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Heath B. Henninger - One of the best experts on this subject based on the ideXlab platform.
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biomechanical evaluation of subpectoral biceps tenodesis dual Suture Anchor versus interference screw fixation
Journal of Shoulder and Elbow Surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference screws have been shown to have superior biomechanical properties compared to Suture Anchors; although, only single Anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare interference screw fixation with a Suture Anchor construct, using 2 Anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an interference screw (8 � 12 mm; Arthrex) or 2 Suture Anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture Anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the Suture Anchor construct ‘‘softened’’ (decreased 9%, P <.001), whereas the screw construct was unchanged (0.4%, P ¼ .078). Suture Anchors had significantly higher ultimate failure strain than the screws (P ¼ .003), but ultimate failure loads were similar between constructs: 280 � 95 N (screw) vs 310 � 91 N (Anchors) (P ¼ .438). Conclusion: The interference screw was significantly stiffer than the Suture Anchor construct. Ultimate failure loads were similar between constructs, unlike previous reports indicating interference screws had higher ultimate failure loads compared to Suture Anchors. Neither construct was superior with regards to stress; although, Suture Anchors could withstand greater elongation prior to failure. Level of evidence: Basic Science, Biomechanics, Cadaver Model. 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.
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Biomechanical evaluation of subpectoral biceps tenodesis: dual Suture Anchor versus interference screw fixation
Journal of shoulder and elbow surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference screws have been shown to have superior biomechanical properties compared to Suture Anchors; although, only single Anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare interference screw fixation with a Suture Anchor construct, using 2 Anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an interference screw (8 � 12 mm; Arthrex) or 2 Suture Anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture Anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the Suture Anchor construct ‘‘softened’’ (decreased 9%, P
Robert Z. Tashjian - One of the best experts on this subject based on the ideXlab platform.
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biomechanical evaluation of subpectoral biceps tenodesis dual Suture Anchor versus interference screw fixation
Journal of Shoulder and Elbow Surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference screws have been shown to have superior biomechanical properties compared to Suture Anchors; although, only single Anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare interference screw fixation with a Suture Anchor construct, using 2 Anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an interference screw (8 � 12 mm; Arthrex) or 2 Suture Anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture Anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the Suture Anchor construct ‘‘softened’’ (decreased 9%, P <.001), whereas the screw construct was unchanged (0.4%, P ¼ .078). Suture Anchors had significantly higher ultimate failure strain than the screws (P ¼ .003), but ultimate failure loads were similar between constructs: 280 � 95 N (screw) vs 310 � 91 N (Anchors) (P ¼ .438). Conclusion: The interference screw was significantly stiffer than the Suture Anchor construct. Ultimate failure loads were similar between constructs, unlike previous reports indicating interference screws had higher ultimate failure loads compared to Suture Anchors. Neither construct was superior with regards to stress; although, Suture Anchors could withstand greater elongation prior to failure. Level of evidence: Basic Science, Biomechanics, Cadaver Model. 2013 Journal of Shoulder and Elbow Surgery Board of Trustees.
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Biomechanical evaluation of subpectoral biceps tenodesis: dual Suture Anchor versus interference screw fixation
Journal of shoulder and elbow surgery, 2013Co-Authors: Robert Z. Tashjian, Heath B. HenningerAbstract:Background: Subpectoral biceps tenodesis has been reliably used to treat a variety of biceps tendon pathologies. Interference screws have been shown to have superior biomechanical properties compared to Suture Anchors; although, only single Anchor constructs have been evaluated in the subpectoral region. The purpose of this study was to compare interference screw fixation with a Suture Anchor construct, using 2 Anchors for a subpectoral tenodesis. Methods: A subpectoral biceps tenodesis was performed using either an interference screw (8 � 12 mm; Arthrex) or 2 Suture Anchors (Mitek G4) with #2 FiberWire (Arthrex) in a Krackow and Bunnell configuration in seven pairs of human cadavers. The humerus was inverted in an Instron and the biceps tendon was loaded vertically. Displacement driven cyclic loading was performed followed by failure loading. Results: Suture Anchor constructs had lower stiffness upon initial loading (P ¼.013). After 100 cycles, the stiffness of the Suture Anchor construct ‘‘softened’’ (decreased 9%, P
Craig L Israelite - One of the best experts on this subject based on the ideXlab platform.
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Suture Anchor repair of patellar tendon rupture after total knee arthroplasty.
Journal of Knee Surgery, 2012Co-Authors: Atul F Kamath, Roshan P. Shah, Nathan Summers, Craig L IsraeliteAbstract:Extensor mechanism disruption after total knee arthroplasty (TKA) is a complex problem that often requires surgical repair for functional deficits. We present a brief technical note on Suture Anchor fixation of a patellar tendon rupture after TKA. A surgical technique and literature review follows. Although Suture Anchor fixation is well described for tendinous repairs in other areas of orthopedic surgery, no study has discussed the use of Suture Anchors in patellar tendon repair after TKA. The technique must be evaluated in more patients with longer follow-up before adoption.
