Reliability of open architecture anchors in biocomposite material: medium term clinical and MRI evaluation. Our experience.

Main Article Content

Paolo Di Benedetto
Nunzio Lassandro
Alessandro Beltrame
Francesco Mancuso
Piero Giardini
Araldo Causero

Keywords

open architecture anchors, shoulder, rotator cuff, tear, tendon repair, arthroscopy

Abstract

Objectives: Comparing radiologic bone ingrowth and the clinical outcomes of an open-construct
(PEEK) (polyether ether ketone) suture anchor with those of a bio-composite suture anchor (glycolic polylactic
acid anchors, beta-tricalcium phosphate and calcium sulphate) in patients with arthroscopic rotator
cuff repair. Methods: From August 2017 to January 2019, 33 patients of both sexes, aged between 44 and
78 years underwent arthroscopic rotator cuff repair for tears considered repairable with an extension not exceeding4 cm. The bioabsorbable anchors used comprised glycolic polylactic acid/beta-tricalcium phosphate/
calcium sulphate, and the non-absorbable anchors in polyetheretherketone (PEEK). All patients underwent
MRI evaluation at 12 months postoperatively to determine complications and identify any re-tear. Results:
Clinical scores showed an improvement from both clinical and functional point of view. There were no statistically significant changes compared to the physical examination. On radiographs, mobilizations, anchor
pull-outs or other complications did not occur in each group. Conclusions: Shoulder function improved after
complete repair of the rotator cuff and similar clinical results were achieved regardless of the material and
shape of the suture anchor. The bioabsorbable anchors in innovative open architecture material seem to have
results comparable to peek anchors. Unfortunately, further studies are needed to define the advantages in using one material compared to the other. (www.actabiomedica.it)

Abstract 936 | PDF Downloads 281

References

1. Aug Deprés-Tremblay G, Chevrier A, Snow M, Hurtig MB, Rodeo S, Buschmann - Rotator cuff repair: a review of surgical techniques, animal models, and new technologies under development. J Shoulder Elbow Surg. 2016.
2. Bulman S, Cotton N, Barnes G. Bone&Joint Science -Vol6(2)Dic 2016.
3. Templenhof S, Rupp S, Seil R. Age related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 199;8:296-9.
4. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010;19:116-20.

5. Francesco Oliva, Leonardo Osti, Johnny Padulo and Nicola Maffulli. Epidemiology of the rotator cuff tears: a new incidence related to thyroid disease. Muscles Ligaments Tendons J. 2014 Jul-Sep; 4(3): 309–314.
6. Di Benedetto ED¹, 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.
7. DeOrio J.K., Cofield . “Results of a second attempt at surgical repair of a failed initial rotator-cuff repair”. J. Bone Joint Surg Am 1984 Apr; 66(4):563-7.
8. 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.
9. Iannotti JP. Full-thickness rotator cuff tears: factors affecting surgical outcome. J Am Acad Orthop Surg 1994; 2: 87–95.
10. 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.

11. 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.

12. 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.

13. Denard PJ, Burkhart SS. The evolution of suture anchors in arthroscopic rotator cuff repair. Arthroscopy. 2013;29:1589-1595.
14. Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional out-come after arthroscopic double-row rotator cuff repair. A prospective outcomestudy. J Bone Joint Surg Am 2007;89:953–60.
15. Long-term degradation of poly-lactic co-glycolide/β-tricalcium phosphate biocomposite anchors in arthroscopic bankart repair: a prospective study. Randelli P, Compagnoni R, Aliprandi A, Cannaò PM, Ragone V, Tassi A, Cabitza P. Arthroscopy. 2014 Feb;30(2):165-71.

16. Suchenski et. al. (2010) J. Arthro. and Rel. Res. Vol. 26(6).

17. Chih-Chu Chang, Section IV:44, “Biodegradable Polymeric Biomaterials” in The Biomedical Engineering Handbook. Bronzino JD Ed. CRC Press.
18. Costantino and Friedman (1994) Otolaryngol Clin North Am. 1994 Oct;27(5).
19. Ogose et al (2006) Biomaterials Vol. 27(8).

20. Pietrzak and Ronk (2000) J Craniofacial Surg. Vol 11(4).
21. Walsh et al (2003) Clin. Orthop. Rel. Res. Vol 406.
22. Constant CR, Murley AHG. A clinical method of functional assessment of the shoulder. Clin Orthop. 1987;214:160-164.

23. 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.

24. 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.

25. Vonhoegen J, John D, Hägermann C. Osteoconductive resorption characteristics of a novel biocomposite suture anchor material in rotator cuff repair. J Orthop Surg Res. 2019 Jan 9;14(1):12.
26. Kim SH¹, Oh JH, Lee OS, Lee HR, Hargens AR. Postoperative imaging of bioabsorbable anchors in rotator cuff repair. Am J Sports Med. 2014 Mar;42(3):552-7.

27. Kim SH, Kim DY, Kwon JE, Park JS, Oh JH. Perianchor cyst formation around biocomposite biodegradable suture anchors after rotator cuff repair. Am J Sports Med 2015;43:2907-2912.

28. Speer KP, Warren RF. Arthroscopic shoulder stabilization: a role for biodegradable materials. Clin Orthop Relat Res. 1993;291:67-74.

29. Milewski, MD, Diduch, DR, Hart, JM, Tompkins M, Ma SY, Gaskin, CM. Bone Replacement of Fast-Absorbing Biocomposite Anchors in Arthroscopic Shoulder. Labral Repairs American Journal of Sports Medicine. 2012;40( 6): 1392-1401.

30. Barber FA, Dockery WD, Cowden CH 3rd. The degradation outcome of biocomposite suture anchors made from poly L-lactide-co-glycolide and beta-tricalcium phosphate. Arthroscopy 2013;29:1834-1839.

31. Chahla J, Liu JN, Manderle B, Beletsky A, Cabarcas B, Gowd A, Inoue N, Chubinskaya S, Trenhaile S, Forsythe B, Cole B, Verma N. Bony Ingrowth of Coil-Type Open Architecture Anchors Compared with Screw-Type PEEK Anchors for the Medial Row in Rotator Cuff Repair. A Randomized Controlled Trial, Arthroscopy: The Journal of Arthroscopic and Related Surgery (2020).