SOFT-TISSUE RECONSTRUCTION IN THE SHOULDER - COMPARISON OF SUTURE ANCHORS, ABSORBABLE STAPLES, AND ABSORBABLE TACKS

We evaluated three mechanical soft tissue fixation devices (SuperAncho r, Suretac, and the Instrument Makar [IM] Bioabsorbable Staple) in a c adaveric model by examining ultimate tensile failure and modes of fail ure in simulated Bankart repairs. We attempted to realistically evalua te the strengths of soft tissue reattachment procedures at the anterio r glenoid under worst-case conditions-load to failure. Twenty fresh-fr ozen cadaveric shoulders were used in this investigation. Each of the three techniques was performed in each anterior glenoid rim at one of three locations: superior, middle, or inferior. The subscapularis musc le-tendon was harvested, used in the repair, and loaded to failure. Th e mean load at failure for the SuperAnchor was 217.32 N; for the IM St aple, 132.32 N; and for the Suretac, 122.37 N. A two-sample t-test dem onstrated that the toad at failure for the SuperAnchor was statistical ly greater (P < 0.001) when compared with the IM Staple and Suretac. T here was no statistical difference between load at failure for the Sur etac and the IM Staple. The most common failure mode for the Mitek was suture breakage (71%). Anchor pullout from bone was the most common f ailure mode for the IM Staple (75%) and Suretac (94%).