Biomechanical Comparison of 3 Suture Anchor Configurations for Repair of Type II SLAP Lesions

Purpose: Our purpose was to compare 3 commonly used suture anchor configurations for repair of type II SLAP lesions. Methods: Biomechanical testing was performed on 3 groups of 7 cadaveric shoulders by use of an optical linear strain measurement system. Standardized type II SLAP lesions were created and repaired via 3 suture anchor configurations: (1) a single simple suture anterior to the biceps; (2) two simple sutures, one anterior and one posterior to the biceps; and (3) a single mattress suture through the biceps anchor. Cyclic traction was applied to the biceps tendon, and strain failure (defined as 2 mm of permanent displacement), yield, and pullout loads were measured. Results: The mean load to strain failure was 63 N in group 1, 70 N in group 2, and 106 N in group 3. The mean load to ultimate failure was 140 N in group 1, 194 N in group 2, and 194 N in group 3. Strain failure load was significantly higher in the mattress suture group than in either of the other two groups (P < .05). Groups 2 and 3 both had a significantly higher load to ultimate failure than group 1. Conclusions: When type II SLAP lesions were subjected to cyclic traction, the load to strain failure was greater with a single anchor and mattress suture than with one or two anchors with simple sutures around the labrum. Fixation with two simple sutures appears to provide intermediate load to strain failure. Clinical Relevance: The results of this study suggest that a single anchor with a mattress suture may be a biomechanically advantageous construct for the repair of type II SLAP lesions.