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Slight Reduction in the Insertion Depth for an All-Suture Anchor Decreases Cyclic Displacement in the Shoulder Glenoid

Published:February 15, 2018DOI:https://doi.org/10.1016/j.arthro.2017.11.014

      Purpose

      To determine if the depth of anchor insertion affects the biomechanical performance of a 1.5-mm all-suture anchor in glenoid bone.

      Methods

      A 1.5-mm all-suture anchor was tested in 8 matched pairs of human cadaver fresh-frozen glenoids. Anchors were inserted at 6 different locations and tested at 3 different depths: 21 mm (preset drilling depth), 17 mm, and 13 mm. Cyclic loading and destructive testing was performed. Displacement after 100 and 200 cycles, along with ultimate failure strength, was determined.

      Results

      After 100 and 200 cycles, anchors placed at 13 and 17 mm had undergone significantly less displacement than those at 21 mm (P < .05). No difference was observed in ultimate load to failure between anchors placed at 21 and 17 mm. However, the ultimate load to failure was significantly lower in anchors placed at 13 mm (P < .05). There were 5 clinical failures in anchors placed at 21 mm, one at 17 mm, and none at 13 mm.

      Conclusions

      The 1.5-mm all-suture anchor tested in this study has an optimal insertion depth of 17 mm, 4 mm shallower than the preset drill depth. At the optimal insertion depth of 17 mm, it underwent significantly less displacement after cyclic loading without a reduction in the ultimate load to failure.

      Clinical Relevance

      Given the results of this study, the optimal insertion depth for this 1.5-mm all-suture anchor is 17 mm, 4 mm shallower than the preset drill depth.
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      References

