Abstract:
BACKGROUND:Biocomposite suture anchors containing osteoconductive materials have gained popularity in rotator cuff repairs. However, little is known about the influence of the addition of osteoconductive materials on implant resorption, bone reaction, tendon healing, and clinical outcomes scores. QUESTIONS/PURPOSES:(1) What percentage of suture anchors were not completely resorbed 2 years after implantation? (2) What are the diameters of the bone bed in relation to the implant? (3) Is tendon integrity correlated with bone tunnel diameter? (4) Is there an association between tunnel widening, periimplant fluid film grade, biodegradation grade, and retear with clinical outcomes scores, such as the Western Ontario Rotator Cuff Index (WORC) and the Oxford Shoulder Score (OSS)? METHODS:Thirty-six patients were enrolled from August 2012 to January 2014. The following inclusion criteria were applied: (1) reparable full-thickness supraspinatus tendon tears, (2) double-row suture bridge techniques applied for supraspinatus repair, (3) use of biocomposites suture anchor implants composed of poly L-lactic acid (PLLA) and β-tricalcium phosphate (TCP) exclusively, and (4) a minimum of 2 years followup. Four patients met the exclusion criteria, and seven of 36 patients (19%) were lost to followup. Thereby, 25 patients (84 implants) were included in this retrospective study. To answer the study's questions, the following methods were applied: (1) The resorption of the implants and periimplant fluid film were assessed on MRI using a four-stage scale system, (2) bone bed diameter was measured on MRI at three different points on the longitudinal central axis of each anchor, (3) tendon integrity was evaluated on MRI according to the Sugaya classification and correlated to bone tunnel diameter, and (4) assessed tunnel diameters, periimplant fluid film grade, biodegradation grade, and tendon condition were related to clinical outcomes scores at the time of followup (2.3 ± 0.3 years). The intraobserver reliability was 0.981 (p < 0.001) and interobserver reliability was 0.895 (p < 0.001). RESULTS:At 2.3 ± 0.3 years, most analyzed suture anchors (76 of 84 [90%]) were, with varying degrees of degradation, still visible. Bone tunnels showed minor widening (0.4 ± 1.4 mm) at the base, but osseous ingrowth was detected as narrowing at the middle (0.1 ± 1.1 mm) and at the apex (1.4 ± 1.7 mm) of the implants. Patients with retears (Sugaya Grades 4-5) had narrower tunnels (3.6 ± 1.8 mm) than patients without retears (Sugaya Grades 1-3; 4.4 ± 1.6 mm; mean difference, 0.782 [95% confidence interval {CI}: 0.009-1.6]; p = 0.050). WORC and Oxford scores were not associated with the tunnel widening amount, fluid film grade, biodegradation grade, or tendon retear. CONCLUSIONS:In light of the results of the present study, surgeons should consider in their daily practice that the resorption process of these implants may be slower than assumed so far, but no association with severe implant-related complications has been found in the short term. Future studies should focus on the evaluation of the effects of osteoconductive materials on resorption, tendon healing, and clinical outcomes in the long term and on the integration process in different rotator cuff reconstruction techniques. LEVEL OF EVIDENCE:Level IV, therapeutic study.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Sgroi M,Friesz T,Schocke M,Reichel H,Kappe Tdoi
10.1097/CORR.0000000000000665subject
Has Abstractpub_date
2019-06-01 00:00:00pages
1469-1478issue
6eissn
0009-921Xissn
1528-1132journal_volume
477pub_type
杂志文章abstract::Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-11-01 00:00:00
abstract::Limb lengthening using callotasis needs careful preoperative planning and great care during the lengthening period. The most common method used to monitor limb lengthening is plain radiography, but the time of frame removal is still left to the judgment of the surgeon. This paper reviews some of the methods used exper...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1994-11-01 00:00:00
abstract::In 15 documented cases, subluxation or dislocation of the hip was discovered months or years after previous multiple normal physical examinations. The examiners were unique in that six were professors specializing in childrens' orthopedics, four were board-certified orthopedists, and five were pediatricians. An increa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::Abnormalities in the hallux valgus foot and changes after surgery were investigated by measuring the distribuiion of load on the foot in walking. Hallux valgus was associated with reduced load imposed on the toes, and on the medial side of the forefoot, compared with a large sample of healthy feet. Abnormalities corre...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:1979-07-01 00:00:00
abstract::Two cases of entrapment of suction drainage tubes between the femoral and tibial components were encountered after total knee arthroplasty. The first patient had an arthrotomy because it was believed that the tube was caught in a suture, and while attempting to remove it a portion remained trapped in the joint. At ope...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:1990-10-01 00:00:00
abstract::Molecular diagnostic strategies have been implemented to enhance the treatment of musculoskeletal infections. Once primarily a research tool, molecular-based assays, have become accepted clinical tests for the genomic detection of certain pathogens involved in bone and joint infections. Currently, culture remains the ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
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journal_title:Clinical orthopaedics and related research
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更新日期:2005-02-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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doi:
更新日期:1986-09-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:1980-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000203474.96549.80
更新日期:2006-06-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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更新日期:2012-05-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-10-01 00:00:00
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-08-01 00:00:00
abstract::The etiology of the foot deformity in patients with Charcot-Marie-Tooth disease has not previously been discussed in relation to the extrinsic muscle function around the foot and ankle. Eight adult patients with a strong familial history were evaluated, and their foot findings were remarkably similar. All demonstrated...
journal_title:Clinical orthopaedics and related research
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更新日期:1988-09-01 00:00:00
abstract:UNLABELLED:The treatment of 30 consecutive adult patients with chronic draining osteomyelitis of the tibia was reviewed. There were four treatment patterns. Eight patients had local debridement with or without soft tissue coverage procedures or bone graft. Three patients had radical debridement and bone transport using...
journal_title:Clinical orthopaedics and related research
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journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
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更新日期:1993-09-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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doi:
更新日期:1990-03-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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journal_title:Clinical orthopaedics and related research
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doi:
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journal_title:Clinical orthopaedics and related research
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doi:10.1097/CORR.0000000000001520
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journal_title:Clinical orthopaedics and related research
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abstract::A heterogeneous group of 17 patients with aseptic necrosis of the femoral head had treatment of 23 hips by bone grafting. Phemister-type tibial grafts were used in 20 and iliac grafts in 3. All hips were evaluated before and after grafting according to roentgenographic stage of disease and the Hospital for Special Sur...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
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更新日期:1977-01-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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abstract::Three cases of an isolated femoral component failure of a hip surface replacement were treated by use of a press-fit bipolar prosthesis to articulate with the retained acetabular cup. At two to three years post-surgery (average, 31 months), these three conversions had good clinical function and maintained an acceptabl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract::The tuck position used in conjunction with the tuck seat continues to satisfy the important requirements of lumbar spine surgery: satisfactory respiratory exchange, diminished venous oozing, and ample exposure. In 253 operations performed since 1971, minimal postoperative morbidity, including deep vein thrombosis, was...
journal_title:Clinical orthopaedics and related research
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doi:
更新日期:1984-04-01 00:00:00
abstract::Polycentric total knee arthroplasty has been performed at the Mayo Clinic on more than 1,600 knees since July 1970. Two groups of 106 and 101 knee arthroplasties performed between July 1970 and July 1971 and June 1971 and January 1972, respectively, were compared at 5 and 7 years. The technique used exposed the joint ...
journal_title:Clinical orthopaedics and related research
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更新日期:1979-11-01 00:00:00
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journal_title:Clinical orthopaedics and related research
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