, to bone. The most common type of surgery in which suture anchors are used is in rotator cuff repairs, where the anchor is implanted into the humerus to create a point of fixation for the supraspinatus.[1–2] Pullout strength, or the force necessary to pull the anchor from the bone, has been previously used as a metric to compare suture anchor performance. In investigating suture anchor performance, it has been suggested that pullout strength is positively correlated to bone mineral density (BMD).[2]

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

Larger screw diameter may not guarantee greater pullout strength for headless screws – a biomechanical study

2017 ◽  
Vol 62 (3) ◽  
Author(s):  
Chen-Chiang Lin ◽  
Kun-Jhih Lin ◽  
Wen-Chuan Chen ◽  
Hung-Wen Wei ◽  
Kang-Ping Lin ◽  
...  
Keyword(s):  
Biomechanical Study ◽  
Unexpected Finding ◽  
Pullout Strength ◽  
Pullout Force ◽  
Holding Power ◽  
Headless Compression Screws ◽  
Screw Diameter ◽  
Transverse Fractures ◽  
Small Bone ◽  
Critical Consideration

AbstractHeadless compression screws (HCSs) are commonly utilized devices for small bone fracture fixation. The Mini-Acutrak 2 and headless reduction (HLR) screws are the newer version types, in which both have fully threaded and variable pitch design. Specifically, the HLR is characterized by two thread runouts to facilitate implantation. With the thread runouts, the holding strength of the screw may be compromised. To the best of our knowledge, no study has examined the pullout force of the global sizes of a HCS. We sought to determine the pullout strength of the HLR and compare the strength of this screw with that of the Mini-Acutrak 2. Synthetic bone blocks with simulated transverse fractures were used to conduct the tests. Four commonly used sizes of the HLR were examined, and one Mini-Acutrak 2 was employed for comparison. Five screws of each size were tested. The pullout force of all screws that were tested in this study ranged from 45.23 to 233.22 N. The results revealed that the pullout force increased as the screw diameter increased. Interestingly, we found that one small screw outperformed the Mini-Acutrak 2, which has a larger diameter. This study provided extensive knowledge regarding the pullout strength of fully threaded HCSs of different sizes. An unexpected finding is that a small screw has higher holding power than a large one because of its increased number of threads. Therefore, we suggest that the thread number should be a critical consideration for the design of size distribution of HCSs.

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