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Suture Anchors screws Introduction, Uses & Surgical Technique

Suture Anchors screws

Suture Anchors screws 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.

Suture Anchors screws are designed with self-drilling and self-tapping tips to achieve rapid and secure fixation. The eyelet allows visual assessment of suture tension and anchor rotation angle as the soft tissue is being reattached.

Suture Anchors screws Uses

The use of Suture Anchors screws have 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.

Suture Anchors screws Uses 1

Suture Anchors screws Uses 2

Suture Anchors screws Inserting

The suture anchor is inserted through the fracture line into bone. The anchors need to be placed sufficiently deep so that the metal part does not protrude above the fracture.

In repairing the soft tissue and small bony fragments, the anchor is placed as close as possible to the articular margin. Once the anchor is securely seated in bone, the handle is removed.

An appropriately angled suture passer is used to shuttle one suture through the labrum.

The sutures are then tied and as the knot is tightened, the fracture is reduced.

The procedure is repeated for any other fragments not suitable for screw fixation.

At the end of the procedure, use the image intensifier to check the placement of fixation devices and the reduction of the joint.

Aftercare

The neurovascular status of the extremity must be carefully monitored. Impaired blood supply or developing neurological loss must be investigated as an emergency and dealt with expediently.

Functional treatment
Functional treatment shall be applied for 2 – 3 days with patient still resting in bed starting on postoperative day 1.
The goal of early active and passive range of motion is to achieve a full range of motion within the first 4 – 6 weeks. Maximum stability is achieved at the time of surgery.
In noncompliant patients consider the use of a hinged knee brace.

Weight bearing
The patient can be fully weight bearing but care must be taken not to apply a varus distracting force. For this reason, crutches are advisable as a means of protection.

Follow up
Wound healing should be assessed on a short term basis within the first two weeks. Subsequently a 8 week follow-up is usually performed.

Suture Anchors screws removal
Suture Anchors screws removal is not mandatory and should be discussed with the patient.

Suture Anchors screws versus other screw

Suture anchors and other screws are commonly used for fixation of humeral greater tuberosity (GT) fractures in either arthroscopic or open surgeries, but no biomechanical studies have been performed to compare the strength of fixation constructs using these two implants. This cadaveric study aimed to compare the biomechanical strength of three different fixation constructs in the management of GT fractures: Double-Row Suture Anchor Fixation (DR); Suture-Bridge Technique using suture anchors and knotless suture anchors (SB); and Two-Screw Fixation (TS). The experimental procedure was designed to assess fracture displacement after cyclic loading, failure load, and failure mode of the fixation construct. Significant differences were found among the SB (321 N), DR (263 N), and TS (187 N) groups (SB > DR > TS, p < 0.05) in the mean force of cyclic loading to create 3 mm displacement. Regarding the mean force of cyclic loading to create 5 mm displacement and ultimate failure load, no significant difference was found between the DR (370 N, 480 N) and SB (399 N, 493 N) groups, but both groups achieved superior results compared with the TS group (249 N, 340 N) (p < 0.05). The results suggested that the suture anchor constructs would be stronger than the fixation construct using screws for the humeral GT fracture. [/av_textblock][av_layout_row border='' min_height_percent='' min_height='10px' color='alternate_color' mobile='av-flex-cells' id='' av_element_hidden_in_editor='1' mobile_breaking='' custom_class='' av_uid='av-6vl0xe'] [av_cell_one_full vertical_align='top' padding='0px' padding_sync='true' background_color='#7bb0e7' src='' attachment='' attachment_size='' background_attachment='scroll' background_position='top left' background_repeat='no-repeat' mobile_display='' custom_class='' av_uid='av-663o8i'][/av_cell_one_full] [/av_layout_row][av_two_third first min_height='' vertical_alignment='av-align-top' space='' row_boxshadow_color='' row_boxshadow_width='10' margin='0px' margin_sync='true' mobile_breaking='' mobile_column_order='' min_col_height='' padding='0px' padding_sync='true' svg_div_top='' svg_div_top_color='#333333' svg_div_top_width='100' svg_div_top_height='50' svg_div_top_max_height='none' svg_div_top_opacity='' svg_div_bottom='' svg_div_bottom_color='#333333' svg_div_bottom_width='100' svg_div_bottom_height='50' svg_div_bottom_max_height='none' svg_div_bottom_opacity='' border='' border_style='solid' border_color='' radius='0px' radius_sync='true' column_boxshadow_color='' column_boxshadow_width='10' background='bg_color' background_color='' background_gradient_direction='vertical' background_gradient_color1='#000000' background_gradient_color2='#ffffff' background_gradient_color3='' src='' attachment='' attachment_size='' background_position='top left' background_repeat='no-repeat' highlight_size='1.1' animation='' link='' linktarget='' link_hover='' title_attr='' alt_attr='' mobile_display='' mobile_col_pos='0' id='' custom_class='' template_class='' aria_label='' av_uid='av-2rqww6a' sc_version='1.0'] [av_textblock size='16' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-2py6fki' sc_version='1.0' admin_preview_bg=''] Do you have any questions for Suture Anchors screws? Please fill this form we will get in touch with you shortly. [/av_textblock][av_textblock size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-2pjq8pu' sc_version='1.0' admin_preview_bg=''] [gravityform id="4" title="false" description="false" ajax="true"] [/av_textblock] [/av_two_third][av_layout_row border='' min_height_percent='' min_height='10px' color='alternate_color' mobile='av-flex-cells' id='' av_element_hidden_in_editor='1' mobile_breaking='' custom_class='' av_uid='av-2ldvfr6'] [av_cell_one_full vertical_align='top' padding='0px' padding_sync='true' background_color='#7bb0e7' src='' attachment='' attachment_size='' background_attachment='scroll' background_position='top left' background_repeat='no-repeat' mobile_display='' custom_class='' av_uid='av-2jrobde'][/av_cell_one_full] [/av_layout_row][av_textblock textblock_styling_align='' textblock_styling='' textblock_styling_gap='' textblock_styling_mobile='' size='' av-desktop-font-size='' av-medium-font-size='' av-small-font-size='' av-mini-font-size='' font_color='' color='' id='' custom_class='' template_class='' av_uid='av-libzbqp4' sc_version='1.0' admin_preview_bg='']

