Purpose
To evaluate osteoconductivity of a poly-L-lactide co-glycolide (PLG)–calcium sulfate
(CS)–β-tricalcium phosphate (β-TCP) biocomposite suture anchor after arthroscopic
shoulder labral repair.
Methods
The subjects of this study were patients who participated in a clinical trial for
acquisition of marketing approval of a PLG–CS–β-TCP biocomposite anchor in Japan.
They underwent arthroscopic labral repair using the anchor, and computed tomographic
(CT) images of the glenoid were obtained 2 years after surgery. Osteoconductivity
at the anchor sites was evaluated with the CT images using the established ossification
quality score. Shoulder function scores including the Rowe score and Japanese Shoulder
Society shoulder instability score were also assessed 2 years after surgery.
Results
CT images and functional scores were obtained from 37 patients, comprising 29 men
and 8 women with a mean age of 29 years (range, 25-33 years) at surgery. A total of
148 anchors were implanted in the 37 shoulders. Osteoconductivity was seen in 133
of 148 anchor sites (90.0%) 2 years after implantation. No significant differences
in osteoconductivity were found by anchor diameter or position. The Rowe score significantly
improved from 39.9 points (95% confidence interval [CI], 33.8-45.9 points) preoperatively
to 96.6 points (95% CI, 95.1-98.1 points) at 2 years postoperatively (P < .001). The Japanese Shoulder Society shoulder instability score also significantly
improved, from 63.1 points (95% CI, 58.4-67.7 points) preoperatively to 96.3 points
(95% CI, 94.7-97.8 points) at 2 years postoperatively (P < .001).
Conclusions
Biocomposite suture anchors made of PLG, CS, and β-TCP exhibited some osteoconductivity
2 years after arthroscopic labral repair, as well as good clinical outcomes.
Level of Evidence
Level IV, therapeutic case series.
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Article Info
Publication History
Published online: November 13, 2019
Accepted:
June 13,
2019
Received:
February 17,
2019
Footnotes
See commentary on page 3179
The authors report the following potential conflicts of interest or sources of funding: The clinical trials and studies were funded by Smith & Nephew. H.S. receives fees to the institution from Smith & Nephew. H.S. receives personal fees (not institutional) and radiographic image interpretation fees from Smith & Nephew KK. K.M. receives grant support from Exactech and 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: Fill It up: The Fate of “Absorbable” ImplantsArthroscopyVol. 35Issue 12
- PreviewSurgeons make conscious decisions daily regarding implants. But do they really know what happens in the body to “absorbable anchors?” How long does it take to resorb, and what fills the space left behind? Absorbable materials can be very different, and well-done studies are important to help us understand the process and to guide our decisions.
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