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In Vitro Evaluation of Screws and Suture Anchors in Metaphyseal Bone of the Canine Tibia

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To compare ease of insertion, load to failure, and mode of failure of cortical and cancellous screws, BoneBiter, IMEX, and TwinFix suture anchors in canine metaphyseal tibial bone. Study Design

Experimental biomechanical study. Animals

Canine cadaveric tibias. Methods

One investigator inserted all anchors and subjectively evaluated ease of placement. Anchor systems were loaded to failure along axis of insertion with audio–video recording to determine failure mode. Results

BoneBiter was the most difficult anchor to insert successfully. Mean±SD loads to failure were cancellous screw (711±193 N), IMEX 4.7 mm 18 g wire (661±163 N), IMEX 4.0 mm 18 g wire (661±165 N), cortical screw (635±184 N), BoneBiter#5 Kevlar suture (393± 109 N), and TwinFix 5.0 mm #2 polyester (267±73 N). No significant differences were noted among the cortical screw, cancellous screw, IMEX 4.7 and 4.0 mm, all of which were significantly (P<.001) greater than BoneBiter and TwinFix. Failure modes were pullout of bone, suture–wire breakage, eyelet breakage, or no failure to 1000 N: screws (18,0,0,2), IMEX (18,1,1,0), BoneBiter (2,8,0,0), and TwinFix (0,10,0,0). Conclusions

Fixation devices were user friendly, with the exception of BoneBiter. Mode of failure is dependent on suture material and anchor design. Cortical and cancellous screws, and IMEX anchors with 18 g wire have significantly greater load to failure compared with BoneBiter and TwinFix suture anchors. Clinical Relevance

Based on load to failure, ease of use, design characteristics, and cost, IMEX anchors may have advantages over other comparable soft tissue fixation devices.
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Keywords: BoneBiter™; Ethibond suture; IMEX™ anchors; Kevlar suture; TwinFix™; biomechanical testing; bone; cancellous screw; cortical screw; dog; suture anchor

Document Type: Research Article

Affiliations: From the Comparative Orthopaedic Laboratory, University of Missouri-Columbia, Columbia, MO.

Publication date: September 1, 2005

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