Rotator cuff repair with bioabsorbable screws: An in vivo and ex vivo investigation
Purpose: The purpose of this study was to evaluate in vivo the clinical outcomes of rotator cuff repairs with bioabsorbable screws compared with metal suture anchors, and to compare the ex vivo initial load to failure of rotator cuff repairs using 3 different bioabsorbable screws, suture anchors, an...
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| Veröffentlicht in: | Arthroscopy 2003-03, Vol.19 (3), p.239-248 |
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| creator | Cummins, Craig A. Strickland, Sabrina Appleyard, Richard C. Szomor, Zoltan L. Marshall, Jeanette Murrell, George A.C. |
| description | Purpose: The purpose of this study was to evaluate in vivo the clinical outcomes of rotator cuff repairs with bioabsorbable screws compared with metal suture anchors, and to compare the ex vivo initial load to failure of rotator cuff repairs using 3 different bioabsorbable screws, suture anchors, and transosseous sutures. Type of Study: In vivo clinical outcomes investigation, and ex vivo biomechanical study. Methods: Three cohorts of patients with rotator cuff tears that measured less than 4 cm2, were sequentially repaired with Mitek Rotator Cuff QuickAnchors (Mitek Surgical Products, Norwood, MA) (n = 9), Arthrex Headed Bio-Corkscrews (n = 9) (Arthrex, Naples, FL), and Mitek Rotator Cuff QuickAnchors (n = 9). Patients were systematically assessed with a specific shoulder questionnaire and 23 shoulder tests performed preoperatively and at 1 and 6 weeks, 3 and 6 months, and 1 year postoperatively. A correlative ex vivo biomechanical study was performed on 53 ovine shoulders to evaluate the initial failure load properties of bioabsorbable screws compared with fixation with suture anchors and transosseous sutures. Results: In the in vivo portion of the study, the cohort treated with the Headed Bio-Corkscrew demonstrated no improvement on any measured parameter until 1-year after rotator cuff repair. In contrast, shoulders repaired with Mitek Rotator Cuff QuickAnchors demonstrated improved overall shoulder function as early as 6 weeks postoperatively (P =.002), had a better constant score at 1-year after repair (88 ± 9 v 73 ± 17; P =.016), and a lower rate of revision rotator cuff repair (P =.029). In the ex vivo portion of the study, the bioabsorbable headed screws, Headed Bio-Corkscrew (100 ± 30 N) and BioTwist (76 ± 35 N), had inferior initial failure load properties compared with suture anchors (140 ± 36 N) and transosseous sutures (147 ± 68 N). In contrast, the BioCuff (190 ± 56 N), a bioabsorbable implant that used a screw and serrated washer design, had equivalent initial failure load properties as the suture repairs. Conclusions: This investigation had poorer early outcomes, a lower shoulder functional score 1-year after repair, and a higher rate of repeat surgery in patients who had their rotator cuff repaired with a bioabsorbable screw than in patients who had their shoulders repaired with a standard metal suture anchor. Furthermore, the biomechanical testing demonstrated a lower tensile load to failure in the tendons repaired with a simple screw de |
| doi_str_mv | 10.1053/jars.2003.50013 |
| format | Article |
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Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 19, No 3 (March), 2003: pp 239–248</description><identifier>ISSN: 0749-8063</identifier><identifier>EISSN: 1526-3231</identifier><identifier>DOI: 10.1053/jars.2003.50013</identifier><identifier>PMID: 12627147</identifier><identifier>CODEN: ARTHE3</identifier><language>eng</language><publisher>Philadelphia, PA: Elsevier Inc</publisher><subject>Absorbable Implants ; Aged ; Anchors ; Animals ; Arthroscopy ; Bioabsorbable ; Biological and medical sciences ; Biomechanical ; Bone Screws ; Cohort Studies ; Debridement ; Equipment Failure ; Female ; Follow-Up Studies ; Humans ; Implants, Experimental ; Load to failure ; Male ; Medical sciences ; Middle Aged ; Ovine infraspinatus model ; Pain, Postoperative - epidemiology ; Pain, Postoperative - etiology ; Prospective Studies ; Recovery of Function ; Reoperation - statistics & numerical data ; Rotator cuff ; Rotator