Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis
Abstract Purpose Suture anchors are commonly used to repair rotator cuff tendons in arthroscopy surgery, and several anchor materials have been created to maximize pull‐out strength and minimize iatrogenic damage. We hypothesized that all‐suture anchors have biomechanical properties equivalent to th...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-01-01
|
| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-023-00608-w |
| _version_ | 1797270740572045312 |
|---|---|
| author | Yi‐Shiuan Yang Chien‐An Shih Ching‐Ju Fang Tzu‐Teng Huang Kai‐Lan Hsu Fa‐Chuan Kuan Wei‐Ren Su Chih‐Kai Hong |
| author_facet | Yi‐Shiuan Yang Chien‐An Shih Ching‐Ju Fang Tzu‐Teng Huang Kai‐Lan Hsu Fa‐Chuan Kuan Wei‐Ren Su Chih‐Kai Hong |
| author_sort | Yi‐Shiuan Yang |
| collection | DOAJ |
| description | Abstract Purpose Suture anchors are commonly used to repair rotator cuff tendons in arthroscopy surgery, and several anchor materials have been created to maximize pull‐out strength and minimize iatrogenic damage. We hypothesized that all‐suture anchors have biomechanical properties equivalent to those of conventional anchors. Our purpose is to compare the biomechanical properties of different anchors used for rotator cuff repair. Methods The Embase, PubMed, Cochrane, and Scopus databases were searched for biomechanical studies on various suture anchors. The search keywords included rotator cuff tears and suture anchors, and two authors conducted study a selection, risk of bias assessment, and data extraction. The failure load, stiffness, and displacement were calculated using the mean differences with 95% confidence intervals (CIs). Failure modes were estimated using summary odds ratios with 95% CIs. The surface under the cumulative ranking curve was used for the relative ranking probabilities. A sensitivity analysis was performed by excluding studies using synthetic bones. Results The polyetheretherketone (PEEK) (p < 0.001) and all‐suture anchors (p < 0.001) had higher failure loads than the biocomposite anchors, whereas no significant difference was observed in stiffness among the anchors. The all‐suture (p = 0.006) and biocomposite anchors (p < 0.001) had displacements higher than the metal anchors. The relative ranking of the included anchors in failure loads and displacement changed in sensitivity analysis. The meta‐analysis did not find significant differences, but the relative ranking probabilities suggested that all‐suture anchor had a higher rate of anchor pull‐out and a lower rate of eyelet or suture breakage. In contrast, the metal anchors were associated with a higher number of eyelet breakage episodes. Conclusions All‐suture anchors showed significantly higher failure loads than the biocomposite anchors and similar cyclic displacements to the biocomposite and PEEK anchors. There were no significant differences in stiffness between all‐suture and conventional suture anchors. The relative ranking of biomechanical properties changed in sensitivity analysis, suggesting the potential effect of bone marrow density. Level of Evidence Level IV. |
| first_indexed | 2024-03-08T04:57:04Z |
| format | Article |
| id | doaj.art-02ea512f46f341099b3bbcca9ff81250 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-04-25T02:09:04Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-02ea512f46f341099b3bbcca9ff812502024-03-07T12:46:41ZengWileyJournal of Experimental Orthopaedics2197-11532023-01-01101n/an/a10.1186/s40634-023-00608-wBiomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysisYi‐Shiuan Yang0Chien‐An Shih1Ching‐Ju Fang2Tzu‐Teng Huang3Kai‐Lan Hsu4Fa‐Chuan Kuan5Wei‐Ren Su6Chih‐Kai Hong7Department of MedicineCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of Orthopaedic SurgeryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of SecretariatNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of MedicineCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of Orthopaedic SurgeryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of Orthopaedic SurgeryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of Orthopaedic SurgeryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwanDepartment of Orthopaedic SurgeryNational Cheng Kung University HospitalCollege of MedicineNational Cheng Kung UniversityTainanTaiwanAbstract Purpose Suture anchors are commonly used to repair rotator cuff tendons in arthroscopy surgery, and several anchor materials have been created to maximize pull‐out strength and minimize iatrogenic damage. We hypothesized that all‐suture anchors have biomechanical properties equivalent to those of conventional anchors. Our purpose is to compare the biomechanical properties of different anchors used for rotator cuff repair. Methods The Embase, PubMed, Cochrane, and Scopus databases were searched for biomechanical studies on various suture anchors. The search keywords included rotator cuff tears and suture anchors, and two authors conducted study a selection, risk of bias assessment, and data extraction. The failure load, stiffness, and displacement were calculated using the mean differences with 95% confidence intervals (CIs). Failure modes were estimated using summary odds ratios with 95% CIs. The surface under the cumulative ranking curve was used for the relative ranking probabilities. A sensitivity analysis was performed by excluding studies using synthetic bones. Results The polyetheretherketone (PEEK) (p < 0.001) and all‐suture anchors (p < 0.001) had higher failure loads than the biocomposite anchors, whereas no significant difference was observed in stiffness among the anchors. The all‐suture (p = 0.006) and biocomposite anchors (p < 0.001) had displacements higher than the metal anchors. The relative ranking of the included anchors in failure loads and displacement changed in sensitivity analysis. The meta‐analysis did not find significant differences, but the relative ranking probabilities suggested that all‐suture anchor had a higher rate of anchor pull‐out and a lower rate of eyelet or suture breakage. In contrast, the metal anchors were associated with a higher number of eyelet breakage episodes. Conclusions All‐suture anchors showed significantly higher failure loads than the biocomposite anchors and similar cyclic displacements to the biocomposite and PEEK anchors. There were no significant differences in stiffness between all‐suture and conventional suture anchors. The relative ranking of biomechanical properties changed in sensitivity analysis, suggesting the potential effect of bone marrow density. Level of Evidence Level IV.https://doi.org/10.1186/s40634-023-00608-wRotator cuff injuriesRotator cuff repairSuture anchorsAll‐suture anchorsBiocomposite anchorsPEEK anchor |
| spellingShingle | Yi‐Shiuan Yang Chien‐An Shih Ching‐Ju Fang Tzu‐Teng Huang Kai‐Lan Hsu Fa‐Chuan Kuan Wei‐Ren Su Chih‐Kai Hong Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis Journal of Experimental Orthopaedics Rotator cuff injuries Rotator cuff repair Suture anchors All‐suture anchors Biocomposite anchors PEEK anchor |
| title | Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis |
| title_full | Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis |
| title_fullStr | Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis |
| title_full_unstemmed | Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis |
| title_short | Biomechanical comparison of different suture anchors used in rotator cuff repair surgery–all‐suture anchors are equivalent to other suture anchors: a systematic review and network meta‐analysis |
| title_sort | biomechanical comparison of different suture anchors used in rotator cuff repair surgery all suture anchors are equivalent to other suture anchors a systematic review and network meta analysis |
| topic | Rotator cuff injuries Rotator cuff repair Suture anchors All‐suture anchors Biocomposite anchors PEEK anchor |
| url | https://doi.org/10.1186/s40634-023-00608-w |
| work_keys_str_mv | AT yishiuanyang biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT chienanshih biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT chingjufang biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT tzutenghuang biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT kailanhsu biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT fachuankuan biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT weirensu biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis AT chihkaihong biomechanicalcomparisonofdifferentsutureanchorsusedinrotatorcuffrepairsurgeryallsutureanchorsareequivalenttoothersutureanchorsasystematicreviewandnetworkmetaanalysis |