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The Journal of Hip Surgery 2021; 05(02): 055-061
DOI: 10.1055/s-0041-1729870
Original Article

Knotless Suture Anchors: A Comparative Biomechanical Study of Acetabular Rim Anchor Fixation with Implications for Hip Labral Repair

Patrick D. Rowan
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
,
James L. Cook
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
,
Will A. Bezold
1   Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
,
Nathan W. Skelley
2   Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, Missouri
3   Sanford Health Orthopaedics and Sports Medicine, Sanford USD Medical Center and Hospital, Sioux Falls, South Dakota
› Author Affiliations Funding This study was funded by The Barry J. Gainor Resident Research and Scholarship Endowment Fund and the University of Missouri Orthopaedic Association Research Fund. This study was conducted in compliance with the University of Missouri Institutional Review Board's policies regarding use of cadaveric specimens; no IRB number is associated with this project.
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Abstract

The purpose of this study was to analyze relevant initial-implantation biomechanical properties of five knotless suture anchors available for use in acetabular labral repair. Five knotless suture anchor constructs were tested: Arthrex PushLock 2.9, Arthrex PushLock 2.4, Arthrex SutureTak 3.0, Stryker CinchLock SS 2.4, and Stryker CinchLock Flex 2.4. Anchors were placed in synthetic bone blocks and in acetabular bone of cadaveric specimens. Constructs were subjected to cyclic and load-to-failure (LTF) testing. Displacement at 1, 100, 250, and 500 cycles, yield load, ultimate load, and failure mode were compared with statistically significant (p < 0.005) differences. PushLock 2.9 mm and CinchLock SS 2.4 anchor constructs had significantly less displacement than PushLock 2.4 mm after 1 cycle (p = 0.017) and 500 cycles (p = 0.043). Excluding “tare” displacement after the first cycle, all anchor constructs were associated with less than 2.0 mm of displacement after 500 cycles. Arthrex PushLock 2.4 and SutureTak 3.0 had the highest number of failures prior to completing cyclic loading. Arthrex PushLock 2.9 was associated with the highest LTF in cadaver (p = 0.00013) and synthetic (p = 0.009) bone models. Most common failure mode in cadaver bone was eyelet failure for all anchor types. Knotless suture anchors used for arthroscopic hip surgery (2.9 mm PushLock, 2.4 mm PushLock, 3.0 mm SutureTak, 2.4 mm CinchLock SS, and 2.4 mm CinchLock Flex) were associated with material properties that met or exceeded the reported thresholds for successful periarticular soft tissue repair surgeries. Based on cyclic and LTF testing in synthetic bone blocks and cadaveric acetabulums, 2.9 mm PushLocks and 2.4 mm CinchLock SS anchors may have potential biomechanical advantages over the other constructs tested. Further functional ex vivo and preclinical animal model studies are recommended to further characterize suture anchor constructs designed for acetabular labrum repair. These results provide novel and relevant biomechanical testing data that contribute to assessing knotless suture anchor constructs for use in acetabular labral repair.

Keywords

arthroscopic hip surgery - femoroacetabular impingement - knotless suture anchor constructs - acetabular labral repair - biomechanical testing


Publication History

Received: 10 July 2020

Accepted: 28 January 2021

Article published online:
09 June 2021

© 2021. Thieme. All rights reserved.

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