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Pull-out Strength of Suture Anchor and Torque of Buddy Anchor for an Osteoporotic Humeral Head in Rotator Cuff Repair: Parallel Versus Divergent Insertion

Authors
 Woo-Sung Do  ;  Joo-Hyung Kim  ;  Joon-Ryul Lim  ;  Tae-Hwan Yoon  ;  Yong-Min Chun 
Citation
 AMERICAN JOURNAL OF SPORTS MEDICINE, Vol.50(10) : 2782-2786, 2022-08 
Journal Title
AMERICAN JOURNAL OF SPORTS MEDICINE
ISSN
 0363-5465 
Issue Date
2022-08
MeSH
Biomechanical Phenomena ; Cadaver ; Humans ; Humeral Head / surgery ; Rotator Cuff / surgery ; Rotator Cuff Injuries* / surgery ; Suture Anchors* ; Suture Techniques ; Torque
Keywords
buddy anchor ; divergent insertion ; loose anchor ; osteoporotic bone ; parallel insertion ; rotator cuff repair
Abstract
Background: The buddy anchor technique is useful to reinforce loose anchors in the osteoporotic humeral head during arthroscopic rotator cuff repair. However, theoretical parallel insertion of the buddy anchor to index a loose anchor is challenging in arthroscopy and can widen the entry site and decrease structural integrity.

Purpose: To investigate and compare the biomechanical stability between 2 buddy anchor insertion techniques (parallel insertion vs divergent insertion) in the osteoporotic humeral head.

Study design: Controlled laboratory study.

Methods: A total of 24 paired fresh-frozen cadaveric shoulders were used, and each pair was randomly assigned to either the parallel insertion group or the divergent insertion group. In the parallel insertion group, the buddy anchor was inserted parallel to the index loose anchor. In the divergent insertion group, the buddy anchor was inserted at a 20° angle in the medial direction to the index loose anchor. The insertion torque of the buddy anchor and ultimate pull-out strength of the index anchor were measured and compared between the 2 groups.

Results: The mean maximum insertion torque was significantly higher in the parallel insertion group (16.1 ± 1.8 cN·m) compared with the divergent insertion group (12.0 ± 1.5 cN·m) (P < .001). The mean ultimate pull-out strength was significantly higher with divergent insertion (192.2 ± 28.6 N) than with parallel insertion (147.7 ± 23.6 N) (P < .001).

Conclusion: For application of the buddy anchor system in the cadaveric osteoporotic humeral bone model, divergent insertion showed better ultimate pull-out strength than conventional parallel insertion, despite inferior maximum insertion torque.

Clinical relevance: The results of this study widen the applicability and accessibility for the buddy anchor system.
Full Text
https://journals.sagepub.com/doi/10.1177/03635465221104766?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed
DOI
10.1177/03635465221104766
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Do, Woo Sung(도우성)
Yoon, Tae Hwan(윤태환) ORCID logo https://orcid.org/0000-0002-2859-5240
Lim, Joon Ryul(임준열) ORCID logo https://orcid.org/0000-0002-0123-7136
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191775
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