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Relationship Between Insertion Torque, and Pullout Strength Depending on the Size of the Pilot Hole and Biodegradable Suture Anchor in Osteoporotic Humeral Head

골다공증이 있는 상완골 골두의 파일럿 홀 (Pilot Hole)과 흡수성 나사못의 크기에 따른 토크 (Torque)와 뽑힘 강도 (Pullout Strength) 간의 관계

  • Chun, Yong-Min (The Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Young-Han (The Department of Radiology, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Sung-Hwan (The Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Yoo-Jung (The Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine) ;
  • Kim, Sung-Jae (The Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine)
  • 천용민 (연세대학교 의과대학 정형외과학교실) ;
  • 이영한 (연세대학교 의과대학 영상의학과학교실) ;
  • 김성환 (연세대학교 의과대학 정형외과학교실) ;
  • 박유정 (연세대학교 의과대학 정형외과학교실) ;
  • 김성재 (연세대학교 의과대학 정형외과학교실)
  • Received : 2012.02.27
  • Accepted : 2012.06.06
  • Published : 2012.06.30

Abstract

Purpose: The object of this study was to investigate the difference in torque and pullout strength between the standard anchor insertion (5.0 mm) with a small awl (3.7 mm) and larger anchor insertion (6.5 mm), with a standard awl (5.0 mm) in osteoporotic humeral head. Materials and Methods: The embalmed 24 paired cadaveric shoulders were assigned to either Group A or B. After measuring the bone mineral density (BMD) of the ROI (region of interest) in the humeral head, 5.0 mm suture anchors were inserted using a 3.7 mm awl in Group A1, and the same 5.0 mm anchors were inserted using a 5.0 mm awl in Group A2. The 5.0 mm anchors were inserted using a 5.0 mm awl in Group B1, and 6.5 mm anchors were inserted using a 5.0 mm awl in Group B2. We measured the torques at the time of the anchor insertion and pullout strengths. Results: There was no significant difference in the BMD between the groups. The torque of A1 (20.6 $cN{\cdot}m$) was significantly higher than that of A2 (13.2 $cN{\cdot}m$), and the torque of B2 (20.8 $cN{\cdot}m$) was significantly higher than that of B1(12.1 $cN{\cdot}m$). However, the difference in the increased torque between group A and B was not significant. The pullout strength of A1 (204.2 N) was significantly higher than that of A2 (152.9 N), and the pullout strength of B2 (210.9 N) was significantly higher than that of B1 (149.5 N). However, the difference in the increased pullout strength between Group A and B was not significant. Conclusion: In severe osteoporosis, the use of a larger suture anchor with a standard awl increased the torque and pullout strength significantly, in comparison to the use of the same sized suture anchor and awl. If there is an inadequate interval between the anchors on the greater tuberosity, the use of a 3.7 mm awl and 5.0 mm anchor will be beneficial compared to that of a 5.0 mm awl and 6.5 mm anchor, considering that an increase in the pullout strength does not depend on the awl size.

Acknowledgement

Supported by : 연세대학교 의과대학

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