Assessing clinical and patient reported outcomes of Sironix suture anchors in rotator cuff and Bankart repair surgeries

BACKGROUND Rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of life.Arthroscopic rotator cuff repair and Bankart repair has become the standard treatment for restoring function and reducing pain.Recent advancements include new suture anchor technologies,such as the Sironix suture anchor known for its biomechanical strength and promising outcomes.However,there are limited real-world data on its effectiveness and safety,particularly in the Indian population.AIM To evaluate the effectiveness and safety of Sironix suture anchors in rotator cuff and Bankart repair surgeries.METHODS Sixty participants underwent surgery between January 2021 and December 2022,and demographic data and postoperative outcomes were collected through retrospective reviews and telephonic interviews.Validated scales,including the PENN Shoulder Score(PSS),Disabilities of the Arm,Shoulder,and Hand(DASH)score,and Single Assessment Numeric Evaluation(SANE),were utilized for assessment.RESULTS Treatment with Sironix suture anchor devices,including Ceptre Knotted UHMWPE Suture Titanium Anchor,Spyke Knotted UHMWPE Suture Peek Anchor,Stativ Knotted UHMWPE Suture Anchor,and Viplok Knotless Peek Screw Anchor with Titanium Tip,revealed no repair failures.Participants demonstrated high satisfaction and functional improvement,as evidenced by the mean Quick DASH score(32.01)and PSS(71.65)and the satisfactory SANE scores for both injured joints(74.33)and non-injured(83.67)shoulder joints.CONCLUSION The study yielded favorable outcomes for rotator cuff tear repair and Bankart repair.No repair failures were observed,supporting the safety and efficacy of these devices in shoulder injury management.

Minimum 10-year follow-up outcomes of arthroscopic Bankart’s repair with metallic anchors:Reliable results with low redislocation rates

BACKGROUND With stiff competition from alternative albeit more expensive counterparts,it has become important to establish the applicability of metallic anchors for shoulder instability in the modern era.This can be accomplished,in part,by analysing long-term outcomes.AIM To analyse minimum 10-year outcomes from 30 patients following arthroscopic anterior stabilisation using metallic anchors.METHODS Prospectively collected data from arthroscopic Bankart repairs performed using metal anchors during 2007P-2010 were retrospectively analysed in this singlesurgeon study.Comprehensive data collection included historical and clinical findings,dislocation details,operative specifics,and follow-up radiological and clinical findings including shoulder scores.The primary outcomes were patientreported scores(Constant,American Shoulder and Elbow Surgeons[ASES],and Rowe scores)and pain and instability on a visual analogue scale(VAS).RESULTS A 3% recurrence rate of dislocation was noted at the final follow-up.Total constant scores at 10 years postoperatively measured between 76 and 100(mean 89)were significantly better than preoperative scores(mean 62.7).Congruous improvements were also noted in the Rowe and ASES scores and VAS at the 10-year review.CONCLUSION Reliable long-term outcomes with metallic anchors in surgery for shoulder instability can be expected.Our results provide additional evidence of their continued,cost-effective presence in the modern scenario.

Recent Study of Drag Embedment Plate Anchors in China

Experimental and theoretical studies of drag embedment plate anchors recently carried out in Tianjin University are summarized in this research paper, which involve a series of important topics relevant to the study of drag anchors. The techniques for measuring the trajectory and movement direction of drag anchors in soils, the techniques for measuring the moving embedment point and reverse eatenary shape of the embedded drag line, the penetration mechanism and kinematic behavior of drag anchors, the ultimate embedment depth of drag anchors, the movement direction of the anchor with an arbitrary fluke section, the reverse catenary properties of the embedded drag line, the interaetional properties between drag anchor and installation line, the kinematic model of drag anchors in seabed soils, and the analytical method for predicting the anchor trajectory in soils will all be examined. The present work remarkably reduces the uncertainties in design and analysis of drag embedment plate anchors, and is beneficial to improving the application of this new type of drag anchor in offshore engineering.

