{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:30:04Z","timestamp":1789997404251,"version":"4.0.1"},"reference-count":20,"publisher":"American Veterinary Medical Association (AVMA)","issue":"7","license":[{"start":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T00:00:00Z","timestamp":1656633600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To compare biomechanical strength of 4.75- and 5.5-mm suture anchors when pulled at 45\u00b0 or 90\u00b0 angles using 1 versus 2 strands of suture.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>SAMPLE<\/jats:title>\n<jats:p>48 synthetic bone block samples.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>Anchors were inserted into synthetic bone blocks and tested for pullout in 4 configurations (1 suture strand vs 2 strands and 45\u00b0 vs 90\u00b0 insertion angle) for a total of 8 groups with 6 samples each. A 3-way ANOVA was used to compare effect of anchor size, strand amount, and angle of pull.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>All constructs failed via anchor pullout. Anchor configurations with 2 strands of suture and 4.75-mm anchor (mean, 286 \u00b1 24 N) or 5.5-mm anchor (mean, 300 \u00b1 15 N) had greater pullout strength than configurations with only 1 strand of suture and 4.75-mm anchor (mean, 202 \u00b1 12 N) or 5.5-mm anchor (mean, 286 \u00b1 13.6 N). The 5.5-mm anchors had a higher maximum load to failure under axial pull at 45\u00b0 (mean, 300 \u00b1 15 N) and 90\u00b0 (mean, 295 \u00b1 24 N), compared with 4.75-mm anchors at 45\u00b0 (mean, 202 \u00b1 12 N) and 90\u00b0 (mean, 208 \u00b1 15 N). There was a higher maximum load to failure for the double-stranded constructs, regardless of anchor size, at both angles of insertion. Anchors inserted at 45\u00b0 had a higher maximum load to failure than those inserted at 90\u00b0. Constructs with 2 strands of suture had a greater pullout strength regardless of the direction of pull.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>The strength of the anchor construct is likely increased with the use of double-loaded anchors inserted at 45\u00b0. Clinicians should consider using 2 strands in clinical cases.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/ajvr.21.05.0065","type":"journal-article","created":{"date-parts":[[2022,6,1]],"date-time":"2022-06-01T13:02:10Z","timestamp":1654088530000},"source":"Crossref","is-referenced-by-count":1,"title":["Biomechanical evaluation of a 4.75-mm and a 5.5-mm bone anchor at two insertion angles using one and two strands of suture"],"prefix":"10.2460","volume":"83","author":[{"given":"Sarah A.","family":"Salyer","sequence":"first","affiliation":[{"name":"The Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan T.","family":"Suber","sequence":"additional","affiliation":[{"name":"Capital Animal Hospital Veterinary Surgical Center, Columbia, SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia M.","family":"Melara","sequence":"additional","affiliation":[{"name":"Arthrex Inc, Naples, FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina R.","family":"Kieves","sequence":"additional","affiliation":[{"name":"The Ohio State University, Columbus, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"key":"B1","series-title":"Clin Biomech","first-page":"70","article-title":"The history of suture anchors in orthopaedic surgery","volume":"61","year":"2019","unstructured":"Visscher LE, Jeffery C, Gilmour T, Anderson L, Couzens G. The history of suture anchors in orthopaedic surgery. Clin Biomech. 2019;61:70\u201378."},{"issue":"04","key":"B2","series-title":"Vet Comp Orthop Traumatol","first-page":"208","article-title":"Clinical case applications of Mitek\u00ae tissue anchors in veterinary orthopaedics","volume":"6","year":"1993","unstructured":"Edwards MR, Taylor RA, Franceschi RA. Clinical case applications of Mitek\u00ae tissue anchors in veterinary orthopaedics. Vet Comp Orthop Traumatol. 1993;6(04):208\u2013212."},{"key":"B3","series-title":"Vet Comp Orthop Traumatol","first-page":"43","article-title":"Cranial cruciate ligament rupture in large and giant dogs. A retrospective evaluation of a modified lateral extracapsular stabilization","volume":"20","year":"2007","unstructured":"Gu\u00e9n\u00e9go L, Zahra A, Madel\u00e9nat A, Gautier R, Marcellin-Little D, Hulse D. Cranial cruciate ligament rupture in large and giant dogs. A retrospective evaluation of a modified lateral extracapsular stabilization. Vet Comp Orthop Traumatol. 