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Reprint of: The Deadman Theory of Suture Anchors: Observations Along a South Texas Fence Line

  • Stephen S. Burkhart
    Correspondence
    Address correspondence to Stephen S. Burkhart, M.D., The San Antonio Orthopaedic Group, 150 E. Sonterra Blvd, Suite 300, San Antonio, TX 78258, U.S.A.
    Affiliations
    Department of Orthopaedic Surgery, the University of Texas Health Science Center at San Antonio, Texas, U.S.A.
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      Abstract

      Suture anchors are being 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.
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      References

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      2. Bachner EJ, Snyder SJ. Arthroscopic fixation of the torn rotator cuff tendon using suture anchors and permanent mattress sutures: A preliminary report. Presented at the Arthroscopy Association of North America, 1994 Speciality Day Meeting, New Orleans, LA, February 27, 1994.

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      5. Burkhart SS. The deadman theory of suture anchors. Presented at Update 1994: New Perspectives in Arthroscopy and Sports Medicine, Palm Springs, CA, March 16-19, 1994.