Testing and modeling of cyclically loaded rock anchors

The Norwegian Public Roads Administration(NPRA) is planning for an upgrade of the E39 highway route at the westcoast of Norway. Fixed links shall replace ferries at seven fjord crossings. Wide spans and large depths at the crossings combined with challenging subsea topography and environmental loads call for an extension of existing practice. A variety of bridge concepts are evaluated in the feasibility study. The structures will experience significant loads from deadweight, traffic and environment. Anchoring of these forces is thus one of the challenges met in the project. Large-size subsea rock anchors are considered a viable alternative. These can be used for anchoring of floating structures but also with the purpose of increasing capacity of fixed structures. This paper presents first a thorough study of factors affecting rock anchor bond capacity. Laboratory testing of rock anchors subjected to cyclic loading is thereafter presented. Finally, the paper presents a model predicting the capacity of a rock anchor segment, in terms of a ribbed bar, subjected to a cyclic load history. The research assumes a failure mode occurring in the interface between the rock anchor and the surrounding grout. The constitutive behavior of the bonding interface is investigated for anchors subjected to cyclic one-way tensile loads. The model utilizes the static bond capacity curve as a basis, defining the ultimate bond sbuand the slip s1 at τ. A limited number of input parameters are required to apply the model. The model defines the bond-slip behavior with the belonging rock anchor capacity depending on the cyclic load level(τcy/τ), the cyclic load ratio(R= τcy/τcy), and the number of load cycles(N). The constitutive model is intended to model short anchor lengths representing an incremental length of a complete rock anchor.

Reliability analysis of prestressed anchors in rock slopes of open-pit mines

Prestressed anchor cables are widely used for slope reinforcement,but the loss of prestress makes it difficult to guarantee the reinforcement effect.Anchor cable prestress degradation was considered as a stochastic process,and the probability density function of this process was established using gamma theory and impact theory respectively.Combined with the failure threshold,the probability density was integrated to find the time-dependent reliability of the anchor cable.Based on the monitoring data of the prestress degradation of the anchor cable,parameters in the probability density function were solved by the maximum likelihood method,and the time-varying reliability and service life of the anchor cable were obtained analytically.The applicability of two degradation theories,gamma stochastic process and impact theory,was compared.The results showed that the probability density curves of both degradation models were normally distributed and the error of reliability results did not exceed 0.06.The life prediction results of the gamma stochastic process were closer to the actual life of 400 h than the 500 h of the impact theory,and the probability curves of the anchor cable life also indicated that the impact theory overestimated the service life probability of the anchor cable.Taking the anchor cable reinforcement within the slope of the Dagushan open-pit mine as an example,and the results verify the feasibility of using gamma theory to predict the degradation of anchor cables and provides theoretical support for prevention of the degradation of anchor cables in the slope of an open-pit mine under the action of external forces.

Upper bound analysis of ultimate pullout capacity of shallow 3-D circular plate anchors based on nonlinear Mohr-Coulomb failure criterion

Based on the nonlinear Mohr-Coulomb failure criterion and the associated flow rules,the three-dimensional(3-D)axisymmetric failure mechanism of shallow horizontal circular plate anchors that are subjected to the ultimate pullout capacity(UPC)is determined.A derivative function of the projection function for projecting the 3-D axisymmetric failure surface on plane is deduced using the variation theory.By using difference principle,the primitive function of failure surface satisfying boundary condition and numerical solution to its corresponding ultimate pullout capacity function are obtained.The influences of nonlinear Mohr-Coulomb parameters on UPC and failure mechanism are studied.The result shows that UPC decreases with dimensionless parameter m and uniaxial tensile strength increases but increases when depth and radius of plate anchor,surface overload,initial cohesion,geomaterial density and friction angle increase.The failure surface is similar to a symmetrical spatial funnel,and its shape is mainly determined by dimensionless parameter m;the surface damage range expands with the increase of radius and depth of the plate anchor as well as initial cohesion but decreases with the increase of dimensionless parameter m and uniaxial tensile strength as well as geomaterial density.As the dimensionless parameter m=2.0,the numerical solution of UPC based on the difference principle is proved to be feasible and effective through the comparison with the exact solution.In addition,the comparison between solutions of UPC computed by variation method and those computed by upper bound method indicate that variation method outperforms upper bound method.

Study on mechanical principle of reinforcing sidewalls and corners of roadway to control floor heave by anchors

The movement principle of sidewalls and floor of extraction opening is analyzed, it is found that floor heave not only has something to do with the floor strata, but sidewalls. The effect of sidewall anchor and corner anchor is studied, the mechanical principle of reinforcing sidewalls and corners is put forward and applied in engineering practice.

