title: The effect of the trabecular microstructure on the pullout strength of suture anchors.
abstract: This study investigates how the microstructural properties of trabecular bone affect suture anchor performance. Seven fresh-frozen humeri were tested for pullout strength with a 5mm Arthrex Corkscrew in the greater tuberosity, lesser tuberosity, and humeral head. Micro-computed tomography analysis was performed in the three regions of interest directly adjacent to individual pullout experiments. The morphometric properties of bone mineral density (BMD), structural model index (SMI), trabecular thickness (TbTh), trabecular spacing (TbS), trabecular number (TbN), and connectivity density were compared against suture anchor pullout strength. BMD (r=0.64), SMI (r=-0.81), and TbTh (r=0.71) showed linear correlations to the pullout strength of the suture anchor with p-values<0.0001. A predictive model was developed to explain the variances in the individual BMD, SMI, and TbTh correlations. The multi-variant model of pullout strength showed a stronger relationship (r=0.86) compared to the individual experimental results. This study helps confirm BMD is a major influence on the pullout strength of suture anchors, but also illustrates the importance of local microstructure in pullout resistance of suture anchors.
authors.affiliation: MedShape Solutions, Research and Development, 1575 Northside Drive, Suite 440, Atlanta, GA 30318, USA. chris@medshapesolutions.com
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Yakacki
authors.forename: Mariya
authors.initials: M
authors.lastname: Poukalova
authors.forename: Robert E
authors.initials: RE
authors.lastname: Guldberg
authors.forename: Angela
authors.initials: A
authors.lastname: Lin
authors.forename: Minn
authors.initials: M
authors.lastname: Saing
authors.forename: Scott
authors.initials: S
authors.lastname: Gillogly
authors.forename: Ken
authors.initials: K
authors.lastname: Gall
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000502:physiology / Q000601:surgery*; D008875:Middle Aged; D053441:Suture Anchors; D013536:Suture Techniques / Q000592:standards*; D013718:Tensile Strength; D055114:X-Ray Microtomography
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