Department of Trauma-, Hand-, and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Institute of Biomechanics, Hamburg University of Technology (TUHH), Hamburg, Germany.
J Shoulder Elbow Surg. 2019 Dec;28(12):2433-2437. doi: 10.1016/j.jse.2019.04.053. Epub 2019 Jul 13.
The possibility of implanting a conventional anchor at the pullout site following all-suture anchor failure was evaluated in a biomechanical cadaveric model. The hypothesis of the study was that anchor revision would yield equal biomechanical properties.
Ten human humeri were obtained, and bone density was determined via computed tomography. After all-suture anchor (n = 5) and conventional 4.5-mm anchor (n = 5) insertion, biomechanical testing was conducted. Following all-suture anchor pullout, a conventional 5.5-mm anchor was inserted at the exact site of pullout (n = 5) and biomechanical testing was reinitiated. Testing was conducted using an initial preload of 20 N, followed by an unlimited cyclic protocol, with a stepwise increasing force of 0.05 N for each cycle at a rate of 1 Hz until system failure. The number of cycles, maximum load to failure, stiffness, displacement, and failure mode, as well as macroscopic observation at the failure site including diameter, shape, and cortical destruction, were registered.
The defect following all-suture pullout showed a mean diameter of 4 mm, and conventional revision was possible in each sample. There was no significant difference between the initial all-suture anchor implantation and the conventional anchor implantation or the conventional revision following all-suture failure regarding mean pullout strength, stiffness, displacement, or total number of cycles until failure.
Conventional anchor revision at the exact same site where all-suture anchor pullout occurred is possible and exhibits similar biomechanical properties.
在生物力学尸体模型中评估了在全缝线锚定失败后在拔出部位植入常规锚定的可能性。该研究的假设是，锚固件修复将产生相等的生物力学特性。
获得了 10 个人的肱骨，并通过计算机断层扫描确定了骨密度。在全缝线锚（n = 5）和常规 4.5 毫米锚（n = 5）插入后，进行生物力学测试。在全缝线锚拔出后，在拔出的确切部位插入常规 5.5 毫米锚（n = 5）并重新开始生物力学测试。测试使用 20 N 的初始预加载进行，然后进行无限循环协议，每个循环以 1 Hz 的速度逐步增加 0.05 N 的力，直到系统失效。记录了循环次数、失效时的最大载荷、刚度、位移和失效模式，以及失效部位的宏观观察，包括直径、形状和皮质破坏。
全缝线拔出后的缺陷平均直径为 4 毫米，每个样本都可以进行常规修复。在初始全缝线锚定植入和常规锚定植入或全缝线失败后的常规锚定修复方面，平均拔出强度、刚度、位移或失效前的总循环次数方面，没有显著差异。
在全缝线锚拔出发生的确切部位进行常规锚定修复是可行的，并且具有相似的生物力学特性。
