Revisability of polyetheretherketone suture anchors utilised in primary and revision Bankart repair |
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| Institution: | 1. Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, Ludwig Maximilian University (LMU) Munich, Marchioninistrasse 15, 81377 Munich, Germany;2. Praxis für Orthopädie & Unfallchirurgie, Kastanienallee 9, 82049, Pullach-Großhesselohe, Germany;3. Doncaster and Bassetlaw NHS Trust, Thorne Road, Doncaster DN2 5LT, United Kingdom;4. Helios Klinik München Perlach, Schmidbauerstraße 44, 81737 Munich, Germany;1. Wake Forest School of Medicine, Department of Radiology, Winston-Salem, NC, USA;2. University of Missouri, Department of Orthopaedic Surgery, Columbia, MO, USA;3. Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, USA;1. Ningbo University School of Medicine, Ningbo, China;2. Department of Orthopaedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China;1. Department of Orthopaedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga, 520-2192, Japan;2. Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;3. Department of Orthopedic Surgery, Keio University, School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan;4. Department of Orthopedic Surgery, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Okayama, Okayama, 701-1154, Japan;5. Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan;6. Department of Orthopedic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan;7. Department of Orthopedic Surgery, National Hospital Organization Murayama Medical Center, 2-37-1 Gakuen, Musashimurayama, Tokyo, 208-0011, Japan;8. Department of Orthopedic Surgery, Shizuoka City Shimizu Hospital, 1231 Miyakami, Shimizu-ku, Shizuoka, 424-8636, Japan;9. Department of Orthopedic Surgery, Keiyu Hospital, 3-7-3 Minatomirai, Nishi-ku, Yokohama, Kanagawa, 220-0012, Japan;10. Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, 53 Honcho, Hirosaki, Aomori, 036-8203, Japan;11. Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-0856, Japan;12. Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka, 431-3125, Japan;13. Department of Orthopedics, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochugi, 329-0498, Japan;14. Department of Orthopedic Surgery, Graduate School of Medicine and Dental Science, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, Kagoshima, 890-8520, Japan;15. Department of Orthopedic Surgery, University of Yamanashi, 1110 Shimokato, Chuo-ku, Yamanashi, 409-3898, Japan;p. Department of Orthopedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1143, Japan;q. Department of Orthopedic Surgery, Niigata University Medicine and Dental General Hospital, 1-754 Asahimachidori, Chuo-ku, Niigata, Niigata, 951-8520, Japan;r. Department of Orthopedic Surgery, Tohoku Medical and Pharmaceutical University, 4-4-1 Komatsushima, Aobaku, Sendai, Miyagi, 981-8558, Japan;s. Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryomachi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan;t. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa-ku, Nagoya, Aichi, 466-0065, Japan;u. Department of Orthopedic Surgery, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan;v. Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan;w. Japanese Organization of the Study for Ossification of Spinal Ligament (JOSL), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan;1. Division of Sports Medicine, Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, U.S.A.;2. Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, California, U.S.A.;3. Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, U.S.A.;4. Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina, U.S.A. |
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| Abstract: | BackgroundPolyetheretherketone (PEEK) suture anchors are frequently used in Bankart shoulder stabilisation. This study analyzed the primary stability and revisability of PEEK anchors in-vitro in case of primary Bankart repair and revision Bankart repair after failed primary repair.MethodsTo simulate primary Bankart repair, 12 anchors (Arthrex PEEK PushLock® 3.5 mm) were implanted in 1, 3, 5, 7, 9 and 11 o'clock positions in cadaveric human glenoids and then cyclically tested. To simulate revision Bankart repair, 12 anchors were implanted in the same manner, over-drilled and 12 new anchors of the same diameter were implanted into the same bone socket as the primary anchors and then cyclically tested. The maximum failure loads (Fmax), system displacements, force at clinical failure and modes of failure were recorded.ResultsOne primary anchor failed prematurely due to a technical problem. Three out of 12 revision anchors (25%) dislocated while setting the 25 N preload. The Fmax, the displacement and clinical failure of the remaining 9 revision anchors were non-significant when compared to the 11 primary repair anchors. The main mode of failure in the primary and revision Bankart surgery group was suture slippage. Anchor dislocations were observed four times in the primary and once in the revision repair groups.ConclusionsRevision Bankart repair using PEEK anchors of the same diameter in a pre-existing bone socket is possible but bears high risk of premature anchor failure and can jeopardize the reconstruction. PEEK suture anchor in revision Bankart surgery should be implanted in a new bone socket if possible. |
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