The Effect of Suture Anchor Insertion Angle on Calcaneus Pullout Strength

Challenging the Deadman’s Angle

William M. Weiss, Ramon P. Saucedo, John D. Robinson, Chung Chieh Jason Lo, Randal P. Morris, Vinod Panchbhavi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background. Refractory cases of Achilles tendinopathy amenable to surgery may include reattachment of the tendon using suture anchors. However, there is paucity of information describing the optimal insertion angle to maximize the tendon footprint and anchor stability in the calcaneus. The purpose of this investigation is to compare the fixation strength of suture anchors inserted at 90° and 45° (the Deadman’s angle) relative to the primary compressive trabeculae of the calcaneus. Methods. A total of 12 matched pairs of adult cadaveric calcanei were excised and potted to approximate their alignment in vivo. Each pair was implanted with 5.5-mm bioabsorbable suture anchors placed either perpendicular (90°) or oblique (45°) to the primary compressive trabeculae. A tensile load was applied until failure of anchor fixation. Differences in failure load and stiffness between anchor fixation angles were determined by paired t-tests. Results. No significant differences were detected between perpendicular and oblique suture anchor insertion relative to primary compressive trabeculae in terms of load to failure or stiffness. Conclusion. This investigation suggests that the fixation strength of suture anchors inserted perpendicular to the primary compression trabeculae and at the Deadman’s angle are possibly comparable. Levels of Evidence: Biomechanical comparison study.

Original languageEnglish (US)
Pages (from-to)411-414
Number of pages4
JournalFoot and Ankle Specialist
Volume10
Issue number5
DOIs
StatePublished - Oct 1 2017

Fingerprint

Suture Anchors
Calcaneus
Tendons
Tendinopathy

Keywords

  • Achilles tendonitis
  • biomechanical failure testing
  • calcaneus
  • fixation strength
  • suture anchor

ASJC Scopus subject areas

  • Surgery
  • Podiatry
  • Orthopedics and Sports Medicine

Cite this

The Effect of Suture Anchor Insertion Angle on Calcaneus Pullout Strength : Challenging the Deadman’s Angle. / Weiss, William M.; Saucedo, Ramon P.; Robinson, John D.; Lo, Chung Chieh Jason; Morris, Randal P.; Panchbhavi, Vinod.

In: Foot and Ankle Specialist, Vol. 10, No. 5, 01.10.2017, p. 411-414.

Research output: Contribution to journalArticle

Weiss, William M. ; Saucedo, Ramon P. ; Robinson, John D. ; Lo, Chung Chieh Jason ; Morris, Randal P. ; Panchbhavi, Vinod. / The Effect of Suture Anchor Insertion Angle on Calcaneus Pullout Strength : Challenging the Deadman’s Angle. In: Foot and Ankle Specialist. 2017 ; Vol. 10, No. 5. pp. 411-414.
@article{b718728198154b9c8f7a2a13a822573a,
title = "The Effect of Suture Anchor Insertion Angle on Calcaneus Pullout Strength: Challenging the Deadman’s Angle",
abstract = "Background. Refractory cases of Achilles tendinopathy amenable to surgery may include reattachment of the tendon using suture anchors. However, there is paucity of information describing the optimal insertion angle to maximize the tendon footprint and anchor stability in the calcaneus. The purpose of this investigation is to compare the fixation strength of suture anchors inserted at 90° and 45° (the Deadman’s angle) relative to the primary compressive trabeculae of the calcaneus. Methods. A total of 12 matched pairs of adult cadaveric calcanei were excised and potted to approximate their alignment in vivo. Each pair was implanted with 5.5-mm bioabsorbable suture anchors placed either perpendicular (90°) or oblique (45°) to the primary compressive trabeculae. A tensile load was applied until failure of anchor fixation. Differences in failure load and stiffness between anchor fixation angles were determined by paired t-tests. Results. No significant differences were detected between perpendicular and oblique suture anchor insertion relative to primary compressive trabeculae in terms of load to failure or stiffness. Conclusion. This investigation suggests that the fixation strength of suture anchors inserted perpendicular to the primary compression trabeculae and at the Deadman’s angle are possibly comparable. Levels of Evidence: Biomechanical comparison study.",
keywords = "Achilles tendonitis, biomechanical failure testing, calcaneus, fixation strength, suture anchor",
author = "Weiss, {William M.} and Saucedo, {Ramon P.} and Robinson, {John D.} and Lo, {Chung Chieh Jason} and Morris, {Randal P.} and Vinod Panchbhavi",
year = "2017",
month = "10",
day = "1",
doi = "10.1177/1938640016679705",
language = "English (US)",
volume = "10",
pages = "411--414",
journal = "Foot & ankle specialist",
issn = "1938-6400",
publisher = "SAGE Publications Ltd",
number = "5",

