2015 ISAKOS Biennial Congress ePoster #2410

Bone Absorbtion Around Medial-Row PEEK Anchors After Arthroscopic Footprint Reconstruction

Kengo Kirimura, MD, Hamamatsu, Shizuoka JAPAN
Hiroyuki Sugaya, MD, Toshima, Tokyo JAPAN
Norimasa Takahashi, MD, 千葉市美浜区打瀬2-22, 千葉県 JAPAN
Nobuaki Kawai, MD, Kushiro-Shi, Hokkaido JAPAN
Hamamatsu City Rehabilitation Hospital, Hamamatsu, Shizuoka, JAPAN

FDA Status Cleared

Summary: Bone absorption around medial row PEEK suture anchors using suture bridging technique to repair rotator cuff tears were evaluated using MRI. The presence and number of bone resorption around PEEK anchors had a significant negative association with the re-tear of rotator cuff repair (P=0.012, P=0.007 respectively). The micro-motion around PEEK anchor might cause the bone absorption.

Abstract:

Purpose

The purpose of this study is to evaluate the frequency of the bone absorption around PEEK suture anchor inserted at the medial row during arthroscopic footprint reconstruction using suture bridging technique.

Methods

118 consecutive shoulders had undergone arthroscopic suture bridge rotator cuff repair with PEEK anchor for medial row and postoperative MRI one year after surgery. (61 male, 62 female, mean age; 63.0-years) 114 shoulders were supraspinatus and/or infraspinutus tears and 45 shoulders were associated with subscapularis tears. 4 shoulders were isolated subscapularis tears. There were 20 partial-thickness, 51 small to medium, and 43 large to massive full-thickness tears. The total amount of medial row PEEK anchors were 293. In this study, we used TwinFix PK FT, TwinFix ULTRA PK anchor (Smith & Nephew) for medial row and Versalok system anchor (Depuy Mitek) for lateral row. The anchor insertion area was divided into 3 parts of greater tuberosity (GT) and 2 parts of lesser tuberosity (LT). The location of medial row anchors at the greater and lesser tuberosity were named as anterior (GTA), middle (GTM), and posterior (GTP), and upper (LTU) and lower (LTL), respectively. The bone absorption of around of PEEK anchors were classified according to severity level (Grade0 - no bone absorption, Grade1 -mild bone absorption, Grade2 – moderate bone absorption, Grade3- severe bone absorption).In addition, Grade 2 and 3 was defined serious bone absorption. We evaluated the incidence of different area, age, gender and type of preoperative rotator cuff tear of the bone absorption of around PEEK anchors and relationship between re-tear rate of rotator cuff and the bone absorption of around PEEK anchor.

Results

The incidence of the bone absorption of around PEEK anchors was 55.9% (164/293). The bone absorption and serious rate of different area was that GTA area was highest (72%, 27% respectively). The bone absorption rate of the different types of rotator cuff tear were that partial thickness tear was 69.2% (18/26), small to medium full-thickness tears was 67.5% (77/114) and large full thickness to massive tears had 45.0% (67/146). The logistic regression analysis showed that the presence and number of bone resorption around PEEK anchors controlling for pre-operative rotator cuff tear size, age and gender had a significant negative association with the re-tear of rotator cuff repair (P=0.012, P=0.007 respectively). The presence of severe bone resorption was tended to frequent in young age controlling for gender and in men controlling for age, but not statistically significant (P=0.25 and P=0.29 respectively). Contrary, the incidence of re-tear of rotator cuff repair was not associated with the presence of severe bone resorption.

Conclusion

The micro-motion around PEEK anchor might cause the bone absorption around PEEK anchors due to moderate absorption rate of the active age group. However, the re-tear rate of rotator cuff tear after arthroscopic rotator cuff repair was not high, it can be assumed the absorption around PEEK anchors have an insignificant effect on rotator cuff repair.