Design and Mechanical Evaluation of Sutureless Implants for the Surgery Treatment of Rotator Cuff Tears

2021 ◽  
Author(s):  
Marcília Valéria Guimarães ◽  
Elton Bonifácio ◽  
Thiago Carmo ◽  
Cleudmar Araújo
Keyword(s):  
Rotator Cuff ◽  
Mechanical Behavior ◽  
Functional Disability ◽  
Statistical Significance ◽  
Testing Machine ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Pullout Strength ◽  
Rigid Foam ◽  
Pullout Tests

Abstract Rotator cuff (RC) tears cause pain and functional disability of the shoulder. Despite advances in suture anchors, there are still reports about the incidence of surgical-related injuries to RC mainly associated with sutures. The purpose of this study was to design and evaluate the mechanical behavior of sutureless implants to repair RC tears. We hypothesized that the implants present mechanical characteristics suitable for the surgical treatment of RC tears as suture anchors. Three different implants (T1,T2,T3) were designed and fabricated with titanium: T1 has two rods and rectangular head; T2 has two rods with a small opening and enlarged rectangular head and T3 has three rods and a circular head. The implants were fixed in rigid polyurethane foam blocks by a series of blows, and the applied mechanical loads along with the number of blows were quantified. Pullout tests using tapes fixed between the implant head and testing machine grip were conducted until implant failure. The maximum pullout strength and displacement of the implant relative to the rigid foam block were computed. Statistical significance was set at p < 0.05. Owing to its geometric configuration, implant T2 presented the best characteristics related to stability, strength, and ease of insertion. Implant T2 confirms our hypothesis that its mechanical behavior is compatible with that of suture anchors which could lead to the reduction of RC repair failures and simplify the arthroscopic procedure.

scholarly journals Pullout strength of all suture anchors in the repair of rotator cuff tears: a biomechanical study

2013 ◽  
Vol 37 (10) ◽  
pp. 2017-2023 ◽  
Author(s):  
Alexandre Galland ◽  
Stéphane Airaudi ◽  
Renaud Gravier ◽  
Sophie Le Cann ◽  
Patrick Chabrand ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biomechanical Study ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Pullout Strength

scholarly journals DOES HYPERCHOLESTOLEMIA PREDISPOSE TO ROTATOR CUFF PATHOLOGIES?

2017 ◽  
Vol 10 (4) ◽  
pp. 373 ◽  
Author(s):  
Surendra Umesh Kamath ◽  
Sunil Murthy
Keyword(s):  
Rotator Cuff ◽  
Total Cholesterol ◽  
Rotator Cuff Tear ◽  
Indian Population ◽  
Statistical Significance ◽  
Elevated Serum ◽  
Density Lipoprotein ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Cuff Tear

Background:  Rotator cuff tear are one of most common orthopedic musculoskeletal problem gaining importance due to large health scale expenditure. Causes of rotator cuff tears are multifactorial and unclear.  Previous studies have suggested relation between elevated serum lipid profile and rotator cuff tear in western population. We therefore undertook study in our Indian population to correlate association of hypercholesterolemia with rotator cuff tear.Objective: To find association of rotator cuff pathology with hypercholesterolemia in Indian patients.Materials and methods: After obtaining clearance from institutional ethics committee. We prospectively collected fasting lipid samples of population who came to our hospitals with complaints of shoulder pain during our study period. 50 patients had rupture of rotator cuff which was confirmed by ultrasound of involved shoulder. 50 were seen for non-cuff related complaints.  We followed strict inclusion and exclusion criteria.Results: Total cholesterol, Triglycerides and low density lipoprotein concentration of patients with rotator cuff tendon tear were on higher side than control group. High density lipoprotein trend showed being lower than control group.  21 of 50 (42%) had high cholesterol (total cholesterol greater than 240mg/dl) than compared to 18 of 50 (36%) in control group. however P value=0.539 and showed no statistical significance between groups.Conclusion: In Indian population there was no correlation between hypercholesterolemia and rotator cuff tear which is statistically significant.Key words Rotator cuff tear, Hypercholesterolemia, Indian population.   