Full-scale pullout tests of rock anchors in a limestone quarry focusing on bond failure at the anchor-grout and grout-rock interfaces

Rock anchors are a common safety measure for stabilising large-scale infrastructure,such as bridge towers,retaining walls,rock slopes and windmills.There are four principal failure modes for rock anchors:(a)tensile failure of the steel anchor,(b)anchor-grout interface failure,(c)grout-rock interface failure,and(d)rock mass uplift.Field tests were performed in a limestone quarry.These tests were designed to test failure modes B and C through pullout.In the tests of failure mode B,the shear stress on the anchor-grout interface is the largest at the top of the grout column and attenuates towards the distal end for small loads.The shear stress becomes uniformly distributed when the applied load is approximately 50%of the ultimate pullout load.The anchors designed to test failure mode C were installed with an endplate and had a higher toughness than the straight bar anchors.The shear stress on the grout-rock interface is the largest at the endplate and attenuates upward before slip starts along the interface.When the ultimate pullout load is reached,and the grout column starts to slip,the shear stress is approximately constant.The bond shear strength on the anchor-grout interface was approximately 20%of the uniaxial compressive strength of the grout,and the bond strength of the grout-rock interface was around 5%for that of the grout.The grout-rock interface is likely determined by whichever is weaker,the grout or the rock.

Developments, Expectations of Wave Energy Converters and Mooring Anchors in the UK

The paper introduces the important developments of Wave Energy Converters (WECs) in the UK, and the generic an- chor types for WECs and similar structures. Several WECs and their characteristics are introduced to explain the development direction. The anchors are discussed in relation to the behaviour and performance of WECs, and comparisons are made with simi- lar aspects of the offshore industry. Typical and desirable features of anchors for WECs are summarized. Additionally, expectations and research suggestions for WECs and their anchor design are presented.

Six-Degree-of-Freedom Measurement of Plate Anchors in Centrifuge by Magnetometers

The six-degree-of-freedom movement of an offshore plate anchor is essential to evaluate anchor performance.As an emerging technology,magnetometer has shown its potential in measuring the six-degree-of-freedom movement of offshore anchors under 1-g model laboratory tests.The paper presents the feasibility of adopting a magnetometer system in geotechnical centrifuge testing.Interference factors that may affect the measuring accuracy of the magnetometer system are investigated.The results demonstrate that the magnetometer system can accurately catch the anchor movement in the soils with the restrictions of:(1)the model anchor was made with stainless steel;(2)the system was placed at least 30 cm away from the side wall of soil model tank;(3)started the measurement when the artificial acceleration by centrifuge was stable.

Cyclic load testing of pre-stressed rock anchors for slope stabilization

The objective of this research was to assess the characteristics of seismic induced damage and the deformation patterns of pre-stressed cement-grouted cables that are used for rock slope stabilization projects subjected to quasi-static cyclic loading.The experimental configuration includes the installation of 15 pre-stressed cables in a slope model made of concrete blocks(theoretically rigid rock mass) on top of a pre-existing sliding surface.The study showed that:(i) The pre-stressed cables exhibited great seismic performance.Rapid displacement of the model blocks was observed after the complete loss of the initial pre-stress load under continued applied cyclic loads and exceedance of the state of equilibrium,which implies the higher the initial pre-stress load,the better the seismic performance of the rock anchor;(ii) The failure of the pre-stressed cables was due to fracture at the connection of the tendons and cable heads under cyclic loading.The sequence of failure had a distinct pattern.Failure was first observed at the upper row of cables,which experienced the most severe damage,including the ejection of cable heads.No evidence of de-bonding was observed during the cyclic loading;(iii) The stress distribution of the bond length for pre-stressed cables was highly non-uniform.High stress concentrations were observed at both the fixed end and the free end of the bond length both before and immediately after the state of equilibrium is exceeded.The results obtained can be used to evaluate the overall performance of pre-stressed rock anchors subject to seismic loading and their potential as rockfall prevention and stabilization measures.

Experimental study on the stability of plate anchors in clay under cyclic loading

Although the bearing capacity of plate anchors in clay has been studied extensively, the results considering the effects of offshore cyclic loading are relatively rare. In the present study, 1g model tests are carried out to investigate the effect of cyclic loading on the bearing capacity of plate anchors in clay. The ultimate pullout capacity of plate anchors in clay decreases as the accumulated plastic shear strain grows due to the strain-softening of clay under cyclic loading. The load-displacement curves of these tests are presented and the effects of overburden stress and cyclic loading amplitude on the strain-softening behavior are discussed.

