title: Modes of failure of knotted and knotless suture anchors in an arthroscopic bankart repair model with the capsulolabral tissues intact.
abstract: The purpose of this study was to assess failure modes of knotless and knotted anchors in a Bankart repair model with the capsulolabral soft tissues intact. Previous reports used a model stripped of soft tissues. In 8 matched pairs of cadaver shoulders, a Bankart lesion was repaired arthroscopically using either 2 Bio-SutureTak anchors (Arthrex, Naples, Florida) or 2 Bioknotless anchors (Mitek, Westwood, Massachusetts). The shoulders were mounted with the repaired capsulolabral tissues attached to a custom sinusoidal clamp, and were tested in cyclic loading (20-80 N, 100 cycles, 0.5 mm/s) and then load to failure (1.25 mm/s). Cut-through at the suture-tissue interface (23/32 anchors) was more common than pullout at the anchor-bone interface (9/32) as a mode of failure (P = .02). Failure at the suture-tissue interface occurred in 10/16 knotted and 13/16 knotless anchors. Mean (SD) ultimate load of knotted vs knotless anchors was 125.3 (67.4) N and 96.9 (95.1) N, respectively. Mean (SD) stiffness of knotted vs knotless anchors was 20.9 (6.4) N/mm and 19.8 (8.6)N/mm, respectively. We concluded that both knotted and knotless anchors fail most often at the suture-tissue interface. The tested model with the capsulolabral tissues intact is distinct from previous models, which tested the anchor-bone interface only.
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Anil S
authors: AS
authors: Ranawat
authors: S Raymond
authors: SR
authors: Golish
authors: Mark D
authors: MD
authors: Miller
authors: Paul E
authors: PE
authors: Caldwell
authors: Naveen
authors: N
authors: Singanamala
authors: Gehron
authors: G
authors: Treme
authors: Ryan
authors: R
authors: Costic
authors: Joseph M
authors: JM
authors: Hart
authors: Jon K
authors: JK
authors: Sekiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000295:instrumentation* / Q000379:methods; D002102:Cadaver; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000601:surgery; D008297:Male; D018583:Pliability; D011474:Prosthesis Design; D011475:Prosthesis Failure; D016059:Range of Motion, Articular; D012783:Shoulder Dislocation / Q000503:physiopathology / Q000601:surgery*; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D053441:Suture Anchors; D013536:Suture Techniques / Q000295:instrumentation*