Biomechanical study: determining the optimum insertion angle for screw-in suture anchors - is Deadman's Angle correct?

Green, Robert N., Donaldson, Oliver W., Dafydd, Meilyr, Evans, Samuel Lewin ORCID: https://orcid.org/0000-0003-3664-2569 and Kulkarni, Rohit 2014. Biomechanical study: determining the optimum insertion angle for screw-in suture anchors - is Deadman's Angle correct? Arthroscopy: The Journal of Arthroscopic & Related Surgery 30 (12) , pp. 1535-1539. 10.1016/j.arthro.2014.07.010

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Abstract

Purpose To assess the effect of the insertion angle and the angle of applied load on the pullout strength of screw-in suture anchors. Methods Screw-in metallic suture anchors were inserted into a 10–lb/cu ft synthetic cancellous bone block at 30°, 45°, 60°, and 90° to the surface. The suture pull angle was then varied in 30° increments between 0° and 180°. Five constructs were tested to failure (anchor pullout) for each combination of angles using a Zwick tensile testing machine (Zwick Roell, Ulm, Germany). Results There were a total of 25 combinations. The greatest pullout strength was seen with a suture anchor inserted at 90° to the bone block with a pull angle of 90° to the bone (mean, 306 N; standard deviation [SD], 9 N). The weakest pullout strength was seen with a suture anchor inserted at 30° with the angle of pull at 120° (i.e., opposite to the direction of insertion of the anchor) (mean, 97 N; SD, 11 N). A simulated deadman's angle of 45° with an angle of pull of 150° produced a pullout strength of 127 N (SD, 4 N). The pullout strengths for each insertion angle were greatest when the angle of pull was similar to the angle of insertion (P < .0001, repeated-measures analysis of variance). Conclusions The angle of applied load to a suture anchor and the insertion angle significantly influence the biomechanical pullout strength of screw-in suture anchors. The insertion angle of the suture anchor should replicate the angle of applied load to ensure the optimum pullout strength.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Engineering
Subjects:	T Technology > TJ Mechanical engineering and machinery
Publisher:	Elsevier
ISSN:	0749-8063
Last Modified:	28 Oct 2022 08:59
URI:	https://orca.cardiff.ac.uk/id/eprint/72906

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