Limit analysis of ultimate uplift capacity and failure mechanism ofshallow plate anchors in multi-layered soils

Considering the fact that in some complex cases,plate anchors are buried in multi-layered geotechnical materials,the ultimate dynamic analysis was performed to investigate the uplift capacity and failure mechanism of shallow strips and circular plate anchors in multi-layered soils.The nonlinear strength criterion and non-associated flow rule of geotechnical materials were introduced to investigate the influence of nonuniformity on the pullout performance and failure mechanism of shallow plate anchors.The expressions of the detaching curves or surfaces were obtained to reflect the failure mechanism,which can be used to figure out the ultimate uplift capacity and failure range.The results are generally in agreement with the numerical simulations and previous research.The effects of various parameters on the ultimate uplift capacity and failure mechanism of plate anchors in multi-layered soils were investigated,and it is found that the ultimate uplift capacity and failure range of shallow anchors increase with the increase of initial cohesion and dilatancy coefficient,but decrease with the unit weight,axial tensile stress and nonlinear coefficient.

3DT-PP:localization and path planning of mobile anchors over complex 3D terrains

Mobile anchors are widely used for localization in WSNs.However,special properties over 3D terrains limit the implementation of them.In this paper,a novel 3D localization algorithm is proposed,called 3 DT-PP,which utilizes path planning of mobile anchors over complex 3 D terrains,and simulations based upon the model of mountain surface network are conducted.The simulation results show that the algorithm decreases the position error by about 91%,8.7%and lowers calculation overhead by about 75%,1.3%,than the typical state-of-the-art localization algorithm(i.e.,'MDS-MAP','Landscape-3D').Thus,our algorithm is more potential in practical WSNs which are the characteristic of limited energy and 3D deployment.

An Analytical Method for Positioning Drag Anchors in Seabed Soils

Positioning drag anchors in seabed soils are strongly influenced not only by the properties of the anchor and soil, but also by the characteristics of the installation line. The investigation on the previous prediction methods related to anchor positioning demonstrates that the prediction of the anchor position during dragging has inevitably introduced some key and unsubstantiated hypotheses and the applicability of these methods is limited. In the present study, the interactional system between the drag anchor and installation line is firstly introduced for the analysis of anchor positioning. Based on the two mechanical models for embedded lines and drag anchors, the positioning equations for drag anchors have been derived both for cohesive and noncohesive soils. Since the drag angle at the shackle is the most important parameter in the positioning equations, a novel analytical method that can predict both the variation and the exact value of the drag angle at the shackle is proposed. The analytical method for positioning drag anchors which combines the interactional system between the drag anchor and the installation line has provided a reasonable theoretic approach to investigate the anchor behaviors in soils. By comparing with the model flume experiments, the sensitivity, effectiveness and veracity of the positioning method are well verified.

Mechanical responses of anchoring structure under triaxial cyclic loading

Dynamic load on anchoring structures(AS)within deep roadways can result in cumulative damage and failure.This study develops an experimental device designed to test AS under triaxial loads.The device enables the investigation of the mechanical response,failure mode,instability assessment criteria,and anchorage effect of AS subjected to combined cyclic dynamic-static triaxial stress paths.The results show that the peak bearing strength is positively correlated with the anchoring matrix strength,anchorage length,and edgewise compressive strength.The bearing capacity decreases significantly when the anchorage direction is severely inclined.The free face failure modes are typically transverse cracking,concave fracturing,V-shaped slipping and detachment,and spallation detachment.Besides,when the anchoring matrix strength and the anchorage length decrease while the edgewise compressive strength,loading rate,and anchorage inclination angle increase,the failure intensity rises.Instability is determined by a negative tangent modulus of the displacement-strength curve or the continued deformation increase against the general downward trend.Under cyclic loads,the driving force that breaks the rock mass along the normal vector and the rigidity of the AS are the two factors that determine roadway stability.Finally,a control measure for surrounding rock stability is proposed to reduce the internal driving force via a pressure relief method and improve the rigidity of the AS by full-length anchorage and grouting modification.

