Clinical and radiological outcomes with PEEK suture anchors used in rotator cuff repair: our experience confirm that a perianchor fluid signal on RM does not affect clinical outcome at one year of follow up

Clinical and radiological outcomes with PEEK suture anchors used in rotator cuff repair: our experience confirm that a perianchor fluid signal on RM does not affect clinical outcome at one year of follow up

Authors

  • Paolo Di Benedetto clinic of orthopaedics, University Hospital of Udine
  • Giovanni Gorasso Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
  • Alessandro Beltrame Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
  • Francesco Mancuso Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
  • Michele Mario Buttironi Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy
  • Araldo Causero Clinic of Orthopedics, Academic Hospital of Udine, Udine, Italy Medical Department, Universitiy of Udine, Italy

Keywords:

polyetherketone (PEEK) suture anchors, shoulder, rotator cuff tear, tendon repair, arthroscopy

Abstract

Introduction / objectives

 Osteolytic-type reactions of the perianchor bone which in magnetic resonance are manifested as hyperintensity of the signal in T2 images are reported in many studies. T  The objective of the present study is to evaluate and compare to the literature data the clinical and radiological results of a group of patients who underwent arthroscopic suture of a rotator cuff tear using polyetherketone (PEEK) suture anchors.

Materials and methods

Twenty patients, aged between 44 and 73 years, who underwent arthroscopic repair of the rotator cuff for lesions smaller than 4 cm considered reparaible between August 2017 and January 2019, were enrolled in the present study. Patients were evaluated clinically with clinical examination, Constant scale and ASES scale pre and post surgery. MRI either pre and post operation at one year were evaluated to obtain data about tendon healing and evaluate bone reaction to PEEK anchors.

Results:

MRI analysis showed a tendon signal according to Sugaya classification of type 1 in the 25% of patients, type 2 in the 60% of cases and type 3 in the remaining 15% . Osteolysis was grade 0 in 65%, grade 1 in 30 % and grade 2 in 5% of cases. No anchors pull out or mobilization were reported.

Conclusions:

The presence of a T2 hyperintense signal osteolysis like on MRI control using PEEK anchors for the sutur of rotator cuff lesions does not find correlation whit the final clinical result of the procedure.

References

Templenhof S, Rupp S, Seil R. Age related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 1999; 8: 296-9.

Zumstein MA, et al. The biology of rotator cuff healing. Orthop Traumatol Surg Res (2016)

Stephen S Burkhart 1, Ian K Y Lo Arthroscopic rotator cuff repair J Am Acad Orthop Surg 2006 Jun; 14 (6): 333-46

Di Benedetto ED, Di Benedetto P, Fiocchi A, Beltrame A, Causero A. Partial repair in irreparable rotator cuff tear: our experience in long-term follow-up. Acta Biomed. 2017 Oct 18; 88 (4S): 69- 74

Di Benedetto P, Beltrame A, Cicuto C, Battistella C, Gisonni R, Cainero V, Causero A. Rotator Cuff Tears Reparability Index Based on Pre-Operative MRI: Our Experience. Acta Biomed, 90 (1-S), 36-46. 2019 Jan 10.

Kim JY, Park JS, Rhee YG. Can Preoperative Magnetic Resonance Imaging Predict the Reparability of Massive Rotator Cuff Tears? Am J Sports Med. 20 Jun; 45 (7): 1654-1663. doi: 10.1177 / 0363546517694160. Epub 2017 Mar 8.

Kuptniratsaikul V, Laohathaimongkol T, Umprai V, Yeekian C, Prasathaporn N. Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears. BMC Musculoskelet Disord. 2019 Mar 18; 20 (1): 111.

Di Benedetto P, Di Benedetto ED, Beltrame A, Gisonni R, Cainero V, Causero A. Arthroscopic rotator cuff repair with or without PrP: our experience. Acta Biomed. 2016 Apr 15; 87 Suppl 1: 75-83

Luke E Visscher, Chris Jeffery, Timothy Gilmour, Libby Anderson, et al. History of suture anchors in orthopedic surgery Review Clin Biomech (Bristol, Avon) 2019 Jan; 61: 70-78

Maureen Suchenski 1, Mary Beth McCarthy, David Chowaniec, Derek Hansen, William McKinnon, John Apostolakos, Robert Arciero, Augustus D Mazzocca. . 2010 Jun; 26 (6): 821-31.