Cuff - surgery ; Rotator Cuff Injuries ; Sheep ; Shoulder Pain - epidemiology ; Shoulder Pain - etiology ; Species Specificity ; Stress, Mechanical ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Suture Techniques - instrumentation ; Technology. Biomaterials. Equipments ; Treatment Outcome</subject><ispartof>Arthroscopy, 2003-03, Vol.19 (3), p.239-248</ispartof><rights>2003 Arthroscopy Association of North America</rights><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c373t-984f8bde6a7473f0ac54900f706e793e1af8165f25c691a5330f33101bc103af3</citedby><cites>FETCH-LOGICAL-c373t-984f8bde6a7473f0ac54900f706e793e1af8165f25c691a5330f33101bc103af3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0749806302376400$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14618091$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12627147$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cummins, Craig A.</creatorcontrib><creatorcontrib>Strickland, Sabrina</creatorcontrib><creatorcontrib>Appleyard, Richard C.</creatorcontrib><creatorcontrib>Szomor, Zoltan L.</creatorcontrib><creatorcontrib>Marshall, Jeanette</creatorcontrib><creatorcontrib>Murrell, George A.C.</creatorcontrib><title>Rotator cuff repair with bioabsorbable screws: An in vivo and ex vivo investigation</title><title>Arthroscopy</title><addtitle>Arthroscopy</addtitle><description>Purpose: The purpose of this study was to evaluate in vivo the clinical outcomes of rotator cuff repairs with bioabsorbable screws compared with metal suture anchors, and to compare the ex vivo initial load to failure of rotator cuff repairs using 3 different bioabsorbable screws, suture anchors, and transosseous sutures. Type of Study: In vivo clinical outcomes investigation, and ex vivo biomechanical study. Methods: Three cohorts of patients with rotator cuff tears that measured less than 4 cm2, were sequentially repaired with Mitek Rotator Cuff QuickAnchors (Mitek Surgical Products, Norwood, MA) (n = 9), Arthrex Headed Bio-Corkscrews (n = 9) (Arthrex, Naples, FL), and Mitek Rotator Cuff QuickAnchors (n = 9). Patients were systematically assessed with a specific shoulder questionnaire and 23 shoulder tests performed preoperatively and at 1 and 6 weeks, 3 and 6 months, and 1 year postoperatively. A correlative ex vivo biomechanical study was performed on 53 ovine shoulders to evaluate the initial failure load properties of bioabsorbable screws compared with fixation with suture anchors and transosseous sutures. Results: In the in vivo portion of the study, the cohort treated with the Headed Bio-Corkscrew demonstrated no improvement on any measured parameter until 1-year after rotator cuff repair. In contrast, shoulders repaired with Mitek Rotator Cuff QuickAnchors demonstrated improved overall shoulder function as early as 6 weeks postoperatively (P =.002), had a better constant score at 1-year after repair (88 ± 9 v 73 ± 17; P =.016), and a lower rate of revision rotator cuff repair (P =.029). In the ex vivo portion of the study, the bioabsorbable headed screws, Headed Bio-Corkscrew (100 ± 30 N) and BioTwist (76 ± 35 N), had inferior initial failure load properties compared with suture anchors (140 ± 36 N) and transosseous sutures (147 ± 68 N). In contrast, the BioCuff (190 ± 56 N), a bioabsorbable implant that used a screw and serrated washer design, had equivalent initial failure load properties as the suture repairs. Conclusions: This investigation had poorer early outcomes, a lower shoulder functional score 1-year after repair, and a higher rate of repeat surgery in patients who had their rotator cuff repaired with a bioabsorbable screw than in patients who had their shoulders repaired with a standard metal suture anchor. Furthermore, the biomechanical testing demonstrated a lower tensile load to failure in the tendons repaired with a simple screw design compared to suture anchors with a mattress stitch. Of note, the implant that used a screw and washer design demonstrated a greater ability to resist initial tensile load.