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Metal suture anchors show superior results to absorbable anchors in rotator cuff repair
Absorbable anchors related to a significantly lower DASH score than metal anchors.
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HOLLYWOOD, Fla. – Improving outcomes after arthroscopic rotator cuff repair may depend on whether a surgeon chooses to use metal or absorbable suture anchors.
Italian researchers conducted a prospective, randomized study on 50 patients treated with arthroscopic rotator cuff repair using either absorbable or metal suture anchors. Through multivariate and univariate analysis, they found that metal suture anchors were related to a significantly lower Disabilities of the Arm, Shoulder and Hand (DASH) score (14.6), as compared to absorbable suture anchors (27.9).
“Clinical subjective results were significantly better when metal anchors were used – independently from any other variables that we considered in this study,” Andrea Grasso, MD, of the Villa Valeria Clinic in Rome, said at the Arthroscopy Association of North America 25th Annual Meeting.
Source: Grasso A |
Grasso and his colleagues randomly split the 50 patients into two groups. Group I included 25 patients who underwent arthroscopic rotator cuff repair with the Corkscrew (Arthrex) metal suture anchors. Group II included patients who underwent rotator cuff repair with the Biocorkscrew (Arthrex) absorbable anchors, Grasso said. Surgeons performed subacromial decompression in all cases.
Nine patients (18%) were lost at follow-up, including four in Group I and five in Group II. Researchers evaluated outcomes using the Constant score and DASH and Work-DASH self-administered questionnaires, Grasso said. They also conducted a student T-test and Chi-square test to compare the independent variables between the two groups.
At two-year follow-up, the researchers performed a univariate and multivariate statistical analysis to determine the independent variables associated with outcome, considering the following as independent variables: age, gender, area, dominance, shape of the tear, location, area, retraction, reducibility, degeneration, repair technique, number of anchors and anchor type. They set the significance at P<.05.
Positive, negative correlation
Researchers found a significant difference in average age, gender, dominance and retraction of the tear between the two groups. However, “Regarding univariate analysis, we didn’t find significant correlation between [the outcomes and] the gender, the dominance, the area of the tears and the number of anchors,” Grasso said.
Still, the researchers did find a positive correlation between:
- patient age and the DASH score,
- tear shape and DASH and Work-DASH scores,
- location of the tear and the Work-DASH score,
- the tear reducibility and Work-DASH score,
- and the type of anchor and DASH scores.
“Regarding the technique of repair, we found a correlation with both the subjective score for anchor and combined [or] side-to-side plus anchors,” Grasso said.
He added: “Regarding the retraction of the tear, we found a negative correlation with the Constant [score], meaning the greater the grade of retraction, the poorer the results,” Grasso said.
Based on these findings, researchers rejected their null hypothesis that they would not find a significant difference in clinical outcome between the two groups.
For more information:
- Grasso A, Milano G, Zarelli D, et al. Comparison between arthroscopic rotator cuff repair with metal and absorbable suture anchors: A prospective randomized study. #SS-28. Presented at the Arthroscopy Association of North America 25th Annual Meeting. May 18-21, 2006. Hollywood, Fla.