Abstract
Suture anchor fixation is a common method for securing bone and soft tissue in the body, with proven applications in the hip, elbow, hand, knee and foot. A critical limiting factor of suture anchors is the pull-out strength, particularly in suboptimal bone. This study introduces a novel 3D printed threadless suture anchor with a rectangular cross-section. The titanium anchor was designed with surface fenestration and a porous central core to improve bone ingrowth. The aim of this study was to compare the pull-out properties of the novel threadless anchor with a traditional circular threaded suture anchor. The anchors were inserted into a 0.24 g/cm3 synthetic cancellous bone block at angles of 90° and 135° to the surface. The sutures were pulled at 180° (parallel) to the surface under a static pull test (anchor pullout) and cyclic load test using a tensile testing machine. Under the static load, the greatest pullout strength was seen with the novel threadless anchor inserted at 90° (mean, 105.6 N; standard deviation [SD], 3.5 N). The weakest pullout strength was seen with the threaded anchor inserted at 90° (mean, 87.9 N; SD, 4.1 N). In the cyclic load test, all six of the threaded anchors with a 90° insertion angle pulled out after 18 cycles (70 N). All of the threadless anchors inserted at 90° survived the cyclic test (90 N). In conclusion, the novel threadless suture anchor with rectangular cross-section and traditional threaded suture anchor had similar pullout survivorship when inserted at either 90° or 135°. In addition, the 3D printed threadless anchor has the potential for good bone integration to improve long-term stabilization.
Highlights
Fixation with suture anchors is a common method of securing bone and soft tissue during orthopedic surgery, and is prevalent in endoscopic surgery
3D printing allows for the rapid development of hollow or perforated structures which can be tailored to different orthopedic applications to improve bone ingrowth
By referring the previous literatures related to the processing of the selective laser melted (SLM) machine used in this study, our anchor was designed to have porosities of 70% and pore sizes of 600 μm
Summary
Fixation with suture anchors is a common method of securing bone and soft tissue during orthopedic surgery, and is prevalent in endoscopic surgery. Various designs of suture anchor have been proposed, including different materials, shapes and sizes, with the intent of ensuring a secure fixation between the soft tissue and bone until healing is complete [1,2,3]. Metallic suture anchors with nonabsorbable sutures are routinely used and provide a good initial fixation, clinical studies have reported anchorassociated complications such as migration, loosening, breakage, and interference from surrounding tissues [4,5]. 3D printing allows for the rapid development of hollow or perforated structures which can be tailored to different orthopedic applications to improve bone ingrowth. MacBarb et al [7] designed a perforated 3D printed structure with a porous outer surface which demonstrated good bone ingrowth when implanted in an ovine model. Wei et al [9] used 3D-printed technology to develop a suture anchor with barbs and their results indicated that the 3D-printed technology could make the anchor maximum strength to hold reshaped tissue structures
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
