title: Comparative evaluation of bone suture anchor to bone tunnel fixation of tibialis anterior tendon in cadaveric cuboid bone: a biomechanical investigation.
abstract: A multiphase biomechanical study was performed using human tibialis anterior tendons and cuboid bones, comparing the fixation of the tendon to the bone using bone anchors and bone tunnels. Twenty-six specimens were tested for ultimate load to failure comparing Mitek Superanchor fixation with no. 1 and no. 5 braided polyethelyne suture to bone tunnel fixation. Mitek Superanchor with no. 5 suture failed at 223 N, compared with Mitek Superanchor with no. 1 suture at 134 N and bone tunnel at 143 N (P = 0.033). Mitek with no. 1 suture versus bone tunnel was not significantly different. The Mitek with no. 5 suture failed at the tendon/suture interface (75%), the Mitek with no. 1 suture failed at the suture/anchor interface (56%), and bone tunnel fixation failed most commonly by fracture of the tunnel (76%). This study is the first biomechanical analysis of the pullout strengths of bone tunnels or suture anchors in the cuboid bone. We have shown that the suture anchor has a pullout strength comparable or superior to a conventional bone tunnel in an in vitro situation. We believe it is a viable alternative to fixation of the tibialis anterior tendon to the cuboid when there is insufficient tendon length or failure of the bone tunnel.
authors.affiliation: Foothills Hospital, Calgary, Alberta, Canada.
authors.forename: C W
authors.initials: CW
authors.lastname: Fennell
authors.forename: J M
authors.initials: JM
authors.lastname: Ballard
authors.forename: D S
authors.initials: DS
authors.lastname: Pflaster
authors.forename: R H
authors.initials: RH
authors.lastname: Adkins
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002102:Cadaver; D005069:Evaluation Studies as Topic; D005528:Foot / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D006801:Humans; D016268:Internal Fixators; D008875:Middle Aged; D010865:Pilot Projects; D013536:Suture Techniques; D013709:Tendon Transfer / Q000379:methods*; D013710:Tendons / Q000502:physiology / Q000601:surgery*; D016474:Weight-Bearing