Primary fixation strength of rotator cuff repair techniques: a comparative study |
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| Institution: | 1. Department of Orthopaedics and Traumatology (M.D., A.C.A.), Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey;2. Department of Orthopaedics and Traumatology (O.K.), Vehbi Koc Foundation, American Hospital, Istanbul, Turkey;1. Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA;2. Department of Orthopedic Surgery, UPMC Pinnacle, Harrisburg, PA, USA;3. Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, PA, USA;4. WVU Medicine, United Hospital Center Orthopaedics, Bridgeport, WV, USA;1. Department of Sports Medicine, Foshan Hospital of Traditional Chinese Medicine, Foshan, China;2. Guangzhou University of Chinese Medicine, Guangzhou, China;3. 6th Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, China;1. PanAm Clinic, University of Manitoba, Winnipeg, MB, Canada;2. Department of Orthopedic Surgery, Emory University, Atlanta, GA, USA;3. Boston Shoulder Institute, Massachusetts General Hospital, Boston, MA, USA;1. Department of Biomedical Engineering, University of Melbourne, Parkville, Victoria, 3010, Australia;2. Department of Surgery, Austin Health, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, 3010, Australia;3. Department of Orthopaedic Surgery, Epworth Healthcare, Richmond, Victoria, 3121, Australia;1. Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan;2. Kurihara Central Hospital, Kurihara, Japan;1. Department of Orthopedic Surgery, Emory University, Atlanta, GA, USA;2. PanAm Clinic, University of Manitoba, Winnipeg, MB, Canada;3. Tufts University School of Medicine, Boston, MA, USA;4. Kansas City University of Medicine and Biosciences, Kansas City, MO, USA;5. King Edward Memorial Hospital, Hamilton, Bermuda;6. Department of Orthopedic Surgery, Massachusetts General Hospital, Boston, MA, USA |
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| Abstract: | Purpose:The goal of the study was to compare the primary fixation strength of transosseous suture, suture anchor, and hybrid repair techniques for rotator cuff repair.Type of Study:Animal model experiment.Methods:Thirty-two sheep shoulders were divided into 4 homogeneous groups, according to bone density and tendon dimensions. Infraspinatus tendons were transected from their insertions and reattached using 4 different techniques. Group 1 was repaired with a single Mason-Allen stitch and 2 transosseous tunnels for each end of the suture, knotted on the lateral cortex of proximal humerus; group 2 was repaired with double Mason-Allen stitches and 2 transosseous tunnels; group 3 was repaired with 2 Corkscrews (Arthrex, Germany); and group 4 was repaired with 2 Corkscrews combined with a single Mason-Allen transosseous suture. All specimens were tested for their fixation strengths with a material testing system.Results:The mode of failure in group 1 was mainly suture breakage. In groups 3 and 4, the tendons pulled out from the sutures. In group 2, sutures broke the bony bridge between the 2 tunnels. The mean load to failure value was 160.31 ± 34.59 N in group 1, 199.36 ± 11.73 N in group 2, 108.32 ± 15.98 N in group 3, and 214.24 ± 28.52 N in group 4. Anchor fixation was significantly weaker compared with other groups (P <.001). Combination of a transosseous suture and anchor fixation (group 4) was significantly stronger than the single transosseous suture (group 1) and double anchor techniques (group 3) (P <.001).Conclusions:Hybrid technique was the strongest among the tested rotator cuff repair techniques. With the addition of one transosseous suture to two anchors, the strength of the repair could be doubled. |
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