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A Meta-Analysis of Biomechanical Studies for Suture Button Pullout Versus Suture Anchor Repair of Flexor Digitorum Profundus Avulsions.

MedStar author(s):

Imbergamo, Casey

, MUMH

, Orthopaedic Surgery Residency

, Orthopaedic Surgery Residency

Citation: Hand. :15589447221126760, 2022 Oct 05PMID: 36196928Institution: Curtis National Hand Center | MedStar Union Memorial HospitalDepartment: Orthopaedic Surgery ResidencyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: IN PROCESS -- NOT YET INDEXEDYear: 2022 ISSN:

1558-9447

Name of journal: Hand (New York, N.Y.)Abstract: BACKGROUND: There is no current consensus on which of the two most common flexor digitorum profundus (FDP) avulsion repair constructs, via suture button pullout (SBP) or suture anchor (SA), is biomechanically superior. Our purpose was to compare these repair methods via systematic review and meta-analysis of available literature.CONCLUSIONS: Via meta-analysis, there was increased initial construct stiffness and less gap formation for SA compared to SBP for FDP reinsertion, with no significant differences for ultimate failure load.METHODS: We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review of PubMed, the Cochrane library, and Embase. We only included studies with direct comparison data for both techniques. We performed a meta-analysis comparing the reported biomechanical results using pooled data for initial repair stiffness (N/mm), gap formation (mm), and ultimate load to failure (N).RESULTS: Seven studies met inclusion criteria, including a total of 201 cadaveric specimens. Four studies reported initial construct stiffness, with pooled analysis showing superiority for SA repairs (P < .05). Four studies evaluated gap formation, with pooled analysis demonstrating less gapping with SA repair (P < .05). Mean gap formation was 2.4 (+/-1.4) mm and 3.9 (+/-2.0) mm for the SA and SBP groups, respectively. All 7 studies assessed load to failure, with pooled analysis revealing no significant difference between groups (P > .05). We lacked statistical power to determine equivalence between techniques for load to failure. Both groups had failure values significantly lower than the native FDP.All authors: Imbergamo CM, Means KR Jr, Miles MR, Sequeira SBFiscal year: FY2023 Digital Object Identifier:

https://dx.doi.org/10.1177/15589447221126760

ORCID:

https://orcid.org/0000-0002-9040-357X https://orcid.org/0000-0001-5347-470X https://orcid.org/0000-0002-9040-357X https://orcid.org/0000-0001-5347-470X
https://orcid.org/0000-0002-9040-357X https://orcid.org/0000-0001-5347-470X https://orcid.org/0000-0002-9040-357X https://orcid.org/0000-0001-5347-470X

Date added to catalog: 2022-10-27

Holdings ( 1 )
Title notes ( 5 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	36196928	Available		36196928

BACKGROUND: There is no current consensus on which of the two most common flexor digitorum profundus (FDP) avulsion repair constructs, via suture button pullout (SBP) or suture anchor (SA), is biomechanically superior. Our purpose was to compare these repair methods via systematic review and meta-analysis of available literature.

CONCLUSIONS: Via meta-analysis, there was increased initial construct stiffness and less gap formation for SA compared to SBP for FDP reinsertion, with no significant differences for ultimate failure load.

METHODS: We performed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic review of PubMed, the Cochrane library, and Embase. We only included studies with direct comparison data for both techniques. We performed a meta-analysis comparing the reported biomechanical results using pooled data for initial repair stiffness (N/mm), gap formation (mm), and ultimate load to failure (N).

RESULTS: Seven studies met inclusion criteria, including a total of 201 cadaveric specimens. Four studies reported initial construct stiffness, with pooled analysis showing superiority for SA repairs (P < .05). Four studies evaluated gap formation, with pooled analysis demonstrating less gapping with SA repair (P < .05). Mean gap formation was 2.4 (+/-1.4) mm and 3.9 (+/-2.0) mm for the SA and SBP groups, respectively. All 7 studies assessed load to failure, with pooled analysis revealing no significant difference between groups (P > .05). We lacked statistical power to determine equivalence between techniques for load to failure. Both groups had failure values significantly lower than the native FDP.

English