Do double-row suture-locking anchors impact the biomechanical outcomes of rotator cuff surgery? A biomechanical study

International audienceIntroduction: Several surgical techniques for arthroscopic repair of the rotator cuff have been described in the literature. The aim of this study was to determine whether the suture thread locking method in double-row anchors influences their biomechanical properties. We compared the pullout strength of two anchors with different locking mechanisms.Introduction: Several surgical techniques for arthroscopic repair of the rotator cuff have been described in the literature. The aim of this study was to determine whether the suture thread locking method in double-row anchors influences their biomechanical properties. We compared the pullout strength of two anchors with different locking mechanisms.Methods: We performed 30 pullout tests at 135° using two different double-row anchors, an interference fit lock (5.5 mm SwiveLock) and a combination lock (5.5 mm MultiFix S). One anchor of each type was implanted on the tuberosity of a bovine humeral bone.Results: Mean pullout strength was 239.29 ± 83.73 N for the SwiveLock anchors and 253.82 ± 87.65 N for the MultiFIX S anchors, mean displacement (in millimeters) was 28 ± 9 and 30 ± 12, respectively which were not statistically significantly different.Conclusion: The addition of an internal lock in the double-row suture-locking anchor did not improve the biomechanical properties in a pullout test of 135

Three- and four-part displaced proximal humeral fractures in patients older than 70 years: reverse shoulder arthroplasty or nonsurgical treatment?

International audienceBackground: The objective of our study was to evaluate the results of surgical treatment by reverse shoulder arthroplasty (RSA) compared with nonsurgical treatment after 2 years of follow-up in patients aged 70 years or older with displaced 3-part or 4-part proximal humeral fractures. Methods: Two groups were formed: the RSA group (n = 28) and the nonsurgical group (n = 32). Minimum follow-up was 2 years. We included patients with 3-part or 4-part fractures according to the Neer classification. Main outcome measures were the Constant-Murley score, the 11-item version of the Disabilities of the Arm, Shoulder and Hand score, and the Subjective Shoulder Value score. An autonomy score, a cognitive assessment score, and a pain score were also measured. Results: Clinical features in the 2 groups were not significantly different. The Constant-Murley mean score was significantly higher for the RSA group (82.1% vs. 76.8%; P = .03). Amplitudes were all higher in favor of the RSA group (P < .02). There was no significant difference in mean score on the 11-item version of the Disabilities of the Arm, Shoulder and Hand score, the preoperative and postoperative Subjective Shoulder Value score, the autonomy score, the cognitive assessment score, or the pain score in both groups at the last follow-up. The complication rate was higher for the RSA group. Conclusions: These results suggest that RSA treatment of proximal humeral fractures with 3-part or 4-part displaced fragments in elderly patients provides better functional outcomes than does nonsurgical treatment. However, the observed clinical difference was relatively small. This solution must be proposed only to patients who have a significant functional demand. Level of evidence: Level III; Retrospective Cohort Design; Treatment Stud

Morphometric Tibial Implant Decreases Posterior Overhang Rate and Improves Clinical Outcomes: Results of a Prospective, Matched Controlled Study

International audienceBackground: Tibial implant's positioning in total knee arthroplasty (TKA) requires a compromise between implant's rotation and bone coverage. We hypothesized that morphometric tibial trays (MTTs) would improve implant positioning and clinical outcomes as compared with symmetrical tibial trays.Methods: Thirty-three patients were included prospectively accordingto the following criteria: age from 18 to 85 years, body mass index 3 mm were assessed using computerized tomography. The IKS and the KOOS were compared at 3-year follow-up.Results: Bone coverage (90% vs 88%, P = .07) and rotation (mean difference 0.7 +/- 3 degrees; P = .69) were not different between the 2 groups. The percentage of patient with a PO was lower in the morphologic group (2/33 vs 14/33, P = .01, odds ratio = 10.3 [2.12-50.24]). Functional scores were superior in the morphometric group: IKS (mean difference 20 +/- 21 points; P = .0005), mainly due to a difference in the IKS pain subscore (mean difference 11 +/- 15 points; P = .0002). According to the multivariate analysis, an MTT had a positive, independent effect on IKS pain (P = .006) and KOOS pain subscores (P = .03) at the last follow-up.Conclusion: The use of an MTT in TKA did not modify the tibial implant position in the axial plane; however, it decreased implant's posterior overhang and improved functional scores. The clinical improvement was mainly found on pain scores

Do double-row suture-locking anchors impact the biomechanical outcomes of rotator cuff surgery? A biomechanical study.

Introduction: Several surgical techniques for arthroscopic repair of the rotator cuff have been described in the literature. The aim of this study was to determine whether the suture thread locking method in double-row anchors influences their biomechanical properties. We compared the pullout strength of two anchors with different locking mechanisms.Methods: We performed 30 pullout tests at 135° using two different double-row anchors, an interference fit lock (5.5 mm SwiveLock) and a combination lock (5.5 mm MultiFix S). One anchor of each type was implanted on the tuberosity of a bovine humeral bone.Results: Mean pullout strength was 239.29 ± 83.73 N for the SwiveLock anchors and 253.82 ± 87.65 N for the MultiFIX S anchors, mean displacement (in millimeters) was 28 ± 9 and 30 ± 12, respectively which were not statistically significantly different.Conclusion: The addition of an internal lock in the double-row suture-locking anchor did not improve the biomechanical properties in a pullout test of 135°

Do double-row suture-locking anchors impact the biomechanical outcomes of rotator cuff surgery? A biomechanical study

International audienceIntroduction: Several surgical techniques for arthroscopic repair of the rotator cuff have been described in the literature. The aim of this study was to determine whether the suture thread locking method in double-row anchors influences their biomechanical properties. We compared the pullout strength of two anchors with different locking mechanisms.Introduction: Several surgical techniques for arthroscopic repair of the rotator cuff have been described in the literature. The aim of this study was to determine whether the suture thread locking method in double-row anchors influences their biomechanical properties. We compared the pullout strength of two anchors with different locking mechanisms.Methods: We performed 30 pullout tests at 135° using two different double-row anchors, an interference fit lock (5.5 mm SwiveLock) and a combination lock (5.5 mm MultiFix S). One anchor of each type was implanted on the tuberosity of a bovine humeral bone.Results: Mean pullout strength was 239.29 ± 83.73 N for the SwiveLock anchors and 253.82 ± 87.65 N for the MultiFIX S anchors, mean displacement (in millimeters) was 28 ± 9 and 30 ± 12, respectively which were not statistically significantly different.Conclusion: The addition of an internal lock in the double-row suture-locking anchor did not improve the biomechanical properties in a pullout test of 135