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 19, No 3 (March), 2003: pp 239–248</description><subject>Absorbable Implants</subject><subject>Aged</subject><subject>Anchors</subject><subject>Animals</subject><subject>Arthroscopy</subject><subject>Bioabsorbable</subject><subject>Biological and medical sciences</subject><subject>Biomechanical</subject><subject>Bone Screws</subject><subject>Cohort Studies</subject><subject>Debridement</subject><subject>Equipment Failure</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Implants, Experimental</subject><subject>Load to failure</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Ovine infraspinatus model</subject><subject>Pain, Postoperative - epidemiology</subject><subject>Pain, Postoperative - etiology</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Reoperation - statistics & numerical data</subject><subject>Rotator cuff</subject><subject>Rotator Cuff - surgery</subject><subject>Rotator Cuff Injuries</subject><subject>Sheep</subject><subject>Shoulder Pain - epidemiology</subject><subject>Shoulder Pain - etiology</subject><subject>Species Specificity</subject><subject>Stress, Mechanical</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Suture Techniques - instrumentation</subject><subject>Technology. Biomaterials. Equipments</subject><subject>Treatment Outcome</subject><issn>0749-8063</issn><issn>1526-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp10MFO3DAQgGGralW20DO3ypf2lmWcSeyEG0KFVkKqVOBsTZwxNcrGi51dytuT7a7EqSf78M3Y-oU4VbBUUOPZI6W8LAFwWQMofCcWqi51gSWq92IBpmqLBjQeiU85P8LssMGP4kiVujSqMgtx-ztONMUk3cZ7mXhNIcnnMP2RXYjU5Zg66gaW2SV-zufyYpRhlNuwjZLGXvLf_T2MW85TeKApxPFEfPA0ZP58OI_F_dX3u8sfxc2v65-XFzeFQ4NT0TaVb7qeNZnKoAdyddUCeAOaTYusyDdK176snW4V1YjgERWozilA8ngsvu33rlN82szv21XIjoeBRo6bbA1CU4HWMzzbQ5dizom9XaewovRiFdhdR7vraHcd7b-O88SXw-pNt-L-zR_CzeDrAVB2NPhEowv5zVVaNdCq2bV7x3OIbeBksws8Ou5DYjfZPob_fuIVeKqOSQ</recordid><startdate>20030301</startdate><enddate>20030301</enddate><creator>Cummins, Craig A.</creator><creator>Strickland, Sabrina</creator><creator>Appleyard, Richard C.</creator><creator>Szomor, Zoltan L.</creator><creator>Marshall, Jeanette</creator><creator>Murrell, George A.C.</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030301</creationdate><title>Rotator cuff repair with bioabsorbable screws: An in vivo and ex vivo investigation</title><author>Cummins, Craig A. ; Strickland, Sabrina ; Appleyard, Richard C. ; Szomor, Zoltan L. ; Marshall, Jeanette ; Murrell, George A.C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c373t-984f8bde6a7473f0ac54900f706e793e1af8165f25c691a5330f33101bc103af3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Absorbable Implants</topic><topic>Aged</topic><topic>Anchors</topic><topic>Animals</topic><topic>Arthroscopy</topic><topic>Bioabsorbable</topic><topic>Biological and medical sciences</topic><topic>Biomechanical</topic><topic>Bone Screws</topic><topic>Cohort Studies</topic><topic>Debridement</topic><topic>Equipment Failure</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Implants, Experimental</topic><topic>Load to failure</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Ovine infraspinatus model</topic><topic>Pain, Postoperative - epidemiology</topic><topic>Pain, Postoperative - etiology</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Reoperation - statistics & numerical data</topic><topic>Rotator cuff</topic><topic>Rotator Cuff - surgery</topic><topic>Rotator Cuff Injuries</topic><topic>Sheep</topic><topic>Shoulder Pain - epidemiology</topic><topic>Shoulder Pain - etiology</topic><topic>Species Specificity</topic><topic>Stress, Mechanical</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Suture Techniques - instrumentation</topic><topic>Technology. Biomaterials. Equipments</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cummins, Craig A.</creatorcontrib><creatorcontrib>Strickland, Sabrina</creatorcontrib><creatorcontrib>Appleyard, Richard C.</creatorcontrib><creatorcontrib>Szomor, Zoltan L.</creatorcontrib><creatorcontrib>Marshall, Jeanette</creatorcontrib><creatorcontrib>Murrell, George A.C.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Arthroscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cummins, Craig A.</au><au>Strickland, Sabrina</au><au>Appleyard, Richard C.</au><au>Szomor, Zoltan L.