The effect of an inclined landing surface on biomechanical variables during a jumping task
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Biomechanical comparison of a knotless suture anchor with standard suture anchor in the repair of type II SLAP tears
by
Michael J. Sileo, M.D., Steven J. Lee, M.D., Ian J. Kremenic, M.E., Karl Orishimo, M.S., Simon Ben-Avi, Ph.D., Malachy McHugh, Ph.D., and Stephen J. Nicholas, M.D.
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last modified
2009-10-09 15:17
Arthroscopy. 2009 Apr;25(4):348-54. Epub 2008 Dec 18.
Purpose: To compare the biomechanical strength of knotless suture anchors and standard suture
anchors in the repair of type II SLAP tears. Methods: Five pairs of cadaveric shoulders (10
shoulders) were dissected free of soft tissue except for the glenoid labrum and long head of the biceps
tendon. Type II SLAP tears were created and repaired with 1 of 2 anchors: the Mitek Lupine suture
anchor or the Mitek Bioknotless suture anchor (DePuy Mitek, Raynham, MA). All specimens were
preloaded to 10 N, and loaded for 25 cycles in 10 N increments to a maximum of 200 N. If specimens
were still intact after 200 N, they were loaded to ultimate failure. The load at which 2 mm of gapping
occurred, load to ultimate failure, mode of failure, and the number of cycles to failure were compared
using the Wilcoxon signed-rank test. Results: Load to 2-mm gapping was lower (P .042) for
knotless anchors (70 N) versus knotted anchors (104 N), with similar differences for ultimate failure
(74 N v 132 N; P = .043), cycles to 2-mm gapping (133 v 219 cycles; P = .042), and cycles to failure
(143 v 297; P = .043). Eight of 10 specimens failed at the soft tissue interface (4 knotless, 4 knotted)
and 2 failed by anchor pullout (1 knotted, 1 knotless). Conclusions: The results of this study suggest
that repair of a type II SLAP with a Mitek knotted suture anchor and mattress suture configuration
through the biceps anchor is stronger than repair with a Mitek knotless suture anchor. The most likely
method of repair failure was at the sutureñsoft tissue interface regardless of the type of anchor used.
The application of a suture anchor that requires arthroscopic knot tying may be preferable to a
knotless anchor for the surgical repair of type II SLAP tears. Clinical Relevance: Repair of type II
SLAP tears with knotless suture anchors may allow for the avoidance of arthroscopic knot tying but
is weaker than repair with standard suture anchors.
Arthroscopy. 2009 Apr;25(4):348-54. Epub 2008 Dec 18.