All-Suture Anchors in Orthopaedic Surgery: Design, Rationale, Biomechanical Data, and Clinical Outcomes

2021 ◽  
Vol 29 (19) ◽  
pp. e950-e960
Author(s):  
David P. Trofa ◽  
Elise C. Bixby ◽  
James E. Fleischli ◽  
Bryan M. Saltzman
Keyword(s):  
Clinical Outcomes ◽  
Orthopaedic Surgery ◽  
Design Rationale ◽  
Suture Anchors

scholarly journals Arthroscopic Fixation of Avulsion Fractures of the Lesser Tuberosity of the Humerus: Clinical Outcomes With a Mean 3.5-Year Follow-up

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110298
Author(s):  
Lin Lin ◽  
Jian Xiao ◽  
Guoqing Cui ◽  
Hui Yan
Keyword(s):  
Los Angeles ◽  
Clinical Outcomes ◽  
Full Range ◽  
Case Series ◽  
Arthroscopic Repair ◽  
Suture Anchors ◽  
Avulsion Fractures ◽  
Lesser Tuberosity ◽  
Arthroscopic Fixation

Background: Avulsion fracture of the lesser tuberosity (AFLT) of the humerus has traditionally been treated with open reduction internal fixation using screw fixation. The clinical outcomes of arthroscopic repair with suture anchors remains unknown. Hypothesis: It was hypothesized that arthroscopic fixation with suture anchors would result in good clinical outcomes for the treatment of AFLT. Study Design: Case series; Level of evidence, 4. Methods: This study included 15 patients who underwent arthroscopic repair of AFLT of the humerus between January 2014 and October 2017. All patients had 3-dimensional computed tomography scans and magnetic resonance imaging to evaluate the avulsed fracture and concomitant injuries before surgery. The arthroscopic double-row and suture-bridge techniques were used based on the morphology of the avulsion fractures. Functional outcomes were assessed with range of motion, the visual analog scale (VAS) for pain, the Subjective Shoulder Value (SSV), the American Shoulder and Elbow Surgeons (ASES) score, and the University of California, Los Angeles (UCLA) shoulder score. The bear-hug test, liftoff test, and internal rotation resistance test at 90° abduction and external rotation (IRRT 90°) were used to evaluate subscapularis tendon integrity. Results: The mean follow-up time was 3.5 years (range, 3-5 years). Comminuted fractures with 1 large part and ≥1 small pieces were seen in 12 cases, partial tear of the supraspinatus in 2 cases, Bankart lesion in 2 cases, and superior labrum anterior to posterior injury in 2 cases. There was a statistically significant improvement from the baseline to the final follow-up in the VAS (from 6.9 ± 1.5 to 1.1 ± 1), SSV (from 30.7 ± 5.1 to 90.5 ± 11.6), ASES (from 28.5 ± 7.7 to 92.3 ± 4.5), and UCLA (from 29.5 ± 6.3 to 94.2 ± 8.3) scores ( P < .001 for all). All patients showed full range of shoulder motion and bilateral symmetric strength on physical examination with the bear-hug test, liftoff test, and IRRT 90° test. Conclusion: The arthroscopic repair of AFLT resulted in excellent reduction and healing of the displaced fragment. At the final follow-up, clinical and functional results were good. Associated injuries occurred in 40% of patients but did not affect outcomes.

Comparison of Outcome of Deltoid Ligament Repair According to Location of Suture Anchors in Rotational Ankle Fracture

2020 ◽  
pp. 107110072095205
Author(s):  
Young Hwan Park ◽  
Kyu Sun Jang ◽  
Eui Dong Yeo ◽  
Gi Won Choi ◽  
Hak Jun Kim
Keyword(s):  
Clinical Outcomes ◽  
Ankle Fracture ◽  
Deltoid Ligament ◽  
Medial Malleolus ◽  
Suture Anchors ◽  
Ligament Repair ◽  
Level Of Evidence ◽  
Clear Space ◽  
Retrospective Comparative Study