}

TY - JOUR

T1 - The Effect of Suture Anchor Insertion Angle on Calcaneus Pullout Strength

T2 - Challenging the Deadman’s Angle

AU - Weiss, William M.

AU - Saucedo, Ramon P.

AU - Robinson, John D.

AU - Lo, Chung Chieh Jason

AU - Morris, Randal P.

AU - Panchbhavi, Vinod

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background. Refractory cases of Achilles tendinopathy amenable to surgery may include reattachment of the tendon using suture anchors. However, there is paucity of information describing the optimal insertion angle to maximize the tendon footprint and anchor stability in the calcaneus. The purpose of this investigation is to compare the fixation strength of suture anchors inserted at 90° and 45° (the Deadman’s angle) relative to the primary compressive trabeculae of the calcaneus. Methods. A total of 12 matched pairs of adult cadaveric calcanei were excised and potted to approximate their alignment in vivo. Each pair was implanted with 5.5-mm bioabsorbable suture anchors placed either perpendicular (90°) or oblique (45°) to the primary compressive trabeculae. A tensile load was applied until failure of anchor fixation. Differences in failure load and stiffness between anchor fixation angles were determined by paired t-tests. Results. No significant differences were detected between perpendicular and oblique suture anchor insertion relative to primary compressive trabeculae in terms of load to failure or stiffness. Conclusion. This investigation suggests that the fixation strength of suture anchors inserted perpendicular to the primary compression trabeculae and at the Deadman’s angle are possibly comparable. Levels of Evidence: Biomechanical comparison study.

AB - Background. Refractory cases of Achilles tendinopathy amenable to surgery may include reattachment of the tendon using suture anchors. However, there is paucity of information describing the optimal insertion angle to maximize the tendon footprint and anchor stability in the calcaneus. The purpose of this investigation is to compare the fixation strength of suture anchors inserted at 90° and 45° (the Deadman’s angle) relative to the primary compressive trabeculae of the calcaneus. Methods. A total of 12 matched pairs of adult cadaveric calcanei were excised and potted to approximate their alignment in vivo. Each pair was implanted with 5.5-mm bioabsorbable suture anchors placed either perpendicular (90°) or oblique (45°) to the primary compressive trabeculae. A tensile load was applied until failure of anchor fixation. Differences in failure load and stiffness between anchor fixation angles were determined by paired t-tests. Results. No significant differences were detected between perpendicular and oblique suture anchor insertion relative to primary compressive trabeculae in terms of load to failure or stiffness. Conclusion. This investigation suggests that the fixation strength of suture anchors inserted perpendicular to the primary compression trabeculae and at the Deadman’s angle are possibly comparable. Levels of Evidence: Biomechanical comparison study.

KW - Achilles tendonitis

KW - biomechanical failure testing

KW - calcaneus

KW - fixation strength

KW - suture anchor

UR - http://www.scopus.com/inward/record.url?scp=85029654434&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85029654434&partnerID=8YFLogxK

U2 - 10.1177/1938640016679705

DO - 10.1177/1938640016679705

M3 - Article

VL - 10

SP - 411

EP - 414

JO - Foot & ankle specialist

JF - Foot & ankle specialist

SN - 1938-6400

IS - 5

ER -