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Bankart repair with cylindrical biocomposite anchors yielded low rate of anchor hole widening
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Regardless of anchor site, results published in Orthopedics showed a low rate of anchor hole widening and excellent ossification among patients who underwent arthroscopic Bankart repair with cylindrical biocomposite anchors made of 70% poly-L-lactide-co-glycolide acid and 30% beta-tricalcium phosphate.
To acquire marketing approval of a poly-L-lactide-co-glycolide acid and beta-tricalcium phosphate biocomposite suture anchor in Japan, researchers evaluated CT scans at 2-year follow-up from 11 of 22 patients who underwent arthroscopic Bankart repair with a total of 47 anchors. Width and ossification of anchor holes were independently evaluated in four grades by three surgeons using CT scans. Consensus of the three surgeons was used to determine the final grade when the evaluations disagreed, according to researchers.
Results showed 83% of 47 anchor sites had narrowed anchor holes and 45% of 47 anchor sites were almost completely filled. Researchers noted ossification in 98% of anchor sites. According to results, 34% of anchor sites had nearly complete or complete ossification. On comparison of the anteroinferior with other anchor sites, researchers found both anchor hole width and ossification score were not significantly different. – by Casey Tingle
Disclosures: Matsuki reports he has received grants from Johnson & Johnson and Exactech. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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Daniel E. Davis, MD, MS
The purpose of this study was to evaluate labral anchors that were made of poly-L-lactide-coglycolide (PLGA) with beta-tricalcium phosphate (beta-TCP), an osteoconductive material, in cylindrical-type anchors for tunnel widening and absorption. There were 11 patients and 47 anchors available for follow up CT scan at an average of 30 months. The authors found that 87% of the bone tunnels showed narrowing and 98% showed ossification. There was no significant difference found based on the location of the anchor site.
This study is certainly interesting and shows encouraging results with PLGA-beta-TCP anchors in not creating tunnel widening or osteolysis. Some limitations of the study are the small subject and anchor numbers with no power analysis to know if there is truly no significant difference on their outcomes. Additionally, it would be interesting to know how well the labral tissue healed and if healing rates are affected different in those cases in which the bone tunnel did not close or there is limited ossification. This would admittedly take additional resources with an MRI or second-look arthroscopy. The findings do point, however, to the advancements that have been made in bone anchor technology and they are promising.
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