Non-absorbable Suture Anchor

What is an anchoring suture?

Suture anchors are broadly used for attaching soft tissue (e.g., tendons, ligaments, and meniscus) to the bone and have become essential devices in sports medicine and during arthroscopic surgery. As the usage of suture anchors has increased, various material-specific advantages and challenges have been reported. As a result, suture anchors are continually changing to become safer and more efficient. In this ever-changing environment, it is clinically essential for the surgeon to understand the key characteristics of existing anchors sufficiently.

The use of suture anchors has revolutionized orthopedic surgery because it allows for simple and efficient fixation of soft tissue (e.g., tendons and ligaments) to the bone in both open and arthroscopic surgery around the shoulder, elbow, wrist, and lower limb joints.) Shoulder surgery particularly has experienced a significant change in the type of techniques used from open repair of the rotator cuff and labrum using screws, washers, transosseous sutures, and staples to arthroscopic repair using suture anchors.

The primary function of the suture anchor is to attach tissue at the proper site and maintain its position without loosening or excessive tension until physiologic healing is accomplished. An ideal suture anchor is easy to handle, maintains enough pull-out strength, prevents suture abrasion, and is absorbable without resulting in any reactions as the material dissolves.) Various types of anchors have been developed, and designs of anchors have evolved over the recent decade to maximize their effectiveness in creating a firm tendon-to-bone repair.

METALLIC SUTURE ANCHOR

The first suture anchor designs were nonabsorbable and metallic. A specific metal can be used combined with other metals to form an alloy or alone. The two most commonly used metal anchors are titanium and stainless steel. Titanium is widely used for orthopedic applications, and it is a strong, light material by itself, but it can also be combined with iron or aluminum (Fig. 1).5) Stainless steel is an alloy of carbon, chromium, and iron. It is more resistant to corrosion than regular steel and stronger than pure iron.5) Stainless steel anchors become encapsulated by a fibrous membrane rich in inflammatory cells, whereas titanium forms a surface layer of calcium and phosphate, which links directly to the bone without evidence of this fibrous layer and with minimal inflammatory response. An oxide layer spontaneously forms, and calcium and phosphate precipitate on this layer. Then, osteoblasts bind to the surface and actively secrete osteoid matrix

Non-absorbable Suture Anchor: A Comprehensive Guide

Suture anchors are essential tools used in various orthopedic and surgical procedures. Non-absorbable suture anchors, in particular, have gained significant attention due to their durability and longevity. In this article, we will discuss non-absorbable suture anchors, their applications, and the benefits they offer in surgical procedures.

What are Non-absorbable Suture Anchors?

Non-absorbable suture anchors are medical devices designed to anchor sutures in bones or soft tissues. They are typically made of materials such as titanium, stainless steel, or other biocompatible metals that provide strength and durability. Non-absorbable suture anchors are not designed to dissolve over time, and they remain in the body indefinitely.

Types of Non-absorbable Suture Anchors

There are two main types of non-absorbable suture anchors: interference and cortical.

Interference Suture Anchors

Interference suture anchors are designed to compress the bone around the suture. These types of anchors are typically used in areas where there is a lack of bone mass or quality, such as the glenoid labrum, which is a ring of cartilage around the shoulder socket. Interference suture anchors provide excellent pull-out strength and stability, which makes them ideal for high-stress areas.

Cortical Suture Anchors

Cortical suture anchors are designed to be used in dense cortical bone. These anchors are typically used in areas where there is a high concentration of bone mass, such as the greater tuberosity of the humerus. Cortical suture anchors are ideal for areas where there is limited space and require high pull-out strength.

Applications of Non-absorbable Suture Anchors

Non-absorbable suture anchors are used in various surgical procedures, including:

Rotator Cuff Repair

Non-absorbable suture anchors are commonly used in rotator cuff repair surgeries. Rotator cuff injuries are prevalent in athletes and people who perform repetitive overhead motions. Non-absorbable suture anchors provide a durable and reliable anchor point for the sutures used to repair the rotator cuff.

Labral Repair

The labrum is a ring of cartilage that lines the rim of the shoulder socket. Labral tears are a common injury that can be repaired using non-absorbable suture anchors. These anchors provide an excellent anchor point for sutures used to repair the labrum, ensuring a successful and long-lasting outcome.

Ligament Repair

Non-absorbable suture anchors are used in various ligament repair surgeries, including ankle and knee ligament repair. These anchors provide an excellent anchor point for sutures used to repair torn or damaged ligaments, ensuring the stability and functionality of the joint.

Advantages of Non-absorbable Suture Anchors

Non-absorbable suture anchors offer several advantages over absorbable suture anchors, including:

Durability

Non-absorbable suture anchors are designed to be permanent fixtures in the body, providing a long-lasting and durable anchor point for sutures.

Strength

Non-absorbable suture anchors offer excellent pull-out strength, ensuring the sutures remain securely anchored in place.

Reduced Inflammation

Unlike absorbable suture anchors, non-absorbable suture anchors do not dissolve over time, reducing the risk of inflammation and infection.

Conclusion

Non-absorbable suture anchors are essential tools used in various orthopedic and surgical procedures. They offer several advantages over absorbable suture anchors, including durability, strength, and reduced inflammation. With their applications in rotator cuff repair, labral repair, and ligament repair, non-absorbable suture anchors are an essential component of modern surgical procedures. Understanding the different types of non-absorbable suture anchors and their applications can help surgeons and medical professionals provide optimal patient care and improve surgical outcomes.

FAQs

1. What are the materials used to make non-absorbable suture anchors?

Non-absorbable suture anchors are typically made of materials such as titanium, stainless steel, or other biocompatible metals that provide strength and durability.

2. Are non-absorbable suture anchors permanent fixtures in the body?

Yes, non-absorbable suture anchors are designed to be permanent fixtures in the body, providing a long-lasting and durable anchor point for sutures.

3. What are the advantages of non-absorbable suture anchors over absorbable suture anchors?

Non-absorbable suture anchors offer several advantages over absorbable suture anchors, including durability, strength, and reduced inflammation.

4. In what surgical procedures are non-absorbable suture anchors commonly used?

Non-absorbable suture anchors are commonly used in rotator cuff repair, labral repair, and ligament repair surgeries.

5. What are interference and cortical suture anchors?

Interference suture anchors compress the bone around the suture and are typically used in areas where there is a lack of bone mass or quality, while cortical suture anchors are designed to be used in dense cortical bone and are ideal for areas where there is limited space and require high pull-out strength.