2007;20:43\u201350.17364096"},{"issue":"5","key":"B4","series-title":"J Hand Surg Am","first-page":"1051","article-title":"Fixation of tendon grafts for collateral ligament reconstructions: a cadaveric biomechanical study","volume":"30","year":"2005","unstructured":"Lee SK, Kubiak EN, Liporace FA, Parisi DM, Iesaka K, Posner MA. Fixation of tendon grafts for collateral ligament reconstructions: a cadaveric biomechanical study. J Hand Surg Am. 2005;30(5):1051\u20131055.16182066"},{"issue":"8","key":"B5","series-title":"Arthroscopy","first-page":"900","article-title":"The effect of insertion angle on the pullout strength of threaded suture anchors: a validation of the deadman theory","volume":"30","year":"2014","unstructured":"Clevenger TA, Beebe MJ, Strauss EJ, Kubiak EN. The effect of insertion angle on the pullout strength of threaded suture anchors: a validation of the deadman theory. 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Arthroscopy. 2017;33(6):1113\u20131121.28017468"},{"issue":"8","key":"B8","series-title":"Arthroscopy","first-page":"859","article-title":"Suture anchor materials, eyelets, and designs: update 2008","volume":"24","year":"2008","unstructured":"Barber FA, Herbert MA, Beavis RC, Barrera Oro F. Suture anchor materials, eyelets, and designs: update 2008. Arthroscopy. 2008;24(8):859\u2013867.18657733"},{"issue":"9","key":"B9","series-title":"Arthroscopy","first-page":"1589","article-title":"The evolution of suture anchors in arthroscopic rotator cuff repair","volume":"29","year":"2013","unstructured":"Denard PJ, Burkhart SS. The evolution of suture anchors in arthroscopic rotator cuff repair. Arthroscopy. 2013;29(9):1589\u20131595.23876609"},{"issue":"10","key":"B10","series-title":"Arthroscopy","first-page":"1236","article-title":"Rotator cuff repair: an ex vivo analysis of suture anchor repair techniques on initial load to failure","volume":"21","year":"2005","unstructured":"Cummins CA, Appleyard RC, Strickland S, Haen PS, Chen S, Murrell GA. Rotator cuff repair: an ex vivo analysis of suture anchor repair techniques on initial load to failure. Arthroscopy. 2005;21(10):1236\u20131241."},{"issue":"1","key":"B11","series-title":"Am J Sports Med","first-page":"163","article-title":"Biomechanical analysis of a double-loaded glenoid anchor configuration: can fewer anchors provide equivalent fixation?","volume":"41","year":"2013","unstructured":"Kamath GV, Hoover S, Creighton RA, Weinhold P, Barrow A, Spang JT. Biomechanical analysis of a double-loaded glenoid anchor configuration: can fewer anchors provide equivalent fixation? 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Arthroscopy. 2016;32(7):1415\u20131420.27157660"},{"issue":"2","key":"B14","series-title":"Arthrosc Tech","first-page":"e213","article-title":"The use of double-loaded suture anchors for labral repair and capsular repair during hip arthroscopy","volume":"1","year":"2012","unstructured":"Slikker W, Van Thiel GS, Chahal J, Nho SJ. The use of double-loaded suture anchors for labral repair and capsular repair during hip arthroscopy. Arthrosc Tech. 2012;1(2):e213\u2013217.23766998"},{"issue":"5","key":"B15","series-title":"Foot Ankle Spec","first-page":"411","article-title":"The effect of suture anchor insertion angle on calcaneus pullout strength: challenging the deadman's angle","volume":"10","year":"2017","unstructured":"Weiss WM, Saucedo RP, Robinson JD, Lo CJ, Morris RP, Panchbhavi VK. The effect of suture anchor insertion angle on calcaneus pullout strength: challenging the deadman's angle. Foot Ankle Spec. 2017;10(5):411\u2013414.27881831"},{"issue":"12","key":"B16","series-title":"Arthroscopy","first-page":"1535","article-title":"Biomechanical study: determining the optimum insertion angle for screw-in suture anchors\u2013is deadman's angle correct?","volume":"30","year":"2014","unstructured":"Green RN, Donaldson OW, Dafydd M, Evan SL, Kulkarni R. Biomechanical study: determining the optimum insertion angle for screw-in suture anchors\u2013is deadman's angle correct? Arthroscopy. 2014;30(12):1535\u20131539.25218007"},{"issue":"4","key":"B17","series-title":"J Shoulder Elbow Surg","first-page":"e124","article-title":"Does anchor insertion angle or placement of the suture anchor affect glenoid rim fracture occurrence after arthroscopic Bankart repair?","volume":"29","year":"2020","unstructured":"Park JY, Lee JH, Oh KS, Chung SW, Park H, Park JY. 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