Innovative Implant Facilitates Improved Soft Tissue To Bone Fixation

With an emerging bioresorbable implant, surgeons can fixate soft tissue to bone with the aid of ultrasound technology.

The SonicAnchor utilizes ultrasonic SonicFusion™ technology to liquefy the anchor tip and facilitate interdigitation of the implant with the surrounding cancellous bone structure, according to the manufacturer Stryker. The implant enhances dynamic load stability by 95 percent without the presence of cortical bone, according to Stryker’s product literature.

Shane Hollawell, DPM, has used the SonicAnchor for approximately six months. Using the anchor (and sometimes multiple anchors) in 25 cases, Dr. Hollawell notes it has been successful in all cases of attaching ligament and/or tendon to bone in the foot and ankle.

The SonicAnchor is useful for lateral ankle ligament repair, acute deltoid ligament re-attachment, Kidner procedures, flexor digitorum longus transfer for posterior tibial tendon dysfunction, Achilles tendon reattachment in cases of Haglund’s deformity and/or retrocalcaneal spur resection procedures, according to Dr. Hollawell, an Associate Clinical Professor at Rutgers University/Robert Wood Johnson Medical School. In addition, Stryker notes the device is indicated for lateral and medial stabilization, hallux valgus or midfoot reconstruction, and metatarsal ligament repair.

Christopher Hyer, DPM, FACFAS, has also used the Sonic Anchor for about six months.

“It is a very effective soft tissue anchor that provides impressive pullout strength,” says Dr. Hyer, the Fellowship Director of the Advanced Foot & Ankle Surgical Fellowship in Westerville, Ohio. “I find it very effective in cases when I need to anchor into cancellous bone where traditional corkscrew and suture-based anchors struggle to maintain footing.”

Dr. Hollawell says using the Sonic-Anchor is not technically demanding. Surgeons place a drill hole through the cannula, which facilitates easy placement that one can confirm via intraoperative imaging, according to Dr. Hollawell. Since the drill hole is also very shallow, he notes it almost eliminates the concern of placing the anchor through the far cortex.   

Stryker emphasizes the device’s small footprint and that surgeons can use a 2.5 mm suture anchor for all the product indications. The company notes the implant’s fully resorbable poly-L-lactide-co-D,L-lactide) (PLDLLA) properties facilitate slower resorption.

With the SonicAnchor, Dr. Hollawell says surgeons have the ability to load different size sutures directly into each individual anchor. He claims the anchor is exceptionally stable in bone and has not noticed any creep or movement of the anchor within the bone when intentionally testing its strength or stability before engaging the soft issue with the attached/embedded suture.

In terms of potential drawbacks, the implant does require a specific handpiece and foot pedal, according to Dr. Hollawell. Dr. Hyer notes the anchor requires an ultrasound generator in the operating room for use. Unless that unit is located in the OR, Dr. Hyer says it may not be possible to use the anchor in a spur of the moment surgical decision.