Osteoconductive resorption characteristics of a novel biocomposite suture anchor material in rotator cuff repair

Jan Vonhoegen,Constanze Hägermann,Dominik John

doi:10.1186/s13018-018-1049-x

Abstract

BackgroundBioabsorbable suture anchors have been associated with bone-derived complications, such as osteolysis and cyst formation, after rotator cuff repair. The purpose of this study was to assess the osseous degradation process of the novel biocomposite suture anchor material polylactic-co-glycolic acid (PLGA)/beta-tricalcium phosphate (ß-TCP)/calcium sulfate (CS) after arthroscopic single-row rotator cuff repair. The focus of interest was the appearance of osteolysis and the rate of total resorption of the implants after 21 months.MethodsForty-eight patients with 82 implanted suture anchors who had undergone arthroscopic rotator cuff repair between January 2015 and March 2016 at our institution were retrospectively evaluated by postoperative magnetic resonance imaging. The appearance of osteolysis was classified by measurement of the peri-implant fluid. The degree of resorption was measured by grading the persistent visibility of the anchor structures. The integrity of the rotator cuff tendon was analyzed to discover possible retear or anchor pull-out complications.ResultsAfter a follow-up of 21.2 (± 5.4) months, osteolysis was detected in only two anchors (2.4%), and none of these defects exceeded the diameter of the former suture anchor (5.5 mm). Fifty percent of the anchors were fully degraded and no longer visible. Furthermore, only two retears of the rotator cuff occurred, and no anchor pull-out complications were detected.ConclusionPGLA/β-TCP/CS is a fully resorbable and osteoconductive suture anchor material that seems to have superior resorption characteristics compared to those of other bioabsorbable suture anchor materials commonly used in arthroscopic rotator cuff repair.Trial registrationThe presented study was retrospectively registered by the commission for ethics at the Ärztekammer Nordrhein with the registration number 2016433 on January 17, 2017. All participating patients gave written consent for participation and the publication of their data.Level of evidenceIV

Highlights

In the past, the use of suture anchors in arthroscopic rotator cuff repair (RCR) was often associated with complications depending on the design and the anchor materials used [1, 2]
We investigated the resorption characteristics of the novel biocomposite suture anchor material Regenesorb® to close the gap between primary stability and absorption
The present study demonstrates that the novel suture anchor material polylactic-co-glycolic acid (PLGA)/Beta tricalcium phosphate (β-TCP)/calcium sulfate (CS) is mostly absorbed at 21 months after RCR

Summary

Introduction

The use of suture anchors in arthroscopic rotator cuff repair (RCR) was often associated with complications depending on the design and the anchor materials used [1, 2]. The problem of rapid absorption was solved by replacing PGA and using poly-L-lactate (PLLA) [8] or a combination of L-lactate and D-lactate (PLDLA). These anchor materials with lower absorption rates were visible in MRI investigations up to 7 years postoperatively, and osteolysis and peri-implant cyst formations in the anchor area were detectable [9, 10]. The focus of interest was the appearance of osteolysis and the rate of total resorption of the implants after 21 months

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