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.
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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.
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