Suture Anchors and Tacks for Shoulder Surgery, Part 1

Abstract

The development and successful clinical application of suture anchors and tacks have revolutionized the surgeon's ability to secure soft tissues to bone via open or arthroscopic surgical techniques. When used carefully and with proper technique, these devices provide viable options for the repair and reconstruction of many intra-articular and extra-articular abnormalities in the shoulder, including rotator cuff tears, shoulder instability, and biceps lesions that require labrum repair or biceps tendon tenodesis. Like many technologies, however, the successful application of these devices requires an understanding of the biology and biomechanics that affect their use in the shoulder as well as knowledge of the factors that can affect subsequent clinical outcomes, including complications.

Biomechanical testing of a new knotless suture anchor compared with established anchors for rotator cuff repair

“…Of foremost importance is the wear of friction at the sharp edges of the metal, which is less pronounced with absorbable anchors because of their softer material. 4,13,17 This was confirmed by the data collected in our study; 3 suture breakages occurred at the eyelet of the metal Super Revo anchor but none in the absorbable UltraSorb and BIOKNOTLESS RC. A further disadvantage of the titanium anchor is its interference with postoperative imaging studies, such as magnetic resonance imaging (MRI), which may complicate revisions.…”

A Biomechanical Analysis of Anterior Bankart Repair Using Suture Anchors

“…The use of suture anchors in the arthroscopic treatment of anterior shoulder instability has been well described both biomechanically 2,3,24,25,27,29,39 and clinically. k The techniques used vary considerably among surgeons and institutions, and thus a comparison of differing suture techniques is difficult.…”

Pullout strength of suture anchors: Effect of mechanical properties of trabecular bone

“…(Barber, Herbert et al 1996; Barber and Herbert 1999; Tingart, Apreleva et al 2004) Mechanical failure at the bone-anchor interface typically results in suture anchor loosening, migration, and pullout. (Djurasovic, Marra et al 2001; McFarland, Park et al 2005; Pietschmann, Fröhlich et al 2009) The force required to pull the anchor from the bone is termed the pullout strength and is often used as a metric to compare the performance of different suture anchors. (Barber, Feder et al 1997; Meyer, Fucentese et al 2003; Tingart, Apreleva et al 2003; Tingart, Apreleva et al 2004; Barber, Herbert et al 2006; Park, Keyurapan et al 2006; Pietschmann, Fröhlich et al 2008; Pietschmann, Fröhlich et al 2009)…”