Authors’ Disclosure Statement: Dr. Roller reports that he is a paid consultant for Bone Solutions Incorporated and a former Arthrex employee. Dr. Cook reports that he receives consulting fees, royalties, speaker honorarium, and grant support from Arthrex. The other authors report no actual or potential conflict of interest in relation to this article.
Acknowledgements: The authors would like to give special thanks to Stacy T. Cheavens, Certified Medical Illustrator, University of Missouri, for creating the illustrations for Figures 1 and 2; and to Vicki Kalsheur, Senior Research Specialist, University of Wisconsin-Madison, for processing the non-decal bone sections.
Dr. Roller is a Resident within the Department of Radiology, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Kuroki is Associate Professor of Veterinary Pathology and Associated Director of the Thompson Laboratory for Regenerative Orthopaedics, Dr. Bozynski is a Veterinary Pathologist, Department of Orthopaedics, and Dr. Pfeiffer is Assistant Professor of Orthopaedics and Bioengineering, University of Missouri, Columbia, Missouri. Dr. Cook is the William & Kathryn Allen Distinguished Chair in Orthopaedic Surgery, Director of the Thompson Laboratory for Regenerative Orthopaedics and Mizzou BioJoint® Center, and Chief of Orthopaedic Research, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri.
Address correspondence to: Brandon L. Roller, MD, PhD, Wake Forest Baptist Medical Center, 1 Medical Center Blvd, Winston-Salem, NC 27157 (tel, 239-293-8256; email, Brandon.L.Roller@gmail.com).
Brandon L. Roller, MD, PhD Keiichi Kuroki, DVM, PhD Chantelle C. Bozynski, DVM Ferris M. Pfeiffer, PhD James L. Cook, DVM, PhD . Use of a Novel Magnesium-Based Resorbable Bone Cement for Augmenting Anchor and Tendon Fixation. Am J Orthop. February 13, 2018
TAKE-HOME POINTS
OsteoCrete, a magnesium-based resorbable bone cement, has potential to safely and effectively augment suture anchor fixation.
OsteoCrete increases anchor pull-out strength within 15 minutes of injection.
OsteoCrete has a more profound impact on anchors when used within bone of decreased density and quality.
OsteoCrete does not result in any untoward effect when placed near, or in contact with, rotator cuff or biceps tendons during fixation procedures.
OsteoCrete can potentially be used to replace the anchor within tenodesis procedures that utilize transcortical button fixation in addition to anchor fixation.
References
ABSTRACT
The aim of this study was to assess the efficacy and safety of a novel magnesium-based resorbable bone cement (OsteoCrete, Bone Solutions Incorporated) for anchor and tendon fixation.
Cadaveric humeral testing involved straight pull-to-failure of rotator cuff suture anchors; OsteoCrete was injected through one anchor, and a second anchor served as the uninjected control. Testing was conducted 15 minutes post-injection. A canine preclinical model was used to evaluate the safety of the following parameters: Rotator cuff repair: A double-row technique was used to repair transected infraspinatus tendons; OsteoCrete was injected through both anchors in one limb, and the contralateral limb served as the uninjected control. Biceps tenodesis: The transected biceps tendon was implanted into a proximal humeral socket with a transcortical button; OsteoCrete was injected into the socket of one limb, and a screw was used for final fixation in the contralateral control limb. Nondestructive biomechanical testing and histologic assessment were performed after 12 weeks.
OsteoCrete-augmented anchors showed significantly higher load-to-failure compared to that with uninjected controls. In cadaveric humeri with reduced bone quality, OsteoCrete increased the mean load-to-failure by 99%. Within the preclinical model, there were no complications or statistically significant biomechanical/histologic differences between the techniques.
OsteoCrete has the potential for safely providing improved suture anchor and tissue fixation in patients with poor bone or tissue quality.
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