Toth JM, Wang M, Estes BT, Scifert JL, Seim HB III, Turner AS. Polyetheretherketone as a biomaterial for spinal applications. Biomaterials 2006; 27: 324-334.

Pietrzak WS, Sarver DR, Verstynen ML. Bioabsorbable polymer science for the practicing surgeon. J Craniofac Surg1997;8:87-91.

Andres F Cobaleda Aristizabal 1, Eric J Sanders 2, F Alan Barber 2 Adverse events associated with biodegradable lactide-containing suture anchors Arthroscopy. 2014 May;30(5):555-60

Maureen Suchenski 1, Mary Beth McCarthy, David Chowaniec, Derek Hansen, William McKinnon, John Apostolakos, Robert Arciero, Augustus D Mazzocca Material properties and composition of soft-tissue fixation Arthroscopy. 2010 Jun; 26 (6): 821-31

Briem D, Strametz S, Schroder K, et al. Response of primary fi broblasts and osteoblasts to plasma treated polyetheretherketone (PEEK) surfaces. J Mater Sci Mater Med 2005; 16: 671-677.

Yu S, Hariram KP, Kumar R, Cheang P, Aik KK. In vitro apatite formation and its growth kinetics on hydroxyapatite / polyetheretherketone biocomposites. Biomaterials 2005; 26: 2343-2352.); hydroxyapatite fails to form on PEEK.

Constant CR, Murley AHG. A clinical method of functional assessment of the shoulder. Clin Orthop. 1987; 214: 160-164.

American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness.Michener LA, McClure PW, Sennett BJ.J Shoulder Elbow Surg. 2002 Nov-Dec; 11 (6): 587-94.

R. Padua, L. Paduab, E. Ceccarelli, R. Bondi F. Alviti, A. Castagna Italian version of ASES questionnaire for shoulder assessment: cross-cultural adaptation and validation Musculoskelet Surg (2010) 94 (Suppl 1): S85– S90

Yoshida M, Collin P, Josseaume T, Lädermann A, Goto H, Sugimoto K, Otsuka T. Post-operative rotator cuff integrity, based on Sugaya's classification, can reflect abduction muscle strength of the shoulder. Knee Surg Sports Traumatol Arthrosc. 2018 Jan; 26 (1): 161-168.

Kim SH, Oh JH, Lee OS, Lee HR, Hargens AR. Postoperative imaging of bioabsorbable anchors in rotator cuff repair. Am J Sports Med 2014; 42: 552–557.

Paolo Di Benedetto, Nunzio Lassandro, Alessandro Beltrame, Francesco Mancuso, Piero Giardini, Araldo Causero. Reliability of open architecture anchors in biocomposite material: medium term clinical and MRI evaluation. Our experience. Acta Biomed 2020; Vol. 91, Supplement 4: 189-195

Jae-Hoo Lee and Yong-Beom Lee Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study J Clin Med. 2020 Aug; 9 (8): 2545.Published online 2020 Aug 6.

Kim SH, Yang SH, Rhee SM, Lee KJ, Kim HS, Oh JH. The formation of perianchor fluid associated with various suture anchors used in rotator cuff repair: all-suture, polyetheretherketone, and biocomposite anchors. Bone Joint J. 2019 Dec; 101-B (12): 1506-1511

Ivan Micic 1, Erica Kholinne 2, Jae-Man Kwak 3, Kyoung-Hwan Koh 4, In-Ho Jeon 5 Osteolysis is observed around both bioabsorbable and nonabsorbable anchors on serial magnetic resonance images of patients undergoing arthroscopic rotator cuff repair Acta Orthop Traumatol Turc 2019 Nov;53(6):414-419

Speer KP, Warren RF, Pagnani M, Warner JJ. An arthroscopic technique for anterior stabilization of the shoulder with a bioabsorbable tack. J Bone Joint Surg Am. 1996; 78 (12): 1801-1807.

Richard Ma 1, Robert Chow, Luke Choi, David Diduch Arthroscopic rotator cuff repair: suture anchor properties, modes of failure and technical considerations Expert Rev Med Devices . 2011 May;8(3):377-87

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Published

30-12-2020

How to Cite

1.
Clinical and radiological outcomes with PEEK suture anchors used in rotator cuff repair: our experience confirm that a perianchor fluid signal on RM does not affect clinical outcome at one year of follow up. Acta Biomed [Internet]. 2020 Dec. 30 [cited 2024 Mar. 29];91(14-S):e2020019. Available from: https://mattioli1885journals.com/index.php/actabiomedica/article/view/10986