Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study.

Jae-Hoo Lee,Yong-Beom Lee

doi:10.3390/jcm9082545

Abstract

The aim of the current study was to evaluate the functional and radiologic outcomes of biocompatible non-absorbable PEEK (polyetheretherketone) and biocomposite (poly-L-lactic acid/poly(lactic-co-glycolic acid) 70% + β-tricalcium phosphate) anchors, especially in terms of perianchor cyst formation during the first six months postoperatively. We prospectively analysed 29 patients who underwent arthroscopic rotator cuff repair between March and May 2019. Both PEEK and biocomposite suture anchors were used as lateral anchors in one body. Clinical outcomes were assessed using the shoulder range of motion (ROM), visual analogue scale (VAS) for pain and satisfactory score, American Shoulder and Elbow Surgeons (ASES) score, and Simple Shoulder Test (SST). All these were obtained in patients preoperatively at 3 and 6 months after surgery. The imaging evaluation included perianchor cyst formation, anchor absorption, repaired cuff integrity, and retear pattern. All functional outcomes significantly improved over time. The biocomposite anchor had a statistically significant tendency to form higher grades of fluid collection at 3 months after surgery. However, the perianchor cyst reduced by the sixth postoperative month. Six months postoperatively, the functional outcomes were improved after rotator cuff repair and similar degrees of perianchor cyst formation were observed, regardless of the suture anchor material used.

Highlights

A rotator cuff tear is one of the most common pathologic conditions of the shoulder joint which orthopaedic surgeons frequently encounter
We evaluated perianchor cyst formation around two distinct anchors and its effects on the patients’ clinical and radiologic outcomes
The most substantial finding in the current study was that the biocomposite anchor formed comparable amounts of fluid collection with the PEEK anchor

Summary

Introduction

A rotator cuff tear is one of the most common pathologic conditions of the shoulder joint which orthopaedic surgeons frequently encounter. The metallic anchor was the first to be introduced; complications, such as metallic artifacts which interfered with postoperative assessments on magnetic resonance imaging (MRI), were reported. Another complication was implant loosening and migration into a joint space which led to arthritis [1,2,3,4,5]. The earlier developed bioabsorbable anchors yielded several anchor-related complications including osteolysis, synovitis, perianchor cyst formation, systemic allergic reaction, and foreign-body reactions [6,7,8,9] To overcome these problems, the biocompatible, non-absorbable PEEK (polyetheretherketone) anchor and the biocomposite, bioabsorbable (poly-L-lactic acid/poly(lactic-co-glycolic acid) 70% + β-tricalcium phosphate; PLLA/PGA plus β-TCP) anchors were introduced

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Discussion

Conclusion