Background: The suture anchors for the repair of deltoid ligament in rotational ankle fracture are inserted mostly into the medial malleolus, but sometimes are placed into the talus depending on the rupture site. This study sought to compare the radiological and clinical outcomes of deltoid ligament repair according to using these 2 locations for suture anchor placement. Methods: The cases of 131 patients (114 patients with suture anchors on the medial malleolus and 17 patients with suture anchors on the talus) who underwent deltoid ligament repair along with ankle fracture fixation were retrospectively reviewed. Medial clear space oblique (MCSo), medial clear space perpendicular (MCSp), tibiofibular clear space (TFCS), and tibiofibular overlap (TFO) were measured as radiological outcomes, while the Olerud-Molander Ankle Score (OMAS) and visual analog scale (VAS) score for pain were calculated as clinical outcomes. The follow-up period did not differ between the 2 groups (16.8 ± 10.9 months in the medial malleolus group vs 17.9 ± 14.3 months in the talus group; P = .670). Results: There were no differences in MCSo, MCSp, TFCS, and TFO at 3 months after surgery and final follow-up. The OMAS and VAS for pain did not show intergroup differences at final follow-up. Conclusion: The surgical outcome of deltoid ligament repair in rotational ankle fracture did not differ whether the suture anchors were inserted into the medial malleolus or into the talus. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Comparison of the efficacy of a distal clavicular locking plate with and without a suture anchor in the treatment of Neer IIb distal clavicle fractures

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Hua Xu ◽  
Wen Jun Chen ◽  
Xiao Cheng Zhi ◽  
Shi Chang Chen
Keyword(s):  
Clinical Outcomes ◽  
Locking Plate ◽  
Suture Anchor ◽  
Early Stage ◽  
Locking Plates ◽  
Suture Anchors ◽  
Distal Clavicle ◽  
Application Procedure ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures

Abstract Background To compare the clinical outcomes between the use of a distal clavicular locking plate alone and the combined use of a plate and a coracoclavicular suture anchor in the treatment of Neer IIb distal clavicle fractures and to discuss the application procedure of suture anchors. Methods This is a retrospective study. Thirty-four patients with unilateral Neer IIb distal clavicle fractures who underwent open reduction and internal fixation with a distal clavicular locking plate only (16 patients) or with both a plate and a coracoclavicular suture anchor (18 patients) were evaluated. The main observation data included the Constant-Murley Shoulder Function Score (CMS), rate of postoperative complications, and union time. Results The distal clavicular locking plate and coracoclavicular suture anchor combination group had better outcomes in the Constant-Murley score (94.6 ± 4.5 vs. 90.1 ± 9.5) (P < 0.05) and a shorter union time (13.9 ± 2.3 vs. 16.1 ± 3.0) (P < 0.05) than the locking plate only group did, and the rate of complications showed no significant difference, 16.7% vs. 31.2% (5/16) (P>0.05). Conclusions Both methods achieved good results in the treatment of Neer IIb distal clavicle fractures; however, the use of both locking plates and coracoclavicular suture anchors can provide more stability in the early stage after operation than can the use of locking plates alone, which can make the sped of union quicker and result in better clinical outcomes. For elderly patients with comminuted Neer IIb distal clavicle fractures, a locking plate combined with a suture anchor is recommended to provide more stability in the early stage after the operation.

Suture Anchors and Tacks for Shoulder Surgery, Part 1

2005 ◽  
Vol 33 (12) ◽  
pp. 1918-1923 ◽  
Author(s):  
Edward G. McFarland ◽  
Hyung Bin Park ◽  
Ekavit Keyurapan ◽  
Harpreet S. Gill ◽  
Harpal S. Selhi
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Clinical Application ◽  
Shoulder Instability ◽  
Soft Tissues ◽  
Biceps Tendon ◽  
Surgical Techniques ◽  
Shoulder Surgery ◽  
Rotator Cuff Tears ◽  
Suture Anchors

The development and successful clinical application of suture anchors and tacks have revolutionized the surgeon's ability to secure soft tissues to bone via open or arthroscopic surgical techniques. When used carefully and with proper technique, these devices provide viable options for the repair and reconstruction of many intra-articular and extra-articular abnormalities in the shoulder, including rotator cuff tears, shoulder instability, and biceps lesions that require labrum repair or biceps tendon tenodesis. Like many technologies, however, the successful application of these devices requires an understanding of the biology and biomechanics that affect their use in the shoulder as well as knowledge of the factors that can affect subsequent clinical outcomes, including complications.

