2015 ISAKOS Biennial Congress ePoster #2423

Does Anchor Type, Anchor Material or Suture Configuration Affect the Clinical Outcome of Rotator Cuff Repair? Analysis from the New Zealand Rotator Cuff Registry

Matthew J. Brick, MBChB, FRACS, Auckland NEW ZEALAND
Warren Leigh, FRACS, Auckland NEW ZEALAND
Michael A. Caughey, MBChB, FRACS, Auckland NEW ZEALAND
Anthony Maher, MBChB, Auckland NEW ZEALAND

New Zealand Shoulder and Elbow Society, Auckland, NEW ZEALAND

FDA Status Not Applicable

Summary: Two year outcome measures from a large national rotator cuff registry show significant differences in pain scores (p<0.001) between different anchor materials.

Rate:

Abstract:

Introduction

and Aims:

Suture anchors are increasingly used to repair rotator cuff tears, particularly with growing use of mini-open and arthroscopic approaches. Little information exists from large scale clinical studies comparing outcomes for different anchor types, anchor materials or the suture configuration employed in rotator cuff repair.

Methods

Between the 1st March 2009 and 31st December 2010 those patients undergoing repair of either partial or full-thickness tears were recruited by 92 surgeons nationwide. Only patients with pre-op Flex-SF, Pain scores and Operating day questionnaires were included in this analysis. The Operating day questionnaire required the surgeon to complete questions including fixation method (bone tunnels, suture anchors or both), number of anchors, number of margin convergence sutures, suture pattern (mattress, simple, Mason Allen, Suture bridge/trans-osseous equivalent, modified Kessler or other) suture pattern (single row/double row) and anchor type. Outcome was assessed by questionnaires at 6, 12 and 24 months including Flex-SF activity score and pain score.

Results

1383 repairs were analysed. Comparison of the 2 year pain score with the pre-op pain score allowed calculation of improvement in pain for the different anchor materials. PEEK anchors (n=295) improved by 3.47 points on a VAS 0-10 score, titanium (n=238) 2.89, PLLA (n=41) 3.34 and PLDLA (n=284) 3.13. Comparing PEEK and titanium anchors the PEEK showed significantly greater improvement in pain score (p<0.001). PEEK also showed significantly greater improvement than PLDLA (p=0.03). No difference was seen between PEEK and PLLA (p=0.69).
Improvement in Flex-SF score was 15.24 for PEEK, 15.63 for titanium, 16.43 for PLLA and 16.31 for PLDLA. There was no statistically significant difference between the Flex-SF scores. Tear size was no different for each anchor material.
In contrast tear size varied widely with suture pattern making comparison of different suture configurations difficult.
Outcome for those anchor types implanted more than 50 times will be presented with appropriate statistical analysis.

Conclusions

At two years pain scores following rotator cuff repair showed significantly greater improvement for PEEK anchors compared with titanium (p<0.001) or with PLDLA (p<0.03). To our knowledge this is an important new finding and should be considered in anchor selection by the surgeon and indeed by anchor manufacturers particularly if a similar pattern is replicated by other multicentre studies currently in progress.