Purpose
To evaluate the cyclic displacement and ultimate load to failure of 4 all-suture anchors
in human cadaveric shoulder glenoid bone.
Methods
Four all-suture anchors indicated for glenoid labral repair were tested in 14 matched
pairs of human cadaveric fresh-frozen glenoids. Anchors were inserted at 4 different
locations for a total of 112 tests (12-, 3-, 6-, and 9-o’clock positions for right
glenoids). Cyclic loading (10 to 60 N at 1 Hz for 200 cycles) and single pull-to-failure
testing (33 mm/s) were performed. A Kruskal-Wallis 1-way analysis of variance with
the Dunn multiple-comparison post hoc test was used for statistical analysis.
Results
One matched pair was excluded because of poor bone quality. Thus, 13 matched pairs
were included in the study, and a total of 104 tests were performed. The Q-Fix anchors
showed significantly less displacement after 100 cycles (mean ± standard deviation,
1.40 ± 0.97 mm; P < .001) and 200 cycles (1.53 ± 1.00 mm, P < .001) than all other anchors tested. The Q-Fix (191.3 ± 65.8 N), Suturefix (188.3
± 61.4 N), and JuggerKnot (183.6 ± 63.5 N) anchors had significantly greater ultimate
loads to failure than the Iconix anchors (143.5 ± 54.1 N) (P = .01, P = .012, and P = .021, respectively). Displacement greater than 5 mm occurred in 6 Iconix anchors
(22.1%), 5 Suturefix anchors (19.2%), 4 JuggerKnot anchors (15.4%), and 0 Q-Fix anchors
(0%).
Conclusions
The Q-Fix anchors showed less displacement with cyclic loading than the Iconix, JuggerKnot,
and Suturefix anchors. The Iconix anchors had a lower ultimate load to failure than
the Q-Fix, Suturefix, and JuggerKnot anchors. Only the Q-Fix group had no anchors
displace greater than 5 mm with cyclic loading.
Clinical Relevance
All-suture anchors vary in their deployment mechanism, which may alter their strength
and performance. Operators must be aware of these anchors' propensity to displace
while deploying them.
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 accessOne-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 ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Bioabsorbable anchors in glenohumeral shoulder surgery.Arthroscopy. 2009; 25: 788-793
- Cyclic load testing and ultimate failure strength of biodegradable glenoid anchors.Arthroscopy. 2008; 24: 224-228
- A knotless suture anchor: Technique for use in arthroscopic Bankart repair.Arthroscopy. 2001; 17: 213-218
- Knotless suture anchor: Arthroscopic Bankart repair without tying knots.Clin Orthop Relat Res. 2001; : 42-51
- Arthroscopic Bankart repair using knotless suture anchors.Arthroscopy. 2007; 23 (author reply 567-568): 566-567
- Biomechanical evaluation of different suture anchors for the stabilization of anterior labrum lesions.Arthroscopy. 2005; 21: 611-619
- Triple labrum tears repaired with the JuggerKnot soft anchor: Technique and results.Int J Shoulder Surg. 2015; 9: 81-89
- Biomechanical evaluation of classic solid and novel all-soft suture anchors for glenoid labral repair.Arthroscopy. 2012; 28: 642-648
- Cyclic loading biomechanical analysis of the pullout strengths of rotator cuff and glenoid anchors: 2013 update.Arthroscopy. 2013; 29: 832-844
- Pullout strength of all suture anchors in the repair of rotator cuff tears: A biomechanical study.Int Orthop. 2013; 37: 2017-2023
- In vitro comparison of standard and Knotless metal suture anchors.Arthroscopy. 2004; 20: 517-520
- Cyclic load testing of biodegradable suture anchors containing 2 high-strength sutures.Arthroscopy. 2007; 23: 355-360
- Cyclic loading of transosseous rotator cuff repairs: Tension overload as a possible cause of failure.Arthroscopy. 1997; 13: 172-176
- 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
- Knot security in simple sliding knots and its relationship to rotator cuff repair: How secure must the knot be?.Arthroscopy. 2000; 16: 202-207
- 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
- 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
- Biomechanical comparison of all-suture anchor fixation and interference screw technique for subpectoral biceps tenodesis.Arthroscopy. 2016; 32: 1247-1252
- Biomechanical analysis of pullout strengths of rotator cuff and glenoid anchors: 2011 update.Arthroscopy. 2011; 27: 895-905
- All-suture anchors: Biomechanical analysis of pullout strength, displacement, and failure mode.Arthroscopy. 2017; 33: 1113-1121
- What humeri are suitable for comparative testing of suture anchors? An ultrastructural bone analysis and biomechanical study of ovine, bovine and human humeri and four different anchor types.J Biomech. 2010; 43: 1125-1130
- Cyclic and load to failure properties of all-suture anchors in synthetic acetabular and glenoid cancellous bone.Arthroscopy. 2017; 33: 977-985.e5
- Q-FIX all-suture implants.(Accessed December 17, 2017)
- 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
- Strength of single- versus double-anchor repair of type II SLAP lesions: A cadaveric study.Arthroscopy. 2009; 25: 1257-1260
Article info
Publication history
Published online: April 09, 2019
Accepted:
January 14,
2019
Received:
March 28,
2018
Footnotes
See commentary on page 1960
The authors report the following potential conflicts of interest or sources of funding: J.E.F. is a paid consultant for and receives research support from Smith and Nephew and receives research support from Arthrex. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: All-Suture Shoulder Glenoid Anchors: Can We Adequately Tension Them or Knot?ArthroscopyVol. 35Issue 7
- PreviewAll-suture anchors require smaller drill holes (often under 2.0 mm) than comparable solid glenoid anchors (e.g., Gryphon: 2.5-mm drill). A smaller drill allows closer anchor approximation, but there is no indication that this improves repair biomechanics. In fact closely associated multiple fixation points are associated with glenoid fractures, and the same multiple fixation points can be achieved with double- or triple-loaded conventional anchors. All-suture anchors require deployment immediately adjacent to intact cortical bone.
- Full-Text
- Preview