Summary

A novel all suture anchor fixation method for sMCL reconstruction performs similarly to traditional fixation techniques

Abstract

Title: Low-Profile All-Suture Anchor Construct Demonstrates Non-Inferiority to Spiked Washer and Bone Staple in Medial Collateral Ligament Reconstruction: A Cadaveric Biomechanical Study

Purpose

This study aims to compare the biomechanical performance of an “all-suture anchor” construct with that of a spiked washer and a bone staple in tibial-sided superficial medial collateral ligament (sMCL) reconstruction.

Methods

A time-zero cadaveric biomechanical study was conducted using 24 human cadaveric tibiae, with fresh-frozen Peroneus Longus allografts for sMCL reconstructions. Each of the three treatment groups—all-suture anchor, spiked washer, and bone staple—consisted of eight specimens. A servohydraulic uniaxial testing machine was used to assess elongation after 1,000 cycles at 20–50 N, maximum load-to-failure (LTF), elongation at maximum LTF, and failure modes. Differences between groups were analyzed using one-way analysis of variance (ANOVA).

Results

No significant differences were observed across the groups (p>0.05). The mean elongation was 1.09 ± 0.7 mm in the all-suture anchor group, 0.63 ± 1.2 mm in the spiked washer group, and 1.05 ± 0.6 mm in the staple group. Median maximum LTF was 132.11 ± 40.2 N for the all-suture anchor group, 120.75 ± 54.9 N for the spiked washer group, and 123.89 ± 64.1 N for the staple group. Elongation at maximum LTF was 8.63 ± 4.1 mm for the all-suture anchor group, 8.68 ± 5.4 mm for the spiked washer group, and 10.82 ± 6.3 mm for the staple group. The mode of failure for all specimens was tendon pullout.

Conclusions

The “all-suture anchor” construct demonstrated comparable performance to both the spiked washer and bone staple for tibial-sided sMCL reconstruction in this time-zero cadaveric biomechanical assessment.