The history of suture anchors in orthopaedic surgery

2019 ◽  
Vol 61 ◽  
pp. 70-78 ◽  
Author(s):  
Luke E. Visscher ◽  
Chris Jeffery ◽  
Timothy Gilmour ◽  
Libby Anderson ◽  
Gregory Couzens
Keyword(s):  
Orthopaedic Surgery ◽  
Suture Anchors ◽  
History Of

scholarly journals Minimum 10-Year Clinical Outcomes After Arthroscopic 270° Labral Repair in Traumatic Shoulder Instability Involving Anterior, Inferior, and Posterior Labral Injury

2021 ◽  
pp. 036354652110536
Author(s):  
Daniel P. Berthold ◽  
Matthew R. LeVasseur ◽  
Lukas N. Muench ◽  
Michael R. Mancini ◽  
Colin L. Uyeki ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Revision Surgery ◽  
Shoulder Instability ◽  
Suture Anchors ◽  
Analog Scale ◽  
Simple Shoulder Test ◽  
Labral Tears ◽  
Labral Injury

Background: Current literature reports highly satisfactory short- and midterm clinical outcomes in patients with arthroscopic 270° labral tear repairs. However, data remain limited on long-term clinical outcomes and complication and redislocation rates in patients with traumatic shoulder instability involving anterior, inferior, and posterior labral injury. Purpose: To investigate, at a minimum follow-up of 10 years, the clinical outcomes, complications, and recurrent instability in patients with 270° labral tears involving the anterior, inferior, and posterior labrum treated with arthroscopic stabilization using suture anchors. Study Design: Case series; Level of evidence, 4. Methods: A retrospective outcomes study was completed for all patients with a minimum 10-year follow-up who underwent arthroscopic 270° labral tear repairs with suture anchors by a single surgeon. Outcome measures included pre- and postoperative Rowe score, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test, visual analog scale for pain, and Single Assessment Numeric Evaluation (SANE). Western Ontario Shoulder Instability Index (WOSI) scores were collected postoperatively. Complication data were collected, including continued instability, subluxation or dislocation events, and revision surgery. Failure was defined as any cause of revision surgery. Results: In total, 21 patients (mean ± SD age, 27.1 ± 9.6 years) with 270° labral repairs were contacted at a minimum 10-year follow-up. All outcome measures showed statistically significant improvements as compared with those preoperatively: Rowe (53.9 ± 11.4 to 88.7 ± 8.9; P = .005), ASES (72.9 ± 18.4 to 91.8 ± 10.8; P = .004), Simple Shoulder Test (8.7 ± 2.4 to 11.2 ± 1.0; P = .013), visual analog scale (2.5 ± 2.6 to 0.5 ± 1.1; P = .037), and SANE (24.0 ± 15.2 to 91.5 ± 8.3; P = .043). The mean postoperative WOSI score at minimum follow-up was 256.3 ± 220.6. Three patients had postoperative complications, including a traumatic subluxation, continued instability, and a traumatic dislocation, 2 of which required revision surgery (14.2% failure rate). Conclusion: Arthroscopic repairs of 270° labral tears involving the anterior, inferior, and posterior labrum have highly satisfactory clinical outcomes at 10 years, with complication and redislocation rates similar to those reported at 2 years. This suggests that repairs of extensile labral tears are effective in restoring and maintaining mechanical stability of the glenohumeral joint in the long term.

scholarly journals Clinical Outcomes of Arthroscopic Rotator Cuff Repair Using Poly Lactic-co-glycolic Acid Plus β-tricalcium Phosphate Biocomposite Suture Anchors

2018 ◽  
Vol 21 (1) ◽  
pp. 22-29 ◽  
Author(s):  
Seok Won Chung ◽  
Kyung Soo Oh ◽  
Sung Jin Kang ◽  
Jong Pil Yoon ◽  
Joon Yub Kim
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Failure Rate ◽  
Tricalcium Phosphate ◽  
Rotator Cuff Repair ◽  
Glycolic Acid ◽  
Cyst Formation ◽  
Suture Anchors ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

