All-Suture Anchors in Orthopaedic Surgery: Design, Rationale, Biomechanical Data, and Clinical Outcomes.
David P TrofaElise C BixbyJames E FleischliBryan M SaltzmanPublished in: The Journal of the American Academy of Orthopaedic Surgeons (2021)
All-suture anchors (ASAs) are a relatively new alternative to traditional suture anchors, comprised of sutures, suture tapes, or ribbons woven through a soft sleeve. These novel anchors are typically smaller than traditional anchors, allowing for more anchors to be used in the same amount of space or for use when bone stock is limited, for example, in revision settings. They can be inserted through curved guides to reach more challenging locations, and they have thus far had similar loads to failure during biomechanical testing as traditional anchors. However, these benefits must be weighed against new challenges. When using ASAs, care must be taken to fully deploy and seat the anchor against cortical bone for optimal fixation and to prevent gap formation. Furthermore, decortication, often performed to enhance the biologic environment for soft-tissue healing, may weaken the cortical bone on which ASA fixation depends on. The purpose of this article is to provide insight on the designs, advantages, and potential disadvantages associated with ASAs, as well as review the available biomechanical and clinical data.
Keyphrases
- soft tissue
- minimally invasive
- bone mineral density
- healthcare
- finite element analysis
- rheumatoid arthritis
- electronic health record
- total knee arthroplasty
- quality improvement
- bone regeneration
- postmenopausal women
- pain management
- deep learning
- acute coronary syndrome
- risk assessment
- health insurance
- total hip arthroplasty
- data analysis
- machine learning
- artificial intelligence
- percutaneous coronary intervention
- surgical site infection