DePuy Synthes Mitek Sports Medicine
Gryphon® Suture Anchor with Proknot™ Technology
Paul Favorito, MD, Wellington Orthopaedic and Sports Medicine, Cincinnati, OH
The Gryphon® suture anchor with Proknot™ technology is a doubled No. 1 Permacord® high-strength orthopedic suture with a proprietary pre-tied sliding knot. The suture construct is loaded onto a 3.0-mm Gryphonsuture anchor (Peek or Biocryl Rapide® biocomposite material) and has clinical indications for labral repair of the shoulder and hip. In a laboratory setting, Proknot technology has been tested against other high-tensile sutures and commonly tied arthroscopic knots.1 Proknot technology demonstrated higher ultimate strength, significantly less knot volume, and better reproducibility among surgeons.
Surgical pearl: I use the Gryphon Proknot suture anchor for all shoulder Bankart and superior labral anterior to posterior (SLAP) repairs. I have colleagues who also use this anchor for hip arthroscopy.
Once opened on the back table, the surgical assistant may ink the free limb of suture for easy arthroscopic identification. The anchor is placed and, in the case of hard bone frequently encountered in younger patients, a 2.5-mm drill bit may be substituted for the usual 2.4-mm. One important goal of any labral repair is to position knots away from the articular surface. The free suture limb is passed through the labrum, retrieved, and delivered through the open, pre-tied knot on the suture card.
Once the knot is released and dressed, the knot pusher is placed over the suture and the knot is advanced and preliminarily tensioned medial to the articular surface. The suture limbs are separated and one limb of the suture is removed from the knot pusher. As few as 1, or up to 3, half hitches may be placed to secure the knot, taking care to direct it away from the joint surface. The result is a strong but well-positioned knot with minimal mass securing the soft tissue.