Clinical Safety and Efficacy of a Novel Ultrasound-Assisted Bioabsorbable Suture Anchor in Foot and Ankle Surgeries

Abstract

Background: Suture anchors have been used for soft tissue repair in orthopedic surgery for decades. Recently, bioabsorbable suture anchors have increased in popularity and have spurred the introduction of ultrasound-assisted systems. The purpose of our study was to determine the clinical safety and efficacy of a new ultrasound-assisted suture anchor system for foot and ankle procedures. Methods: We retrospectively reviewed 50 cases using the ultrasound-assisted suture anchor with at least 24 months of follow-up. We reviewed demographic data including comorbidities, type of procedure, adverse events, and clinical outcomes using the Foot and Ankle Outcome Score (FAOS) and visual analog scale (VAS) score. We divided complications into minor and major, with major complications requiring revision surgery or leading to long-term morbidity. Our primary outcome was complication rates and our secondary outcome was improvement in clinical scores. Results: The most frequent cases using the anchor included lateral ankle ligament reconstruction ( n = 19), insertional Achilles repair ( n = 15), lateral ligament reconstruction in conjunction with a total ankle arthroplasty ( n = 6), and plantar plate repair ( n = 3). There were 5 superficial wound infections that resolved with wound care and/or oral antibiotics. There were 3 major complications (6%): a deep wound infection that required an irrigation and debridement, a deep venous thrombosis, and a recurrence of varus deformity in a patient who underwent a total ankle arthroplasty with lateral ligament reconstruction. Only the varus deformity recurrence case could possibly be directly linked to the suture anchor (2% of all cases). VAS scores improved from 6.0 to 1.2 ( P < .001) and FAOS improved from 54.7 to 94.2 ( P < .001). Conclusion: This bioabsorbable anchor was a safe device with low failure rates, and it was used for soft tissue repair cases in the foot and ankle with successful clinical outcomes. Level of Evidence: Level IV, retrospective case series.

Management of Insertional Achilles Tendinopathy

“…Recently, a novel ultrasound-assisted liquefying bioabsorbable anchor has been used by some surgeons including the senior author, which is thought to have greater pullout strength when compared with traditional anchors. 28,29 There has also been thought that the insertion angle of the anchor has an effect on pullout strength, but this has been disproven in biomechanical studies. 30…”

Absorbable suture anchor and knotless anchor techniques produced similar outcomes in arthroscopic anterior talofibular ligament repair

“…Furthermore, prominent knots can cause local irritation in some patients with low body mass index (BMI). Therefore, absorbable suture anchors and/or all‐soft knotless anchors were gradually applied [5, 15, 26]. Vega et al described an all‐inside arthroscopic ATFL repair technique using knotless anchors, and was able to restore all patients’ ankle stability, with no major complications [33, 34].…”