Pullout strength of suture anchors in comparison with transosseous sutures for rotator cuff repair

2008 ◽  
Vol 16 (5) ◽  
pp. 504-510 ◽  
Author(s):  
Matthias F. Pietschmann ◽  
Valerie Fröhlich ◽  
Andreas Ficklscherer ◽  
Jörg Hausdorf ◽  
Sandra Utzschneider ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchors ◽  
Pullout Strength ◽  
Cuff Repair

scholarly journals Biomechanical testing of trans-humeral all-suture anchors for rotator cuff repair

2018 ◽  
Vol 11 (1_suppl) ◽  
pp. 77-85
Author(s):  
Mikel Aramberri-Gutiérrez ◽  
Amaia Martínez-Menduiña ◽  
Simon Boyle ◽  
Maria Valencia
Keyword(s):  
Rotator Cuff ◽  
Proximal Humerus ◽  
Biomechanical Testing ◽  
Tensile Load ◽  
Biomechanical Properties ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Load To Failure ◽  
Insertion Sites ◽  
Number Of Cycles

Background Rotator cuff tears are one of the most common causes of shoulder pain. All-suture anchors are increasingly being used in the arthroscopic repair of rotator cuff tears. The purpose of this experimental study is to evaluate the biomechanical properties of all-suture anchors at different insertion sites in the proximal humerus relevant to rotator cuff repairs and the remplissage procedure. Methods Sixteen cadaveric shoulders were used for the study. Four all-suture anchors were inserted in each proximal humerus at common anchor insertion sites on the rotator cuff footprint and a simulated Hill–Sachs defect. Cyclic loading and load-to-failure tests were undertaken. The number of cycles, load to failure and nature of failure were recorded. Results The all-suture anchors placed in the cuff footprint using a transosseous technique displayed superior biomechanical properties. Sutures sited in this way demonstrated a maximum tensile load to failure of 542 N as well as a highest mean load to failure and the maximum number of cycles before anchor failure. In descending order, all-suture anchors placed in the lateral footprint were significantly superior to those located in the medial row and in a simulated Hill–Sachs defect. Discussion Anchors placed in the rotator cuff footprint exceeded the physiological isometric abduction forces for the supraspinatus and infraspinatus. Data obtained from our study suggest that all-suture anchors are strong enough to be used for the repair of rotator cuff tears.

Cement augmentation of suture anchors in the proximal humerus during rotator cuff repair improves pullout strength: a systematic review

2021 ◽  
pp. jisakos-2020-000603
Author(s):  
Jeff S Kimball ◽  
Anirudh K Gowd ◽  
Brian R Waterman ◽  
Seth L Sherman ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Proximal Humerus ◽  
Cement Augmentation ◽  
Suture Anchors ◽  
Inclusion Criteria ◽  
Pullout Strength ◽  
Pullout Force ◽  
Cuff Repair

ImportanceRotator cuff pathology is a growing concern in the ageing population. If cement augmentation of suture anchors improves pullout strength, its application can potentially be applied in cases of poor bone quality to prevent anchor failure.ObjectiveTo evaluate the biomechanical benefits and fixation strength of cement-augmented versus non-augmented suture anchors in the proximal humerus during rotator cuff repair (RCR).Evidence reviewA systematic review of PubMed, Embase and Cochrane Library was performed to identify all published articles reporting on biomechanical analysis of suture anchors in the shoulder in a cadaveric model. Inclusion criteria required fresh-frozen specimens, placement in the footprint of the proximal humerus, and comparative assessment of fixation constructs with or without polymethylmethacrylate (PMMA) or bioabsorbable composite cement augmentation. Biomechanical testing procedure, cement augmentation method and pullout force were assessed.FindingsAfter review of 105 abstracts, seven full manuscripts met inclusion criteria. Six of seven studies reported statistically significant differences in mean pullout force between augmented (three PMMAs, three composites, one PMMA vs composite) and non-augmented anchors. Of two studies evaluating cycles to failure, both found a significant increase in the augmented versus non-augmented anchors. Of two studies stratifying by anchor position, both investigations identified significant differences in mean pullout strength between augmented and non-augmented anchors at the posteromedial and anterolateral anchor positions.Conclusions and relevanceCement augmentation of suture anchors in cadaveric humeri for RCR improves pullout strength regardless of cement type used or anchor position. Cement augmentation may provide a viable option for future clinical application.Level of evidenceIV, systematic review.

