Soft Tissue Reconstruction in the Shoulder

Abstract

We evaluated three mechanical soft tissue fixation de vices (SuperAnchor, Suretac, and the Instrument Makar [IM] Bioabsorbable Staple) in a cadaveric model by ex amining ultimate tensile failure and modes of failure in simulated Bankart repairs. We attempted to realistically evaluate the strengths of soft tissue reattachment pro cedures at the anterior glenoid under worst-case conditions—load to failure. Twenty fresh-frozen cadav eric shoulders were used in this investigation. Each of the three techniques was performed in each anterior glenoid rim at one of three locations: superior, middle, or inferior. The subscapularis muscle-tendon was har vested, used in the repair, and loaded to failure. The mean load at failure for the SuperAnchor was 217.32 N; for the IM Staple, 132.32 N; and for the Suretac, 122.37 N. A two-sample t-test demonstrated that the load at failure for the SuperAnchor was statistically greater (P < 0.001) when compared with the IM Staple and Sure tac. There was no statistical difference between load at failure for the Suretac and the IM Staple. The most com mon failure mode for the Mitek was suture breakage (71 %). Anchor pullout from bone was the most common failure modeforthe IM Staple (75%) and Suretac (94%).