title: In vitro evaluation of screws and suture anchors in metaphyseal bone of the canine tibia.
abstract: OBJECTIVE
  To compare ease of insertion, load to failure, and mode of failure of cortical and cancellous screws, BoneBiter, IMEX, and TwinFix suture anchors in canine metaphyseal tibial bone.
  
  
  METHODS
  Experimental biomechanical study.
  
  
  METHODS
  Canine cadaveric tibias.
  
  
  METHODS
  One investigator inserted all anchors and subjectively evaluated ease of placement. Anchor systems were loaded to failure along axis of insertion with audio-video recording to determine failure mode.
  
  
  RESULTS
  BoneBiter was the most difficult anchor to insert successfully. Mean+/-SD loads to failure were cancellous screw (711+/-193 N), IMEX 4.7 mm 18 g wire (661+/-163 N), IMEX 4.0 mm 18 g wire (661+/-165 N), cortical screw (635+/-184 N), BoneBiter #5 Kevlar suture (393+/- 109 N), and TwinFix 5.0 mm #2 polyester (267+/-73 N). No significant differences were noted among the cortical screw, cancellous screw, IMEX 4.7 and 4.0 mm, all of which were significantly (P<.001) greater than BoneBiter and TwinFix . Failure modes were pullout of bone, suture-wire breakage, eyelet breakage, or no failure to 1000 N: screws (18,0,0,2), IMEX (18,1,1,0), BoneBiter (2,8,0,0), and TwinFix (0,10,0,0).
  
  
  CONCLUSIONS
  Fixation devices were user friendly, with the exception of BoneBiter. Mode of failure is dependent on suture material and anchor design. Cortical and cancellous screws, and IMEX anchors with 18 g wire have significantly greater load to failure compared with BoneBiter and TwinFix suture anchors.
  
  
  CONCLUSIONS
  Based on load to failure, ease of use, design characteristics, and cost, IMEX anchors may have advantages over other comparable soft tissue fixation devices.
authors.affiliation: Comparative Orthopaedic Laboratory, University of Missouri-Columbia, Columbia, MO 65211, USA.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Robb
authors.forename: James L
authors.initials: JL
authors.lastname: Cook
authors.forename: William
authors.initials: W
authors.lastname: Carson
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D001863:Bone Screws / Q000662:veterinary; D002102:Cadaver; D004285:Dogs / Q000293:injuries* / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000662:veterinary*; D066298:In Vitro Techniques; D013536:Suture Techniques / Q000662:veterinary; D013978:Tibial Fractures / Q000601:surgery / Q000662:veterinary*