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Updated: Apr 3, 2026
Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Predicting failures of suture anchors used for rotator cuff repair: a CT-based 3-dimensional finite element analysis
Hirotaka Sano1, Kei Imagawa2, Nobuyuki Yamamoto3
1Division of Orthopedics, Sendai City Hospital, Sendai, Japan.
Background:
Failure of inserted anchors has been recognized as one of the major pathomechanisms of re-tearing after rotator cuff repair.
Objective:
To predict the inserted anchor failure using CT-based 3-dimensional finite element method (CT/3D-FEM).
Methods:
Among twenty patients who underwent rotator cuff repair, 5 had anchor failure (failed anchor group) and 15 had no anchor failure (stable anchor group). A 3D model of proximal humerus was developed for each patient based on the CT data. A virtual pullout testing of TWINFIX™ anchors inserted into bone at 6 different sites was performed using FEM. Then, mean failure load of 6 anchors for each patient was compared between two groups. Moreover, an optimal cut-off value of the mean failure load was determined for predicting anchor failure.
Results:
The mean failure load in the failed anchor group (70.3 N) was significantly lower than that in the stable anchor group (119.0 N; p<0.0001). In our method, the optimum cut-off value of the mean failure load was 75.4 N.
Conclusions:
Failure of the inserted TWINFIX™ anchor could be predicted using CT/3D-FEM. In this method, there seemed to be a high risk of anchor failure in shoulders with a mean failure load of <75.4 N.
