Onlay Fixation With an All-Suture Anchor Provides Sufficient Biomechanical Stability for Lateral Extra-articular...

Area of Science:

• Orthopedic surgery
• Biomedical engineering
• Sports medicine

Background:

• Spiked ligament staples (SLSs) and biocomposite suture anchors (BSAs) are common fixation devices for lateral extra-articular tenodesis (LET).
• Existing devices present issues like hardware prominence, tunnel penetration, and soft tissue irritation.
• Knotless all-suture anchors (ASAs) offer a promising alternative to address these limitations.

Purpose of the Study:

• To compare the biomechanical performance of LET using ASAs versus traditional SLSs and BSAs.
• To evaluate fixation strength and cyclic displacement under simulated anterolateral forces.

Main Methods:

• Human iliotibial band grafts were fixed to porcine femurs using ASAs, SLSs, or BSAs.
• Cyclic loading and load-to-failure tests were conducted using an electromechanical testing machine.
• Key outcomes measured included cyclic displacement, survivorship, and ultimate load to failure.

Main Results:

• ASAs showed comparable cyclic displacement to SLSs and significantly less displacement than BSAs.
• Survivorship was 100% for ASAs, 83% for SLSs, and 0% for BSAs.
• Ultimate load to failure was comparable between ASAs and SLSs, with both exceeding native anterolateral ligament requirements.

Conclusions:

• ASAs represent a biomechanically sound alternative for iliotibial band fixation in LET.
• This technique may mitigate complications associated with SLSs and BSAs.
• ASAs provide comparable fixation strength and improved survivorship compared to traditional methods.