STRUCTURAL PROPERTIES OF THE SUPRASPINATUS TENDON IN TWO JOINT POSITIONS

2001 ◽  
Vol 05 (02) ◽  
pp. 105-112
Author(s):  
Andreas M. Halder ◽  
Mark E. Zobitz ◽  
Fred Schultz ◽  
Kai-Nan An
Keyword(s):  
Rotator Cuff ◽  
Structural Properties ◽  
Ultimate Load ◽  
Tensile Force ◽  
Testing Machine ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Anterior Portion ◽  
Arm Position ◽  
Significant Difference

The supraspinatus tendon is frequently involved in rotator cuff tears. It has been suggested that joint position affects the structural mechanics of the tendon–bone complex. The purpose of this study was to determine regional variations in structural properties of the supraspinatus tendon in two glenohumeral positions. Supraspinatus tendons from 17 fresh frozen cadavers were divided into three strips of equal width and tested with a material-testing machine. The arm orientation was either in hanging position or 60 degrees glenohumeral abduction corresponding to 90 degrees arm abduction assuming 30 degrees scapular rotation. Tensile force, tendon elongation and failure mode were recorded. Overall, there was no significant difference in structural properties between hanging arm position and 60 degrees of glenohumeral abduction (p>0.05). However, the mean ultimate load (385 N, SD 56 N) and mean ultimate stress (14 MPa, SD 3 MPa) of the anterior tendon section with the arm in glenohumeral abduction were lower in 60 degrees abduction than in the hanging arm position (611 N, SD 276 N; 24 MPa, SD 10 MPa). In hanging arm position, the anterior tendon portion had a significantly greater ultimate load and stiffness than the middle and posterior portions (p<0.05). The regional variation in structural properties substantiates the clinical finding that rotator cuff ruptures easily extend posteriorly. Our study suggests that glenohumeral abduction reduces the failure strength of the supraspinatus tendon, specifically of its anterior portion. In our study, the maximum load of the anterior portion was substantially higher than predicted maximum loads transmitted physiologically through the entire tendon.

scholarly journals Do We have Arguments in Decision Making: Conservative or Surgical Treatment in Painful Degenerative Large Rotator Cuff Tears?

2020 ◽  
Author(s):  
Karl Vincent ◽  
Olivier Gagey ◽  
Charlotte Leboeuf-Yde
Keyword(s):  
Clinical Trials ◽  
Rotator Cuff ◽  
Randomized Clinical Trials ◽  
Functional Disability ◽  
Surgical Repair ◽  
Rotator Cuff Tears ◽  
Long Term Results ◽  
Cochrane Library ◽  
Clinical Difference

Abstract Background and Hypotheses: The contemporary research literature indicates that there is no significant clinical difference in terms of improvement of pain and functional disability between surgical repair and rehabilitation treatment for degenerative rotator cuff tears. It could be hypothesized that rehabilitation, which is cheaper and causes few complications, is preferable for smaller lesions, whereas surgical repair might be needed for the larger lesions. The purpose of our review was to assess whether the size of the tear, particularly the large or massive, plays a major role in terms of long-term clinical results for rehabilitation compared to surgical repair.Method: We searched the literature on PubMed, Embase, PEDro, and Cochrane Library database up to March 2020 for randomized controlled clinical trials that compared long term results for surgical vs. rehabilitation concerning large or massive degenerative rotator cuff tears. A systematic, critical review process was planned using a slightly modified SIGN checklist. The review methodology followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and was submitted to PROSPERO and registered under the number CRD42020146161.Results: We found no randomized clinical trials that had dealt with this subject.Conclusion: There is no evidence that would help to choose between surgical repair or rehabilitation in case of large or massive rotator cuff degenerative tears. The reason for this is probably that large tears may be relatively painless since they often occur after retirement and therefore are relatively rarely seen in clinical practice. To obtain enough study subjects, it would therefore be necessary to study this question in multicenter randomized clinical trials.

Modified Margin Convergence Technique Using Suture Anchors for Footprint Reconstruction of Rotator Cuff Tears

Orthopedics ◽  
2010 ◽  
Vol 33 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Kyung Cheon Kim ◽  
Kwang Jin Rhee ◽  
Hyun Dae Shin ◽  
Young Mo Kim ◽  
Dong Kyu Kim ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Suture Anchors ◽  
Margin Convergence
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