Osteoconductive resorption characteristics of a novel biocomposite suture anchor material in rotator cuff repair

Abstract

BackgroundBioabsorbable suture anchors have been associated with bone-derived complications, such as osteolysis and cyst formation, after rotator cuff repair. The purpose of this study was to assess the osseous degradation process of the novel biocomposite suture anchor material polylactic-co-glycolic acid (PLGA)/beta-tricalcium phosphate (ß-TCP)/calcium sulfate (CS) after arthroscopic single-row rotator cuff repair. The focus of interest was the appearance of osteolysis and the rate of total resorption of the implants after 21 months.MethodsForty-eight patients with 82 implanted suture anchors who had undergone arthroscopic rotator cuff repair between January 2015 and March 2016 at our institution were retrospectively evaluated by postoperative magnetic resonance imaging. The appearance of osteolysis was classified by measurement of the peri-implant fluid. The degree of resorption was measured by grading the persistent visibility of the anchor structures. The integrity of the rotator cuff tendon was analyzed to discover possible retear or anchor pull-out complications.ResultsAfter a follow-up of 21.2 (± 5.4) months, osteolysis was detected in only two anchors (2.4%), and none of these defects exceeded the diameter of the former suture anchor (5.5 mm). Fifty percent of the anchors were fully degraded and no longer visible. Furthermore, only two retears of the rotator cuff occurred, and no anchor pull-out complications were detected.ConclusionPGLA/β-TCP/CS is a fully resorbable and osteoconductive suture anchor material that seems to have superior resorption characteristics compared to those of other bioabsorbable suture anchor materials commonly used in arthroscopic rotator cuff repair.Trial registrationThe presented study was retrospectively registered by the commission for ethics at the Ärztekammer Nordrhein with the registration number 2016433 on January 17, 2017. All participating patients gave written consent for participation and the publication of their data.Level of evidenceIV

Regenesorb and polylactic acid hydroxyapatite anchors are associated with similar osseous integration and rotator cuff healing at 2 years

“…In contrast, the reaction surrounding the PLLA/HA polymer anchor was ''less reactive,'' because this material absorbs slower, with near complete resorption taking approximately 7 years (CITE). 22 Based on CT measurements, 74% of the Twinfix Ultra HA anchors with closed architecture had high-quality ossification compared with 60% of the Healicoil Regenesorb anchors with an open architecture. However, it is difficult to determine if the density of surrounding bone is the most appropriate outcome to measure.…”

“…Vonhoegen et al 22 reported that 75% of the Regenesorb anchors could not be distinguished from bone with an MRI at a mean 21.2 months postoperatively in a retrospective clinical study. They used signal on the MRI to identify osteolysis and reported only 2 anchors with minor osteolysis.…”

“…Preclinical and clinical studies have demonstrated near complete resorption of the Regenesorb material by 2 years and replacement with bone compared to slower resorption of the PLLA/HA constructs. 22 The design or architecture of suture anchors is also rapidly evolving. Original designs were similar to screws with some designs being solid while others were cannulated with a solid exterior.…”

Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

“…A follow-up study is needed to document retear occurrence and assess when the bioabsorbable anchor would be completely absorbed. However, this may be estimated based on previously published studies [ 27 , 29 ]. Second, applying two distinct anchors into one body as the strong point of this study simultaneously acted as an obstacle in assessing the functional outcomes.…”

Comparison of Occurrence of Bone Tunnel Laceration, Clinical Results, and Cuff Repair Integrity of Transosseous Arthroscopic Rotator Cuff Repair With and Without Lateral Cortical Augmentation

“…ARCR using suture anchors has become the most common procedure, and excellent clinical results have been reported. 1 , 2 , 3 , 4 However, using suture anchors has certain disadvantages, such as dislocation, 5 cost, 6 , 7 osteolysis, 8 , 9 problems with revision surgery, 10 and perianchor reactions. 11 , 12 To avoid these issues, some surgeons choose transosseous ARCR techniques instead.…”