Pull-out strength of five suture anchors

Area of Science:

• Orthopedic biomechanics
• Biomaterials science
• Surgical device engineering

Background:

• Suture anchors are crucial for soft tissue reattachment in orthopedic surgery.
• Understanding the biomechanical performance of different suture anchor designs is essential for optimizing surgical outcomes.
• Cadaveric models provide a valuable platform for evaluating device failure modes under controlled conditions.

Purpose of the Study:

• To compare the biomechanical properties and failure modes of five commercially available suture anchor devices.
• To identify factors influencing suture anchor performance, including bone quality and loading direction.
• To determine which suture anchor exhibits superior fixation strength in human cadaveric proximal tibiae.

Main Methods:

• Testing five suture anchor devices to failure in 198 trials using human cadaveric proximal tibiae.
• Evaluating anchor performance based on insertion success, pull-out strength, and failure mechanisms.
• Analyzing the effect of bone thickness, proximity to the joint surface, and loading direction on anchor fixation.

Main Results:

• The Mitek GII anchor demonstrated the lowest pull-out failure rate (19%) compared to others (46%).
• Anchors performed significantly better in thicker cortical bone, further from the joint, and when loaded parallel to the bone surface (p < 0.05).
• In perpendicular loading, Mitek GII and Statak anchors exhibited the highest mean failure loads (82.5 N and 90.2 N, respectively).
• The Acufex Rod TAG device experienced insertion failures (23%) in thicker cortical bone.

Conclusions:

• Suture anchor fixation strength is significantly influenced by bone quality and loading conditions.
• The Mitek GII anchor appears to offer superior pull-out resistance, making it a potentially reliable option for tibial fixation.
• Careful consideration of anchor placement and anticipated loading is critical for successful soft tissue reattachment in orthopedic surgery.