Three Medial All Suture Anchors Improves Contact Force Compared to Two Hard Body Anchors in a Biomechanical Two-Tendon Rotator Cuff Tear Model

Tammy R Hoffman; Joseph D Lamplot; Sarah J McClish; Cassie Payne; Patrick J Denard

doi:10.1016/j.asmr.2022.05.012

Three Medial All Suture Anchors Improves Contact Force Compared to Two Hard Body Anchors in a Biomechanical Two-Tendon Rotator Cuff Tear Model

Arthrosc Sports Med Rehabil. 2022 Aug 5;4(5):e1601-e1607. doi: 10.1016/j.asmr.2022.05.012. eCollection 2022 Oct.

Authors

Tammy R Hoffman^{1

2}, Joseph D Lamplot³, Sarah J McClish⁴, Cassie Payne⁴, Patrick J Denard^{1

2}

Affiliations

¹ Southern Oregon Orthopedics, Medford, Oregon, U.S.A.
² Oregon Shoulder Institute, Medford, Oregon, U.S.A.
³ Emory Orthopaedics & Spine Center, Flowery Branch, Georgia, U.S.A.
⁴ Arthrex, Naples, Florida, U.S.A.

Abstract

Purpose: To biomechanically compare a knotless double-row construct with 3 medial all-suture (3AS) anchors with a standard 2 medial hard body (2HB) anchor construct.

Methods: Twelve matched cadaveric shoulder specimens with a mean age of 57 years (range: 54-61 years) were randomized to receive a knotless double-row repair with either a 3AS or 2HB construct. In the 3AS construct, three 2.6-mm all-suture anchors were placed adjacent to the articular margin and secured laterally with two 4.75-mm knotless hard body anchors. In the 2HB construct, two 4.75-mm medial hard body anchors were placed medially, lateral fixation was identical to the 3AS construct. Creep, displacement, stiffness, and ultimate load were recorded for each sample. In addition, a SynDaver model was used to compare contact pressure between the 2 repair constructs.

Results: There were no differences in cyclic displacement at 1, 30, and 100 cycles (P = .616, .497, .190, respectively), cyclic stiffness (.928), ultimate load (.445), or load to failure (P = .445) between the 2 constructs. The 3AS repair construct had improved contact pressure between tendon and bone when compared with the 2HB construct at loads of 20 N, 30 N, and 40 N (P = .01, .02, and .04, respectively).

Conclusions: Displacement and load to failure properties are similar between knotless constructs using either 2HB or 3AS for the medial row. However, contact force may improve with the use of 3 medial all-suture anchors.

Clinical relevance: As all-suture anchors are smaller in size when compared with hard body anchors. For this reason, there is potential to place an additional all-suture medial anchor to improve contact force and potentially improve rotator cuff healing when compared with the use of hard body anchors.