A low-profile all-suture anchor construct provides comparable fixation to both spiked washer and bone staple for tibial-sided medial collateral ligament reconstruction: A cadaveric biomechanical study

IF 2.7 Q1 ORTHOPEDICS

Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2025-02-27 DOI:10.1016/j.jisako.2025.100845

Felipe Moreira Borim , Lachlan Batty , Cindy Zeng , Anna-Katharina Calek , Dale Robinson , David Ackland , Timothy Lording

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Abstract

Objectives

To compare the biomechanical performance of an all-suture anchor construct to that of both a spiked washer and cancellous screw, and a bone staple in tibial-sided superficial medial collateral ligament (sMCL) reconstruction.

Methods

A time-zero cadaveric biomechanical study was conducted using 24 human cadaveric tibia, with fresh-frozen peroneus longus allografts used for an sMCL reconstruction. Specimens were randomized to one of three treatment groups for tibial fixation being an all-suture anchor construct, spiked washer, or bone staple. A servohydraulic uniaxial testing machine was used to assess elongation after 1000 cycles at 20–50N, maximum load-to-failure (LTF), elongation at maximum LT, and modes of failure. Differences between groups were analyzed using one-way analysis of variance (ANOVA).

Results

No statistically significant differences were observed across the groups. Mean elongation after cyclic loading was 1.1 ± 0.7 mm in the all-suture anchor group, 0.6 ± 1.2 mm in the spiked washer group, and 1.1 ± 0.6 mm in the staple group (p = 0.732). Mean maximum LTF was 132.1 ± 40.2N for the all-suture anchor group, 120.8 ± 54.9N for the spiked washer group, and 123.9 ± 64.1N for the staple group (p = 0.605). Mean elongation at maximum LTF was 8.6 ± 4.1 mm for the all-suture anchor group, 8.7 ± 5.4 mm for the spiked washer group, and 10.8 ± 6.3 mm for the staple group (p = 0.605). The mode of failure for all specimens was tendon pullout.

Conclusion

The all-suture anchor construct demonstrated comparable performance to both the spiked washer and bone staple for tibial-sided sMCL reconstruction in this time-zero cadaveric biomechanical assessment.