Diaz Miguel A, Munassi Steven, Teytelbaum David E, Pipitone Anthony, Baker Christopher E
Foundation for Orthopaedic Research & Education, Tampa, Florida, U.S.A.
Florida Orthopaedic Institute, Tampa, Florida, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Feb 15;5(2):e423-e433. doi: 10.1016/j.asmr.2023.01.010. eCollection 2023 Apr.
To compare various suture anchor designs with and without calcium phosphate (CaP) augmentation in an osteoporotic foam block model and decorticated proximal humerus cadaveric model.
This was a controlled biomechanical study, consisting of 2 parts: (1) an osteoporotic foam block model (0.12 g/cc; n = 42) and (2) a matched pair cadaveric humeral model (n = 24). Suture anchors selected were an all-suture anchor, PEEK (polyether ether ketone)-threaded anchor, and a biocomposite-threaded anchor. For each study arm, one half the samples were first filled with injectable CaP and the other half were not augmented with CaP. For the cadaveric portion, the PEEK- and biocomposite-threaded anchors were assessed. Biomechanical testing consisted of a stepwise, increasing load protocol for a total of 40 cycles, followed by ramp to failure.
For the foam block model, the average load to failure for anchors with CaP was significantly greater when compared with anchor fixation augmented without CaP; the all-suture anchor was 135.2 ± 20.2 N versus 83.3 ± 10.3 N ( = .0006); PEEK was 131 ± 34.3 N versus 58.5 ± 16.8 N ( = .001); and biocomposite was 182.2 ± 64.2 N versus 80.8 ± 17.4 N ( = .004). For the cadaveric model, the average load to failure for anchors augmented with CaP was again greater than anchor fixation without CaP; PEEK anchors went from 41.1 ± 21.1 N to 193.6 ± 63.9 N ( = .0034) and biocomposite anchors went from 70.9 ± 26.6 N to 143.2 ± 28.9 N ( = .004).
Augmenting various suture anchors with CaP has shown to significantly increase pull-out strength and stiffness in an osteoporotic foam block and time zero cadaveric bone model.
Rotator cuff tears are common in the elderly patients, in whom poor bone quality jeopardizes treatment success. Exploring methods that increase the strength of fixation in osteoporotic bone to improve outcomes in this patient population is important.
在骨质疏松泡沫块模型和去皮质肱骨近端尸体模型中，比较有和没有磷酸钙（CaP）增强的各种缝线锚钉设计。
这是一项对照生物力学研究，包括2部分：（1）骨质疏松泡沫块模型（0.12 g/cc；n = 42）和（2）匹配对尸体肱骨模型（n = 24）。选择的缝线锚钉为全缝线锚钉、聚醚醚酮（PEEK）螺纹锚钉和生物复合材料螺纹锚钉。对于每个研究组，一半的样本首先填充可注射CaP，另一半不进行CaP增强。对于尸体部分，评估PEEK和生物复合材料螺纹锚钉。生物力学测试包括逐步增加负荷方案，共40个循环，然后斜坡加载至破坏。
对于泡沫块模型，与未进行CaP增强的锚钉固定相比，进行CaP增强的锚钉的平均破坏负荷显著更高；全缝线锚钉为135.2±20.2 N，而未增强的为83.3±10.3 N（P = .0006）；PEEK为131±34.3 N，而未增强的为58.5±16.8 N（P = .001）；生物复合材料为182.2±64.2 N，而未增强的为80.8±17.4 N（P = .004）。对于尸体模型，进行CaP增强的锚钉的平均破坏负荷再次高于未进行CaP增强的锚钉固定；PEEK锚钉从41.1±21.1 N增加到193.6±63.9 N（P = .0034），生物复合材料锚钉从70.9±26.6 N增加到143.2±28.9 N（P = .004）。
在骨质疏松泡沫块和新鲜尸体骨模型中，用CaP增强各种缝线锚钉已显示出可显著提高拔出强度和刚度。
肩袖撕裂在老年患者中很常见，这些患者骨质较差会危及治疗成功。探索提高骨质疏松骨固定强度的方法以改善该患者群体的治疗效果很重要。
