TY - JOUR
AU1 - Yanke, Adam B.
AU2 - Allahabadi, Sachin
AU3 - Wang, Zachary
AU4 - Credille, Kevin T.
AU5 - Shewman, Elizabeth
AU6 - Bonadiman, Joao Artur
AU7 - Elias, Tristan J.
AU8 - Hevesi, Mario
AU9 - Garrigues, Grant E.
AU1 - Verma, Nikhil N.
AB - Background:All-suture anchors and knotless anchors are increasingly used in the repair of anteroinferior labral tears in patients with shoulder instability. Optimal repair constructs may limit recurrent instability.Purpose:To perform a quantitative biomechanical comparison of 3 labral fixation devices for soft tissue Bankart lesions: knotless soft-body tensionable anchor (SB knotless), knotted soft-body anchor (SB knotted), and knotless hard-body PEEK (polyether ether ketone) interference anchor (HB knotless).Study Design:Controlled laboratory study.Methods:A total of 21 glenoid specimens were randomized into 3 groups: SB knotless, SB knotted, and HB knotless. Artificial Bankart lesions were created at the anteroinferior labrum. Anchors were placed at the 3:30, 4:30, and 5:30 clockface positions, and sutures were passed through 1 cm of tissue. Anchors were tested simultaneously as one construct by pulling capsular tissue connected to the anteroinferior quadrant. Cyclic loading (5-25 N, 100 cycles) was followed by load-to-failure testing (15 mm/min). Biomechanical testing variables were collected, and failure mechanisms were recorded per individual anchor.Results:There were no differences in baseline specimen characteristics. There was no difference in elongation during cyclic loading (P = .40). The ultimate load to failure between SB knotless (309.7 ± 125.6 N), SB knotted (226.4 ± 34.8 N), and HB knotless (256.5 ± 90.5 N) did not significantly differ (P = .25). Failure mechanisms differed among groups (P = .008); mechanisms included anchor pullout (SB knotless: 33.3%; SB knotted: 23.8%; HB knotless: 28.6%), suture pull-through (SB knotless: 66.7%; SB knotted: 38.1%; HB knotless: 33.3%), and anchor fixation method failure, defined as knot failure for knotted anchors or locking mechanism failure for knotless anchors (SB knotless: 0.0%; SB knotted: 38.1%; HB knotless: 38.1%).)Conclusion:The SB knotless, SB knotted, and HB knotless labral fixation anchors studied exhibited comparable elongation during cyclic loading, stiffness, and ultimate loads to failure in a cadaveric model. However, the failure mechanisms significantly differed, as SB knotless anchors failed primarily from suture pull-through, while SB knotted and HB knotless anchors were subject to knot failure and locking mechanism failure, respectively.Clinical Relevance:These data support the benefit of SB knotless anchors for anteroinferior labral repair in limiting knot failure typically seen with knotted anchors, perhaps demonstrating that all-suture anchors may have better locking mechanism quality than their PEEK counterparts.
TI - Biomechanical Analysis of Anteroinferior Bankart Repair Anchor Types
JF - The American Journal of Sports Medicine
DO - 10.1177/03635465231180621
DA - 2023-08-01
UR - https://www.deepdyve.com/lp/sage/biomechanical-analysis-of-anteroinferior-bankart-repair-anchor-types-FywdzBCex3
SP - 2642
EP - 2649
VL - 51
IS - 10
DP - DeepDyve
ER -