        • Zumstein M.
        • Jacob H.A.
        • Schneeberger A.G.
        In vitro comparison of standard and Knotless metal suture anchors.
        Arthroscopy. 2004; 20: 517-520
        • Archetti Netto N.
        • Tamaoki M.J.
        • Lenza M.
        • et al.
        Treatment of Bankart lesions in traumatic anterior instability of the shoulder: A randomized controlled trial comparing arthroscopy and open techniques.
        Arthroscopy. 2012; 28: 900-908
        • Thal R.
        Arthroscopic Bankart repair using knotless suture anchors.
        Arthroscopy. 2007; 23 (author reply 567-568): 566-567
        • Nho S.J.
        • Provencher M.T.
        • Seroyer S.T.
        • Romeo A.A.
        Bioabsorbable anchors in glenohumeral shoulder surgery.
        Arthroscopy. 2009; 25: 788-793
        • Barber F.A.
        • Coons D.A.
        • Ruiz-Suarez M.
        Cyclic load testing and ultimate failure strength of biodegradable glenoid anchors.
        Arthroscopy. 2008; 24: 224-228
        • Thal R.
        A knotless suture anchor: Technique for use in arthroscopic Bankart repair.
        Arthroscopy. 2001; 17: 213-218
        • Thal R.
        Knotless suture anchor: arthroscopic Bankart repair without tying knots.
        Clin Orthop Relat Res. 2001; : 42-51
        • Mueller M.B.
        • Fredrich H.H.
        • Steinhauser E.
        • Schreiber U.
        • Arians A.
        • Imhoff A.B.
        Biomechanical evaluation of different suture anchors for the stabilization of anterior labrum lesions.
        Arthroscopy. 2005; 21: 611-619
        • Mazzocca A.D.
        • Chowaniec D.
        • Cote M.P.
        • et al.
        Biomechanical evaluation of classic solid and novel all-soft suture anchors for glenoid labral repair.
        Arthroscopy. 2012; 28: 642-648
        • Agrawal V.
        • Pietrzak W.S.
        Triple labrum tears repaired with the JuggerKnot soft anchor: Technique and results.
        Int J Shoulder Surg. 2015; 9: 81-89
        • Barber F.A.
        • Herbert M.A.
        Cyclic loading biomechanical analysis of the pullout strengths of rotator cuff and glenoid anchors: 2013 update.
        Arthroscopy. 2013; 29: 832-844
        • Galland A.
        • Airaudi S.
        • Gravier R.
        • Le Cann S.
        • Chabrand P.
        • Argenson J.N.
        Pullout strength of all suture anchors in the repair of rotator cuff tears: A biomechanical study.
        Int Orthop. 2013; 37: 2017-2023
        • Roth C.A.
        • Bartolozzi A.R.
        • Ciccotti M.G.
        • et al.
        Failure properties of suture anchors in the glenoid and the effects of cortical thickness.
        Arthroscopy. 1998; 14: 186-191
        • Barber F.A.
        • Coons D.A.
        • Ruiz-Suarez M.
        Cyclic load testing of biodegradable suture anchors containing 2 high-strength sutures.
        Arthroscopy. 2007; 23: 355-360
        • Burkhart S.S.
        • Johnson T.C.
        • Wirth M.A.
        • Athanasiou K.A.
        Cyclic loading of transosseous rotator cuff repairs: Tension overload as a possible cause of failure.
        Arthroscopy. 1997; 13: 172-176
        • Burkhart S.S.
        • Diaz Pagan J.L.
        • Wirth M.A.
        • Athanasiou K.A.
        Cyclic loading of anchor-based rotator cuff repairs: Confirmation of the tension overload phenomenon and comparison of suture anchor fixation with transosseous fixation.
        Arthroscopy. 1997; 13: 720-724
        • Burkhart S.S.
        • Wirth M.A.
        • Simonich M.
        • Salem D.
        • Lanctot D.
        • Athanasiou K.
        Knot security in simple sliding knots and its relationship to rotator cuff repair: How secure must the knot be?.
        Arthroscopy. 2000; 16: 202-207
        • Dwyer T.
        • Willett T.L.
        • Dold A.P.
        • et al.
        Maximum load to failure and tensile displacement of an all-suture glenoid anchor compared with a screw-in glenoid anchor.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24: 357-364
        • Pfeiffer F.M.
        • Smith M.J.
        • Cook J.L.
        • Kuroki K.
        The histologic and biomechanical response of two commercially available small glenoid anchors for use in labral repairs.
        J Shoulder Elbow Surg. 2014; 23: 1156-1161
        • Chiang F.L.
        • Hong C.K.
        • Chang C.H.
        • Lin C.L.
        • Jou I.M.
        • Su W.R.
        Biomechanical comparison of all-suture anchor fixation and interference screw technique for subpectoral biceps tenodesis.
        Arthroscopy. 2016; 32: 1247-1252
        • Barber F.A.
        • Herbert M.A.
        • Hapa O.
        • et al.
        Biomechanical analysis of pullout strengths of rotator cuff and glenoid anchors: 2011 update.
        Arthroscopy. 2011; 27: 895-905
        • Nho S.J.
        • Frank R.M.
        • Van Thiel G.S.
        • et al.
        A biomechanical analysis of shoulder stabilization: Posteroinferior glenohumeral capsular plication.
        Am J Sports Med. 2010; 38: 1413-1419
        • Baldini T.
        • Snyder R.L.
        • Peacher G.
        • Bach J.
        • McCarty E.
        Strength of single- versus double-anchor repair of type II SLAP lesions: A cadaveric study.
        Arthroscopy. 2009; 25: 1257-1260
        • Provencher M.T.
        • Verma N.
        • Obopilwe E.
        • et al.
        A biomechanical analysis of capsular plication versus anchor repair of the shoulder: Can the labrum be used as a suture anchor?.
        Arthroscopy. 2008; 24: 210-216
        • Harris J.D.
        • Brand J.C.
        • Cote M.P.
        • Faucett S.C.
        • Dhawan A.
        Research pearls: The significance of statistics and perils of pooling. Part 1: Clinical versus statistical significance.
        Arthroscopy. 2017; 33: 1102-1112

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