Biomechanical evaluation of knotless anterior and posterior Bankart repairs

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• 作者：Frank Martetschl?ger ; Max P. Michalski…
• 关键词：Bankart repair ; Glenohumeral joint ; Stabilisation ; Knotless suture anchor ; Shoulder instability
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2014
• 出版时间：September 2014
• 年：2014
• 卷：22
• 期：9
• 页码：2228-2236
• 全文大小：945 KB
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• 作者单位：Frank Martetschl?ger (1) (3)
  Max P. Michalski (1)
  Kyle S. Jansson (1)
  Coen A. Wijdicks (1)
  Peter J. Millett (2)
  
  1. Department of BioMedical Engineering, Steadman Philippon Research Institute, Vail, CO, USA
  3. Department for Orthopaedic Sports Medicine, Clinic rechts der Isar, Technical University Munich, Munich, Germany
  2. The Steadman Clinic, Vail, CO, USA
  
• ISSN：1433-7347

文摘

Purpose The value of modern tape-like suture materials and the influence of the number of anchors inserted for arthroscopic Bankart repairs compared to the intact state have yet to be investigated. It was hypothesised: (1) suture-tape repairs will show higher biomechanical strength than common suture repairs, (2) four anchors will be stronger than three, and (3) the strength of the native capsulolabral complex will be greater than repairs. Methods Six matched-paired cadaveric shoulders received Bankart lesions/reconstructions and three underwent intact state testing. Anteroinferior repairs compared suture and suture-tape repairs using three anchors, while posteroinferior repairs compared three and four suture anchors using common sutures. An established testing protocol was run for biomechanical testing. Results There was no significant difference in the maximum loads, loads at 2?mm displacement, stiffness or energy between repair groups or between repairs and the intact state (n.s.). However, failure modes were different: 16/24 (66.7?%) of the repair groups showed glenoid labrum detachment compared to 2/12 (16.7?%) within the intact state group (P?=?0.012). Conclusions While biomechanical parameters of repairs and intact states showed equivalence, failure-mode analysis reaffirms previous findings that capsulolabrum complex refixation is weaker than the native attachment. Therefore, in daily clinical practice, type of suture is secondary and insertion of a fourth anchor will be unlikely to add strength but may confer additional risk and cost.