Biomechanical Studies for Glenoid Based Labral Repairs With Suture Anchors Do Not Use Consistent Testing Methods: A...

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Shoulder instability and SLAP lesions often require surgical repair using suture anchors.
• Biomechanical testing is essential for evaluating the efficacy of these repairs.
• Variability in testing protocols can hinder the interpretation and comparison of study findings.

Purpose of the Study:

• To systematically review and identify variability in biomechanical testing protocols for laboratory-based studies on suture anchor repair for glenohumeral shoulder instability and SLAP lesions.

Main Methods:

• A systematic review of Medline, Embase, Scopus, and Google Scholar was conducted.
• Studies focused on biomechanical testing of labral-based suture anchor repair for shoulder instability and SLAP lesions.
• Risk of bias and study quality were assessed; heterogeneity was evaluated.

Main Results:

• Forty-one studies were included, with a high prevalence of serious or critical risk of bias and variable study quality.
• Significant inconsistencies were found in testing methods, including preloading, load to failure, cyclic loading protocols, anchor insertion angles, and load directions.
• Common outcome measures included load to failure, failure mode, and stiffness.

Conclusions:

• There is a lack of consistency in biomechanical testing protocols for suture anchor repair of shoulder instability and SLAP lesions.
• Substantial variations in testing methods prevent direct comparability between studies.
• Standardization of biomechanical testing protocols is strongly recommended to improve the reliability and comparability of future research.