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Suture Anchor repair of quadriceps tendon rupture after total knee arthroplasty
Journal of Arthroplasty, 2011Co-Authors: Tae Won B Kim, Atul F Kamath, Craig L IsraeliteAbstract:Disruption of the extensor mechanism after total knee arthroplasty (TKA) is a devastating complication, usually requiring surgical repair. Although Suture Anchor fixation is well described for repair of the ruptured native knee quadriceps tendon, no study has discussed the use of Suture Anchors in quadriceps repair after TKA. We present an illustrative case of successful Suture Anchor fixation of the quadriceps mechanism after TKA. The procedure has been performed in a total of 3 patients. A surgical technique and brief review of the literature follows. Suture Anchor fixation of the quadriceps tendon is a viable option in the setting of rupture after TKA.
Reuben Gobezie - One of the best experts on this subject based on the ideXlab platform.
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the outcome and structural integrity of arthroscopic rotator cuff repair with use of the double row Suture Anchor technique surgical technique
Journal of Bone and Joint Surgery American Volume, 2008Co-Authors: Laurent Lafosse, Roman Brzoska, Bruno Toussaint, Reuben GobezieAbstract:BACKGROUND: The reported rate of failure after arthroscopic rotator cuff repair has varied widely. The influence of the repair technique on the failure rates and functional outcomes after open or arthroscopic rotator cuff repair remains controversial. The purpose of the present study was to evaluate the functional and anatomic results of arthroscopic rotator cuff repairs performed with the double-row Suture Anchor technique on the basis of computed tomography or magnetic resonance imaging arthrography in order to determine the postoperative integrity of the repairs. METHODS: A prospective series of 105 consecutive shoulders undergoing arthroscopic double-row rotator cuff repair of the supraspinatus or a combination of the supraspinatus and infraspinatus were evaluated at a minimum of two years after surgery. The evaluation included a routine history and physical examination as well as determination of the preoperative and postoperative strength, pain, range of motion, and Constant scores. All shoulders had a preoperative and postoperative computed tomography arthrogram (103 shoulders) or magnetic resonance imaging arthrogram (two shoulders). RESULTS: There were thirty-six small rotator cuff tears, forty-seven large isolated supraspinatus or combined supraspinatus and infraspinatus tendon tears, and twenty-two massive rotator cuff tears. The mean Constant score (and standard deviation) was 43.2 ± 15.1 points (range, 8 to 83 points) preoperatively and 80.1 ± 11.1 points (range, 46 to 100 points) postoperatively. Twelve of the 105 repairs failed. Intact rotator cuff repairs were associated with significantly increased strength and active range of motion. CONCLUSIONS: Arthroscopic repair of a rotator cuff tear with use of the double-row Suture Anchor technique results in a much lower rate of failure than has previously been reported in association with either open or arthroscopic repair methods. Patients with an intact rotator cuff repair have better pain relief than those with a failed repair. After repair, large and massive rotator cuff tears result in more postoperative weakness than small tears do. LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. ORIGINAL ABSTRACT CITATION: “The Outcome and Structural Integrity of Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor Technique” (2007;89:1533-41).
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interference screw vs Suture Anchor fixation for open subpectoral biceps tenodesis does it matter
BMC Musculoskeletal Disorders, 2008Co-Authors: Peter J. Millett, Brett Sanders, Reuben Gobezie, Sepp Braun, Jon J P WarnerAbstract:Background Bioabsorbable interference screw fixation has superior biomechanical properties compared to Suture Anchor fixation for biceps tenodesis. However, it is unknown whether fixation technique influences clinical results.
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the outcome and structural integrity of arthroscopic rotator cuff repair with use of the double row Suture Anchor technique
Journal of Bone and Joint Surgery American Volume, 2007Co-Authors: Laurent Lafosse, Bruno Toussaint, Roman Brozska, Reuben GobezieAbstract:Background: The reported rate of failure after arthroscopic rotator cuff repair has varied widely. The influence of the repair technique on the failure rates and functional outcomes after open or arthroscopic rotator cuff repair remains controversial. The purpose of the present study was to evaluate the functional and anatomic results of arthroscopic rotator cuff repairs performed with the double-row Suture Anchor technique on the basis of computed tomography or magnetic resonance imaging arthrography in order to determine the postoperative integrity of the repairs. Methods: A prospective series of 105 consecutive shoulders undergoing arthroscopic double-row rotator cuff repair of the supraspinatus or a combination of the supraspinatus and infraspinatus were evaluated at a minimum of two years after surgery. The evaluation included a routine history and physical examination as well as determination of the preoperative and postoperative strength, pain, range of motion, and Constant scores. All shoulders had a preoperative and postoperative computed tomography arthrogram (103 shoulders) or magnetic resonance imaging arthrogram (two shoulders). Results: There were thirty-six small rotator cuff tears, forty-seven large isolated supraspinatus or combined supraspinatus and infraspinatus tendon tears, and twenty-two massive rotator cuff tears. The mean Constant score (and standard deviation) was 43.2 ± 15.1 points (range, 8 to 83 points) preoperatively and 80.1 ± 11.1 points (range, 46 to 100 points) postoperatively. Twelve of the 105 repairs failed. Intact rotator cuff repairs were associated with significantly increased strength and active range of motion. Conclusions: Arthroscopic repair of a rotator cuff tear with use of the double-row Suture Anchor technique results in a much lower rate of failure than has previously been reported in association with either open or arthroscopic repair methods. Patients with an intact rotator cuff repair have better pain relief than those with a failed repair. After repair, large and massive rotator cuff tears result in more postoperative weakness than small tears do. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
Christopher S Ahmad - One of the best experts on this subject based on the ideXlab platform.
