ArticleScientific reports2023
Cortical suspensory button fixation has superior biomechanical properties to knotless anchor suture in anterior cruciate ligament repair: a biomechanical study.
Article in Scientific reports, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Double Adjustable-Loop Cortical Buttons for Minimally Invasive Anatomic Double-Bundle Medial Patellofemoral Ligament Reconstruction.Arthroscopy techniques · 2026Article
- No Differences in Outcomes Between Operative and Non-Operative Approaches for High-Grade Acromioclavicular Joint Injuries: A Systematic Review and Meta-analysis.Indian journal of orthopaedics · 2026Review
- Primary anterior cruciate ligament repair with suture tape augmentation: indications, failure predictors, clinical outcomes, and evidence gaps.Frontiers in sports and active living · 2026Review
- Similar Redislocation Rates Between Knot-Tying and Knotless Suture Anchor for Arthroscopic Bankart Repair: A Systematic Review and Meta-analysis.Orthopaedic journal of sports medicine · 2025Article
- Short graft, short tunnel ACL reconstruction with single hamstring and internal brace leads to comparable outcomes to conventional double hamstring technique: A retrospective study.Journal of experimental orthopaedics · 2025Article
- Arthroscopic Anterior Cruciate Ligament Primary Repair With Suture Combined With Femoral Double Bone Tunnel Suspension Fixation.Arthroscopy techniques · 2025Article
- Dynamic anterior stabilization of the shoulder using buttons.JSES international · 2024Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of our biomechanical study was to assess load-to-failure, stiffness, gap formation following cyclic loading, and the failure mechanism for anterior cruciate ligament (ACL) repair comparing the cortical suspensory button and knotless anchor suture. Eight Thiel's embalmed paired cadaveric knees from four cadavers were dissected. The specimens were assigned to undergo ACL repair either with cortical suspensory button or with knotless anchor suture. The Instron machine replicates cyclic loading and then determines the gap formation. Traction was applied until failure. The load-to-failure, stiffness, and modes of failure in both groups were recorded. The load-to-failure, stiffness, and gap formation were compared between the two groups using the student's t-test. The mean load-to-failure in the cortical suspensory button group was significantly higher than the knotless anchor suture group (212.96 ± 54.57 vs 44.57 ± 20.80, p value < 0.01). No statistically significant difference was found regarding gap formation following cyclic loading and stiffness between the cortical suspensory button group and the knotless anchor suture group. This biomechanical study showed a higher load-to-failure for the ACL repair with cortical suspensory button compared to ACL repair with knotless anchor suture, while no statistically significant difference was found regarding the gap formation following cyclic loading and the stiffness. The load-to-failure in both cortical suspensory button and knotless anchor suture are below regular daily activity load. Thus, an internal brace or external support is recommended during rehabilitation.
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