Advertisement

The deadman theory of suture anchors: observations along a South Texas fence line

  • Stephen S. Burkhart
    Correspondence
    Address correspondence and reprint requests to Stephen S. Burkhart, M.D., Department of Orthopaedic Surgery, the University of Texs Health Science Center at San Antonio, 540 Madison Oak Dr, Suite 620, San Antonio, TX 78258-3931, U.S.A.
    Affiliations
    Department of Orthopaedic Surgery, the University of Texas Health Science Center at San Antonio, Texas, U.S.A.
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Suture anchors are bing increasingly reported as a means of fixation of torn rotator cuff tendons to bone. The author has developed a mechanical model for the suture anchor-rotator cuff construct based on an analogy to the deadman system used to stabilize a corner fence post. Using this model, one can demonstrate a mechanically favorable angle of insertion of the suture anchor (θ1) such that the anchor's pullout strength is increased at low angles of θ1. In addition, the angle that the suture makes with the direction of pull of the rotator cuff (θ2) has a direct effect on tension in the suture. A low angle of θ2 minimizes the total tension in the suture, thereby minimizing the chance of suture breakage.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bartlett EC
        Arthroscopic rotator cuff repair.
        in: Presented at the Arthroscopy Association of North America, Fall Course, Albuquerque, NMOctober 7, 1993
        • Bachner EJ
        • Snyder SJ
        Arthroscopic fixation of the torn rotator cuff tendon using suture anchors and permanent mattress sutures: A preliminary report.
        in: Presented at the Arthroscopy Association of North America, 1994 Speciality Day Meeting, New Orleans, LAFebruary 27, 1994
        • Tippett JW
        Arthroscopic repair of the rotator cuff using plastic suture anchors.
        in: Presented at the Arthroscopy Association of North America, 1994 Specialty Day Meeting, New Orleans, LAFebruary 27, 1994
      1. Faris ME. Personal communication, January 1993.

        • Burkhart SS
        The deadman theory of suture anchors.
        in: Presented at Update 1994: New Perspectives in Arthroscopy and Sports Medicine, Palm Springs, CAMarch 16–19, 1994