</au><au>Marshall, Jeanette</au><au>Murrell, George A.C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rotator cuff repair with bioabsorbable screws: An in vivo and ex vivo investigation</atitle><jtitle>Arthroscopy</jtitle><addtitle>Arthroscopy</addtitle><date>2003-03-01</date><risdate>2003</risdate><volume>19</volume><issue>3</issue><spage>239</spage><epage>248</epage><pages>239-248</pages><issn>0749-8063</issn><eissn>1526-3231</eissn><coden>ARTHE3</coden><abstract>Purpose: The purpose of this study was to evaluate in vivo the clinical outcomes of rotator cuff repairs with bioabsorbable screws compared with metal suture anchors, and to compare the ex vivo initial load to failure of rotator cuff repairs using 3 different bioabsorbable screws, suture anchors, and transosseous sutures. Type of Study: In vivo clinical outcomes investigation, and ex vivo biomechanical study. Methods: Three cohorts of patients with rotator cuff tears that measured less than 4 cm2, were sequentially repaired with Mitek Rotator Cuff QuickAnchors (Mitek Surgical Products, Norwood, MA) (n = 9), Arthrex Headed Bio-Corkscrews (n = 9) (Arthrex, Naples, FL), and Mitek Rotator Cuff QuickAnchors (n = 9). Patients were systematically assessed with a specific shoulder questionnaire and 23 shoulder tests performed preoperatively and at 1 and 6 weeks, 3 and 6 months, and 1 year postoperatively. A correlative ex vivo biomechanical study was performed on 53 ovine shoulders to evaluate the initial failure load properties of bioabsorbable screws compared with fixation with suture anchors and transosseous sutures. Results: In the in vivo portion of the study, the cohort treated with the Headed Bio-Corkscrew demonstrated no improvement on any measured parameter until 1-year after rotator cuff repair. In contrast, shoulders repaired with Mitek Rotator Cuff QuickAnchors demonstrated improved overall shoulder function as early as 6 weeks postoperatively (P =.002), had a better constant score at 1-year after repair (88 ± 9 v 73 ± 17; P =.016), and a lower rate of revision rotator cuff repair (P =.029). In the ex vivo portion of the study, the bioabsorbable headed screws, Headed Bio-Corkscrew (100 ± 30 N) and BioTwist (76 ± 35 N), had inferior initial failure load properties compared with suture anchors (140 ± 36 N) and transosseous sutures (147 ± 68 N). In contrast, the BioCuff (190 ± 56 N), a bioabsorbable implant that used a screw and serrated washer design, had equivalent initial failure load properties as the suture repairs. Conclusions: This investigation had poorer early outcomes, a lower shoulder functional score 1-year after repair, and a higher rate of repeat surgery in patients who had their rotator cuff repaired with a bioabsorbable screw than in patients who had their shoulders repaired with a standard metal suture anchor. Furthermore, the biomechanical testing demonstrated a lower tensile load to failure in the tendons repaired with a simple screw design compared to suture anchors with a mattress stitch. Of note, the implant that used a screw and washer design demonstrated a greater ability to resist initial tensile load.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 19, No 3 (March), 2003: pp 239–248</abstract><cop>Philadelphia, PA</cop><pub>Elsevier Inc</pub><pmid>12627147</pmid><doi>10.1053/jars.2003.50013</doi><tpages>10</tpages></addata></record> |
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| subjects | Absorbable Implants Aged Anchors Animals Arthroscopy Bioabsorbable Biological and medical sciences Biomechanical Bone Screws Cohort Studies Debridement Equipment Failure Female Follow-Up Studies Humans Implants, Experimental Load to failure Male Medical sciences Middle Aged Ovine infraspinatus model Pain, Postoperative - epidemiology Pain, Postoperative - etiology Prospective Studies Recovery of Function Reoperation - statistics & numerical data Rotator cuff Rotator Cuff - surgery Rotator Cuff Injuries Sheep Shoulder Pain - epidemiology Shoulder Pain - etiology Species Specificity Stress, Mechanical Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Suture Techniques - instrumentation Technology. Biomaterials. Equipments Treatment Outcome |
| title | Rotator cuff repair with bioabsorbable screws: An in vivo and ex vivo investigation |
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