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distal biceps tendon repair a cadaveric analysis of Suture Anchor and interference screw restoration of the anatomic footprint
American Journal of Sports Medicine, 2009Co-Authors: Charles M Jobin, Matthew A Kippe, Thomas R Gardner, William N Levine, Christopher S AhmadAbstract:BackgroundDistal biceps tendon repair with interference screw or double Suture-Anchor fixation are 2 successful techniques performed with either 1- or 2-incision approaches. No study has examined the accuracy and quality of the repaired tendon footprint with these devices and approaches.HypothesisA 2-incision approach will allow a more anatomic repair of the distal biceps footprint compared with a 1-incision anterior approach. Fixation technique will affect insertional footprint location and footprint contact area.Study DesignControlled laboratory study.MethodsAfter randomization, 36 distal biceps repairs were performed on human cadaveric upper extremity specimens, with 1- or 2-incision approaches and with fixation devices of either two 5.5-mm Suture Anchors or an 8-mm interference screw. Native and repaired footprint areas and centroid location were calculated with a 3-dimensional digitizer.ResultsInterference screw repair had the smallest footprint area (135 mm2) compared with Suture Anchor repair (197 ...
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Suture Anchor and percutaneous intra-articular transtendon biceps tenodesis.
Sports medicine and arthroscopy review, 2008Co-Authors: Chris Moros, William N Levine, Christopher S AhmadAbstract:Several arthroscopic biceps tenodesis techniques have been described for surgical management of tendonitis and/or partial thickness tears of the long head of the biceps brachii tendon resulting in recalcitrant anterior shoulder pain. This chapter describes an arthroscopic tenodesis using percutaneous intra-articular transtendon technique with Suture Anchor fixation. The percutaneous technique allows excellent access to the biceps tendon, and the addition of a Suture Anchor provides superior fixation to isolated soft tissue fixation.
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tendon bone interface motion in transosseous Suture and Suture Anchor rotator cuff repair techniques
American Journal of Sports Medicine, 2005Co-Authors: Christopher S Ahmad, Andrew M Stewart, Rolando Izquierdo, Louis U BiglianiAbstract:BackgroundAlthough many studies involving rotator cuff repair fixation have focused on ultimate fixation strength and ability to restore the tendon's native footprint, no studies have characterized the stability of the repair with regard to motion between the tendon and repair site footprint.HypothesisSuture Anchor fixation for rotator cuff repair has greater interface motion between tendon and bone than does transosseous Suture fixation.Study DesignControlled laboratory study.MethodsTwelve fresh-frozen human cadaveric shoulders were tested in a custom device to position the shoulder in internal and external rotations with simulated supraspinatus muscle loading. Tendon motion relative to the insertional footprint on the greater tuberosity was determined optically using a digital camera rigidly connected to the humerus, with the humerus positioned at 60° of internal rotation and 60° of external rotation. Testing was performed for the intact tendon, a complete supraspinatus tear, a Suture Anchor repair, and...
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tendon to bone pressure distributions at a repaired rotator cuff footprint using transosseous Suture and Suture Anchor fixation techniques
American Journal of Sports Medicine, 2005Co-Authors: Maxwell C Park, William N Levine, Edwin R Cadet, Louis U Bigliani, Christopher S AhmadAbstract:Background: Interface contact pressure between the tendon and bone has been shown to influence healing. This study evaluates the interface pressure of the rotator cuff tendon to the greater tuberosity for different rotator cuff repair techniques.Hypothesis: The transosseous tunnel rotator cuff repair technique provides larger pressure distributions over a defined insertion footprint than do Suture Anchor techniques.Study Design: Controlled laboratory study.Methods: Simulated rotator cuff tears over a 1 × 2-cm infraspinatus insertion footprint were created in 25 bovine shoulders. A transosseous tunnel simple Suture technique (n = 8), Suture Anchor simple technique (n = 9), and Suture Anchor mattress technique (n = 8) were used for repair. Pressurized contact areas and mean pressures of the repaired tendon against the tuberosity were determined using pressure-sensitive film placed between the tendon and the tuberosity.Results: The mean contact area between the tendon and tuberosity insertion footprint was s...