Different Types of Screws including Suture Anchors screws

Locking Cortical Screws

Cortical Screws

Locking Cancellous Screws

Cancellous Screws

Locking Cannulated Screws

Cannulated Screws

Headless Screws Full Thread

Headless Screws Partially Thread

  • 2.5 mm Headless Compression Screws Partially Thread
  • 3 mm Headless Compression Screws Partially Thread
  • 3.5 mm Headless Compression Screws Partially Thread
  • 4 mm Headless Compression Screws Partially Thread
  • 4.5 mm Headless Compression Screws Partially Thread
  • 5.5 mm Headless Compression Screws Partially Thread
  • 6.5 mm Headless Compression Screws Partially Thread
  • 7.5 mm Headless Compression Screw Partially Thread

Interlocking Nail Screws

Interference Screws

  • 5 mm Interference Screw
  • 6 mm Interference Screw
  • 7 mm Interference Screw
  • 8 mm Interference Screw
  • 9 mm Interference Screw
  • 10 mm Interference Screw

Herbert Screws

Craniomaxillofacial Screws

Malleolar Screws

Bone screws are the most commonly used orthopedic implants. There are many different types and sizes of screws for different types of bones. Most bone screws are made out of stainless steel or titanium alloys. The outer diameter, root diameter, and thread pitch and angle are important in determining screw mechanics.

In orthopedics, screws are typically described by their outer diameter, for example, a “4 mm Suture Anchors screws” has an outside diameter of 4 mm. The pitch of a screw is the linear distance travelled by a screw for one full turn of the screw. The screw advances by a distance equal to the distance between the threads with each full turn. Cortical screws have a lower pitch and therefore more number of threads. Cancellous bone screws have a greater depth of the screw to increase the surface area and therefore improve the purchase, as the bone is weaker.