Outcome of repair of chronic tear of the pectoralis major using corkscrew suture anchors by box suture sliding technique

AIM To assess the functional and clinical results of repair of chronic tears of pectoralis major using corkscrew and sliding suture technique. METHODS In this retrospective study, we reviewed the results of pectoralis major repair in 11 chronic cases(> 6 wk) done between September 2011 and December 2014 at our institute. In all cases repair was done by same surgeon using corkscrew suture anchors and box suture sliding technique. At 6 mo, after surgery magnetic resonance imaging was done to see the integrity of the repair. Functional evaluation was done using Penn and ASES scores. Pre and postoperative Isokinetic strength was measured.RESULTS Average follow-up was 48.27 ± 21.0 mo. The Wilcoxon signed rank test was used to evaluate the outcome scores. The average ASES score increased from an average of 54.63 ± 13.0 preoperatively to 95.09 ± 2.60 after surgery at their last follow-up. The average Penn score also increased from 5.72 ± 0.78, 2.81 ± 1.32 and 45.81 ± 1.72 to 9.36 ± 0.80, 8.27 ± 0.90 and 59 ± 1.34 for pain, satisfaction and function respectively. Follow up magnetic resonance imaging(MRI)(at 6 mo) showed continuity and the bulk of pectoralis major muscle in all cases. Average isokinetic strength deficiency in horizontal adduction at 60° was 13.63% ± 6.93% and at 120° was 10.18% ± 4.93% and in flexion at 60° was 10.72% ± 5.08% and at 120° was 6.63% + 3.74%. Results showed that both ASES and Penn score improved significantly(2 tailed P value = 0.0036).CONCLUSION We could conclude from this series that pectoralis major repair even in chronic cases using 5.5 mm corkscrew anchors give excellent functional and cosmetic results. In chronic cases the repairable length of the tendon is not available and sliding suture technique allows for fixation of worn out tendomuscular junction to bone without letting cutting through the muscle.

Mechanism of high-preload support based on the NPR anchor cable in layered soft rock tunnels

The control of large deformation problems in layered soft rock tunnels needs to solve urgently.The roof problem is particularly severe among the deformation issues in tunnels.This study first analyzes the asymmetric deformation modes in layered soft rock tunnels with large deformations.Subsequently,we construct a mechanical model under ideal conditions for controlling the roof of layered soft rock tunnels through high preload with the support of NPR anchor cables.The prominent roles of long and short NPR anchor cables in the support system are also analyzed.The results indicate the significance of high preload in controlling the roof of layered soft rock tunnels.The short NPR anchor cables effectively improve the integrity of the stratified soft rock layers,while the long NPR anchor cables effectively mobilize the self-bearing capacity of deep-stable rock layers.Finally,the high-preload support method with NPR anchor cables is validated to have a good effect on controlling large deformations in layered soft rock tunnels through field monitoring data.

Artificial Neural Network Model for Predicting Ultimate Tensile Capacity of Adhesive Anchors

To predict the tensile capacity of adhesive anchors, a multilayered feed-forward neural network trained with the back-propagation algorithm is constructed. The ANN model have 5 inputs, including the compressive strength of concrete, tensile strength of concrete, anchor diameter, hole diameter, embedment of anchors, and ultimate load. The predictions obtained from the trained ANN show a good agreement with the experiments. Meanwhile, the predicted ultimate tensile capacity of anchors is close to the one calculated from the strength formula of the combined cone-bond failure model.

Mallet Toe of the Hallux Treated by Bridging Suture Technique Using Suture Anchors: A Case Report and Literature Review

An avulsion fracture of the extensor hallucis longus at the distal end of the great toe is called “mallet toe” of the hallux. It is a rare injury and the treatment options are conservative treatment using a splint, percutaneous or open Kirschner wire fixation similar to that in the mallet finger, or suture anchor fixation. We present a case treated by the bridging technique using two suture anchors. A 57-year-old Japanese man injured his left great toe after a fall while walking barefoot on the bed. His great toe was forced into a hyperplantarflexion position. Plain radiography and computed tomography showed a small bone fragment at the base of the dorsal distal phalanx, suggesting an avulsion fracture of the extensor hallucis longus. He was treated by bridging suture technique with two suture anchors. At first, two suture anchors were inserted to the fracture bed of the distal phalanx, and then the bone fragment and extensor hallucis longus tendon were secured with two horizontal mattress sutures. Finally, bridging sutures were performed using the remaining sutures and the sutures used for mattress suturing. He obtained bony union and symmetric range of motion of the interphalangeal joint. This technique allowed us to fix the small bone fragment rigidly and mobilize the interphalangeal joint earlier to preserve the range of motion. It would be a valuable procedure when the bone fragment is small.