BACKGROUND: This study is performed to evaluate anchor-related outcomes and complications after arthroscopic rotator cuff repair using 30% β-tricalcium phosphate (β-TCP) with 70% poly lactic-co-glycolic acid (PLGA) biocomposite suture anchors.METHODS: A total of 78 patients (mean age, 61.3 ± 6.9 years) who underwent arthroscopic medium-to-large full-thickness rotator cuff tear repair were enrolled. The technique employed 30% β-TCP with 70% PLGA biocomposite suture anchors at the medial row (38 patients, Healix BRTM anchor [Healix group]; 40 patients, Fixone anchor B [Fixone group]). The radiologic outcomes (including perianchor cyst formation or bone substitution) and anatomical outcomes of the healing failure rate were evaluated using magnetic resonance imaging at least 6 months after surgery, the pain visual analogue scale at 3, 6 months, and final follow-up visit, and American Shoulder and Elbow Surgeons scores at least 1 year postoperatively. Anchor-related complications were also evaluated.RESULTS: The perianchor cyst formation incidence was similar for both groups (60.5%, Healix group; 60.0%, Fixone group; p=0.967), although severe perianchor cyst incidence was slightly lower in the Fixone group (15.0%) than in the Healix group (21.1%). There was no occurrence of anchor absorption and bone substitution. No differences were observed in the healing failure rate (13.2%, Healix group; 15.0%, Fixone group; p=0.815) and functional outcome between groups (all p>0.05). Anchor breakage occurred in 5 patients (2 Healix anchors and 3 Fixone anchors); however, there were no major anchor-related complications in either group.CONCLUSIONS: No differences were observed in the clinical outcomes of the Healix and Fixone groups, neither were there any accompanying major anchor-related complications.

scholarly journals ‘Mini-Max’ knotless acetabular labrum repair: repair construct rationale and allocation in a consecutive case series with minimum 1-year clinical outcomes

2021 ◽  
Author(s):  
John J Christoforetti ◽  
Gabriella Bucci ◽  
Beth Nickel ◽  
Steven B Singleton ◽  
Ryan P McGovern
Keyword(s):  
Clinical Outcomes ◽  
Descriptive Analysis ◽  
Case Series ◽  
Labral Repair ◽  
Suture Anchors ◽  
Acetabular Labrum ◽  
Retrospective Case ◽  
Labral Tears ◽  
Patient Reported

ABSTRACT To describe the ‘mini-Max’ approach to labrum repair using non-absorbable 2.4-mm knotless suture anchors and report objective clinical outcomes with a large single-surgeon cohort. Level 3 retrospective case series. A retrospective review was conducted to report the use and allocation of non-absorbable 2.4-mm knotless suture anchors during ‘mini-Max’ labral repair from 2015 to 2018. Descriptive analysis of the labral damage severity, size and number of anchors used to arthroscopically repair the acetabular labrum was performed. Paired-samples t-tests were performed to evaluate whether preoperative and 1-year follow-up patient-reported outcomes (PROs) were statistically significant. An analysis of variance was performed comparing PROs with categorized number of labral anchors. A total of 390 patients were queried in this study, with 330 (85%) diagnosed intraoperatively with acetabular labral tears. A total of 245 patients (137 females and 108 males) with a mean age of 30.1 ± 11.6 years (mean ± SD) at the time of surgery underwent ‘mini-Max’ labral refixation. Of the 245 labral tears, 88 (35.9%) were graded as mild, 113 (46.1%) as moderate and 44 (18.0%) as severe. Labral repairs required an average of 2.1 ± 0.67 anchors across all patients included. Forty-one repairs (16.7%) required one anchor, 139 (56.7%) required two anchors, 63 (25.7%) required three anchors and 2 (0.8%) required four anchors. Significant improvements were reported for all PROs (P ≤ .001) at a minimum of 1-year follow-up. Arthroscopic ‘mini-Max’ labral repair using non-absorbable knotless suture anchors is a safe and effective technique for improving the lives of patients suffering from symptomatic acetabular labrum tears.

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