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Glenoid suture anchor fixation strength: Effect of insertion angle
Omer A Ilahi1, Tarek Al-Fahl, Hasan Bahrani
1Department of Orthopedic Surgery, Baylor College of Medicine, Houston, Texas, USA. oilahi@mysurgeon.com
Summary
Orthogonal insertion of screw-in devices maximizes glenoid rim fixation strength. Deviating from this angle, especially in the anteroinferior quadrant, significantly reduces fixation strength, impacting labral reattachment success.
Area of Science:
- Orthopedic surgery
- Biomechanical engineering
- Sports medicine
Background:
- Glenoid rim fixation is crucial for shoulder stability and labral repair.
- Screw-in devices are commonly used, but their optimal insertion angle is debated.
- Understanding insertion angle effects is vital for improving surgical outcomes.
Purpose of the Study:
- To evaluate the impact of varying screw insertion angles on the fixation strength of devices in the glenoid rim.
- To identify optimal insertion angles for maximizing screw fixation in different glenoid quadrants.
Main Methods:
- Cadaveric glenoids were used for biomechanical analysis.
- 3.0-mm cannulated screws were inserted at orthogonal and deviated angles (20, 40 degrees) in four glenoid quadrants.
- Load to failure testing was performed to measure fixation strength.
Main Results:
- Orthogonal insertion yielded the highest fixation strength, particularly in the posterior superior quadrant.
- Deviating from the orthogonal angle significantly decreased fixation strength in most quadrants.
- The anteroinferior quadrant showed reduced fixation strength even with a 20-degree deviation.
Conclusions:
- Screw-in fixation devices should be inserted orthogonally to the glenoid rim to maximize labral reattachment strength.
- Surgical technique should prioritize orthogonal insertion, especially for Bankart repairs, due to lower fixation strength in the anteroinferior quadrant.