期刊论文详细信息
Journal of Orthopaedic Surgery and Research
Suture anchor fixation strength with or without augmentation in osteopenic and severely osteoporotic bones in rotator cuff repair: a biomechanical study on polyurethane foam model
Halil Atmaca4  Teyfik Demir3  Ozgur Verim1  Mehmet Eroglu2  Levent Altinel4  Mehmet Serhan Er4 
[1] Department of Mechanical Engineering, Faculty of Technology, Afyon Kocatepe University, Afyonkarahisar 03200, Turkey;Department of Orthopaedics and Traumatology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar 03200, Turkey;Department of Biomedical Engineering, TOBB University of Economics and Technology, Ankara 06520, Turkey;Department of Orthopaedics and Traumatology, Faculty of Medicine, Akdeniz University, Antalya 07985, Turkey
关键词: Bone;    Tricalcium phosphate cement;    Rotator cuff repair;    Osteoporosis;    Pullout;    Suture anchor;   
Others  :  1152188
DOI  :  10.1186/1749-799X-9-48
 received in 2013-12-26, accepted in 2014-06-09,  发布年份 2014
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【 摘 要 】

Background

The purpose of the present study was to compare the results of various types of anchor applications with or without augmentation in both osteopenic and severely osteoporotic bone models.

Methods

Two different types of suture anchors were tested in severely osteoporotic (SOP) and osteopenic polyurethane (PU) foam blocks using an established protocol. An Instron machine applied static loading parallel to the axis of insertion until failure, and the mean anchor failure strengths were calculated. The mode of failure (anchor pullout, suture tear) was recorded. The anchors tested included the Corkscrew® (CS) (Arthrex Inc., Naples, FL, USA) (without augmentation, polymethylmethacrylate (PMMA)-augmented, and bioabsorbable tricalcium phosphate (TCP) cement-augmented) and Corkscrew® FT II (CS FT II) 5.5 mm (without augmentation as used routinely).

Results

The mean failure loads for both SOP and osteopenic PU foam blocks, respectively, were as follows: CS, 16.2 and 212.4 N; CS with TCP, 75.2 and 396 N; CS with PMMA, 101.2 and 528.8 N; CS FT II, 13.8 and 339.8 N.

Conclusions

Augmentation of CS with TCP or PMMA would be essential to SOP bones. In the osteopenic bone model, although anchor fixation augmented with PMMA is the best fixation method, CS augmented with TCP cement or CS FT II without any need for augmentation may also be used as an alternative.

【 授权许可】

   
2014 Er et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Jones CK, Savoie FH 3rd: Arthroscopic repair of large and massive rotator cuff tears. Arthroscopy 2003, 19:564-571.
  • [2]Tingart MJ, Apreleva M, Lehtinen J, Zurakowski D, Warner JJ: Anchor design and bone mineral density affect the pull-out strength of suture anchors in rotator cuff repair: which anchors are best to use in patients with low bone quality? Am J Sports Med 2004, 32:1466-1473.
  • [3]Oshtory R, Lindsey DP, Giori NJ, Mirza FM: Bioabsorbable tricalcium phosphate bone cement strengthens fixation of suture anchors. Clin Orthop Relat Res 2010, 468:3406-3412.
  • [4]Meyer DC, Fucentese SF, Koller B, Gerber C: Association of osteopenia of the humeral head with full-thickness rotator cuff tears. J Shoulder Elbow Surg 2004, 13:333-337.
  • [5]Kim KC, Rhee KJ, Shin HD, Kim YM: Arthroscopic footprint reconstruction of a bone cyst-associated rotator cuff tear. Knee Surg Sports Traumatol Arthrosc 2007, 15:1486-1488.
  • [6]Giori NJ, Sohn DH, Mirza FM, Lindsey DP, Lee AT: Bone cement improves suture anchor fixation. Clin Orthop Relat Res 2006, 451:236-241.
  • [7]Meyer DC, Jacob HA, Pistoia W, von Roll A, Gerber C: The use of acrylic bone cement for suture anchoring. Clin Orthop Relat Res 2003, 410:295-302.
  • [8]Ricci WM, Tornetta P 3rd, Petteys T, Gerlach D, Cartner J, Walker Z, Russell TA: A comparison of screw insertion torque and pullout strength. J Orthop Trauma 2010, 24:374-378.
  • [9]Pfeiffer FM, Abernathie DL, Smith DE: A comparison of pullout strength for pedicle screws of different designs: a study using tapped and untapped pilot holes. Spine 2006, 31:E867-870.
  • [10]Arslan AK, Demir T, Ormeci MF, Camuscu N, Tureyen K: Postfusion pullout strength comparison of a novel pedicle screw with classical pedicle screws on synthetic foams. Proc Inst Mech Eng H 2013, 227:114-119.
  • [11]Meyer DC, Mayer J, Weber U, Mueller A, Koch PP, Gerber C: Ultrasonically implanted PLA suture anchors are stable in osteopenic bone. Clin Orthop Relat Res 2006, 442:143-148.
  • [12]Kirchhoff C, Braunstein V, Milz S, Sprecher CM, Fischer F, Tami A, Ahrens P, Imhoff AB, Hinterwimmer S: Assessment of bone quality within the tuberosities of the osteoporotic humeral head: relevance for anchor positioning in rotator cuff repair. Am J Sports Med 2010, 38:564-569.
  • [13]Jackson M, Sylvestre E, Bleau J, Allard P, Begon M: Estimating optimal shoulder immobilization postures following surgical repair of massive rotator cuff tears. J Biomech 2013, 46:179-182.
  • [14]Barber FA, Feder SM, Burkhart SS, Ahrens J: The relationship of suture anchor failure and bone density to proximal humerus location: a cadaveric study. Arthroscopy 1997, 13:340-345.
  • [15]Collinge C, Merk B, Lautenschlager EP: Mechanical evaluation of fracture fixation augmented with tricalcium phosphate bone cement in a porous osteoporotic cancellous bone model. J Orthop Trauma 2007, 21:124-128.
  • [16]Elder S, Frankenburg E, Goulet J, Yetkinler D, Poser R, Goldstein S: Biomechanical evaluation of calcium phosphate cement-augmented fixation of unstable intertrochanteric fractures. J Orthop Trauma 2000, 14:386-393.
  • [17]Moore DC, Frankenburg EP, Goulet JA, Goldstein SA: Hip screw augmentation with an in situ-setting calcium phosphate cement: an in vitro biomechanical analysis. J Orthop Trauma 1997, 11:577-583.
  • [18]Moore DC, Maitra RS, Farjo LA, Graziano GP, Goldstein SA: Restoration of pedicle screw fixation with an in situ setting calcium phosphate cement. Spine 1997, 22:1696-1705.
  • [19]Gibson LJ, Ashby MF: Cancellous bone. In Cellular Solids. New York: Pergamon; 1988:316-331.
  • [20]Strauss E, Frank D, Kubiak E, Kummer F, Rokito A: The effect of the angle of suture anchor insertion on fixation failure at the tendon-suture interface after rotator cuff repair: deadman's angle revisited. Arthroscopy 2009, 25:597-602.
  • [21]Schneeberger AG, von Roll A, Kalberer F, Jacob HA, Gerber C: Mechanical strength of arthroscopic rotator cuff repair techniques: an in vitro study. J Bone Joint Surg Am 2002, 84-A:2152-2160.
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