Screws function by converting the tightening torque into internal tension in the screw and elastic reactions in the surrounding bone. This creates compression between the fracture fragments that the screw is holding together. Screw is typically inserted into holes drilled equal to the root diameter and are either self-tapping or are inserted tapped (threaded) holes. The torque to insert cortical bone screws can be high, so the screws must be properly inserted into the correct size drilled hole and designed to withstand insertion torque levels expected in cortical bone. Cancellous bone screws have large, deep threads that grip the spongy bone well. Because of the relatively low strength of the cancellous bone, failure of the screw itself during insertion is rare, but pull out can be an issue.

Suture Anchors screws Contraindications

Contraindications may be qualified or total, and need to be taken into consideration when evaluating the prognosis in each case. Alternative management techniques may need to be considered under the following conditions:

  • Acute or chronic infections, either local or systemic.
  • Local or systemic accurate or chronic inflammation.
  • Serve muscular, nervous or vascular disease endangering the affected area.
  • Defective bone structures, which would impede adequate anchoring of the implant.
  • All associated diseases which could endanger the function and success of the implant.

Warnings and Precautionary for Suture Anchors screws

Before using Suture Anchors screws, the surgeon and ancillary staff should study the safety information in these instructions, as well as any product-specific information in the product description, surgical procedures and/or brochures.

Screws are made from medical grade materials and are designed, constructed and produced with utmost care. These quality screw assure best working results provided they are used in the proper manner. Therefore, the following instructions for use and safety recommendations must be observed.

Improper use of  screw can lead to damage to the tissue, premature wear, destruction of the instruments and injury to the operator, patients or other persons.

It is vital for the operating surgeon to take an active role in the medical management of their patients. The surgeon should thoroughly understand all aspects of the surgical procedure and instruments including their limitations. Care in appropriate selection and proper use of surgical instruments is the responsibility of the surgeon and the surgical team. Adequate surgical training should be completed before use of implants.

Factors which could impair the success of the operation:

  • Allergies to implanted materials.
  • Localized bone tumours.
  • Osteoporosis or osteomalacia.
  • System disease and metabolic disturbances.
  • Alcohol and drug abuse.
  • Physical activities involving excessive shocks, whereby the implant is exposed to blows and/or excessive loading.
  • Patients who are mentally unable to understand and comply with the doctor’s instructions.
  • Poor general health.

Possible Adverse Effects

The following adverse effects are the most common resulting from implantation:

  • Loosening of the screw, which may result from cyclic loading of the fixation site and/or tissue reaction of the implant.
  • Early and late infection.
  • Further bone fracture resulting from unusual stress or weakened bone substance.
  • Temporary or chronic neural damage resulting from pressure or hematomata.
  • Wound hematomas and delayed wound healing.
  • Vascular disease including venal thrombosis, pulmonary embolism and cardiac arrest.
  • Heterotopic ossification.
  • Pain and discomfort due to presence of the implants.
  • Mechanical failure of the implant, including bending, loosening or breakage.
  • Migration of implant resulting in injury.

Preoperative Planning for Suture Anchors screws

The operating planning is carried out following a thorough clinical evaluation of the patient, Also, x-rays must be taken to allow a clear indication of the bony anatomy and associated deformities. At the time of the operation, the corresponding implantation instruments in addition to a complete size of Suture Anchors screws must be available.

The clinician should discuss with the patient the possible risks and complications associated with the use of implants. It is important to determine pre-operatively whether the patient is allergic to any of the implant materials. Also, the patient needs to be informed that the performance of the device cannot be guaranteed as complications can affect the life expectancy of the device.

Suture Anchors screws Precautions

Suture Anchors screws Warnings

Suture Anchors screws General Adverse Events

As with all major surgical procedures, risks, side effects and adverse events can occur. While many possible reactions may occur, some of the most common include: Problems resulting from anesthesia and patient positioning (e.g. nausea, vomiting, dental injuries, neurological impairments, etc.), thrombosis, embolism, infection, nerve and/or tooth root damage or injury of other critical structures including blood vessels, excessive bleeding, damage to soft tissues incl. swelling, abnormal scar formation, functional impairment of the musculoskeletal system, pain, discomfort or abnormal sensation due to the presence of the device, allergy or hypersensitivity reactions, side effects associated with hardware prominence, loosening, bending, or breakage of the device, mal-union, non-union or delayed union which may lead to breakage of the implant, reoperation.

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