AANA Lab Course 1001 - Foundations in Arthroscopy (Resident/Fellow)-Non-CME Spotlight Demo Sponsored by DePuy

Non-CME Spotlight Demo Sponsored by DePuy_Mitek (Dynacord)-Richard K.N. Ryu, M.D

Pdf Summary

The document presents DYNACORD, an innovative suture designed to improve outcomes in soft tissue repairs, particularly rotator cuff (RC) and tendon-to-bone surgeries. DYNACORD’s unique structure consists of an inner and outer braided sheath made of ultra-high molecular weight polyethylene (UHMWPE) and polyester, surrounding a silicone/salt-filled core. This design combats suture laxity during healing by exploiting a “sponge effect”: salt elutes from the core into surrounding fluids, causing radial expansion of the suture braid and axial shortening of the suture length. This dynamic adjustment helps maintain tension and tissue approximation throughout healing, which is crucial because loss of contact pressure and tendon-to-bone fixation often occurs shortly after repair, leading to high failure rates, especially in large or revision RC repairs (failure rates up to 94% reported).<br /><br />Technical goals for ideal sutures include strong tendon-bone and tendon-tendon fixation, knot security, minimal tissue damage, and restoration of the anatomic footprint. DYNACORD meets these by minimizing laxity and maintaining tissue security over time. Safety evaluations in ovine and porcine models showed no adverse tissue reactions, no systemic toxicity, and less “cheesewiring” (tendon cut-through) compared to FiberWire sutures, demonstrating a favorable safety profile.<br /><br />Indications for DYNACORD are broad: shoulder repairs (rotator cuff, labral, biceps tenodesis), foot/ankle, knee, elbow, and hip surgeries. It works with compatible anchors like Healix Advance, a self-punching, metal-free anchor designed for arthroscopic repairs.<br /><br />Case examples highlight clinical applications in complex shoulder instability and fractures, emphasizing DYNACORD’s reliability in preserving tissue tension and facilitating healing. Overall, DYNACORD offers a strong, safe, dynamic suture solution that addresses traditional suture shortcomings by actively minimizing laxity, optimizing repair strength, and potentially improving clinical outcomes.<br /><br />In summary, DYNACORD is positioned as a "suture of the future" that provides superior handling, strength, and healing environment compatibility for soft tissue repairs.

Keywords

DYNACORD

suture laxity

rotator cuff repair

tendon-to-bone fixation

ultra-high molecular weight polyethylene

sponge effect

tissue tension maintenance

arthroscopic repair

FiberWire comparison

Healix Advance anchor