Acetabular All-Suture Anchor for Labral Repair: Incidence of Intraoperative Failure due to Pullout

To report on the incidence and features of intraoperative anchor pullout in a consecutive series of patients undergoing arthroscopic labral repair of the hip.

Over an 18-month period, 434 consecutive cases underwent labral repair by a single surgeon with a particular anchor system. The following data were recorded: (1) age and gender of all cases; (2) number of anchors used; (3) number of cases in which intraoperative anchor failure occurred; (4) number of anchors that failed; and (5) age and gender of those cases in which anchor failure occurred. Failures were reported for 3-month intervals. One patient underwent repair with an alternative anchor system during this time period and was excluded.

Mean age was 34.2 (14-71) years with 180 males and 254 females. A total of 2,007 anchors were used, averaging 4.6 per case (1-8). Thirty-three anchors pulled out among 30 patients, representing a 1.6% incidence among all anchors. Mean age among pullouts was 37.8 (17-54) years with 11 males and 19 females. There was no difference compared with patient population in which no anchor pulled: mean 33.9 (14-71) years (P = .085) with 169 males and 235 females (P = .578). Pullouts were evenly distributed over the 3-month intervals (4, 4, 6, 6, 5, 8). Pullout was mostly due to failure to securely imbed the anchor in bone. Only 2 were known to pull out in the presence of being securely seated in bone.

These data support that the security of this particular all-suture anchor at implantation is exceptionally reliable for a single experienced surgeon, and there is no demonstrable learning curve. LEVEL OF EVIDENCE: Level IV, retrospective review of a case series.