Tendon-Bone Interface Motion in Transosseous Suture and Suture Anchor Rotator Cuff Repair Techniques

2005 ◽  
Vol 33 (11) ◽  
pp. 1667-1671 ◽  
Author(s):  
Christopher S. Ahmad ◽  
Andrew M. Stewart ◽  
Rolando Izquierdo ◽  
Louis U. Bigliani
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Suture Repair ◽  
Interface Motion ◽  
Bone Interface ◽  
Transosseous Suture ◽  
Supraspinatus Tear ◽  
Cuff Repair ◽  
Suture Anchor Repair

Background Although many studies involving rotator cuff repair fixation have focused on ultimate fixation strength and ability to restore the tendon's native footprint, no studies have characterized the stability of the repair with regard to motion between the tendon and repair site footprint. Hypothesis Suture anchor fixation for rotator cuff repair has greater interface motion between tendon and bone than does transosseous suture fixation. Study Design Controlled laboratory study. Methods Twelve fresh-frozen human cadaveric shoulders were tested in a custom device to position the shoulder in internal and external rotations with simulated supraspinatus muscle loading. Tendon motion relative to the insertional footprint on the greater tuberosity was determined optically using a digital camera rigidly connected to the humerus, with the humerus positioned at 60° of internal rotation and 60° of external rotation. Testing was performed for the intact tendon, a complete supraspinatus tear, a suture anchor repair, and a transosseous tunnel repair. Results Difference in tendon-bone interface motion when compared with the intact tendon was 7.14 ± 3.72 mm for the torn rotator cuff condition, 2.35 ± 1.26 mm for the suture anchor repair, and 0.02 ± 1.18 mm for the transosseous suture repair. The transosseous suture repair demonstrated significantly less motion when compared with the torn rotator cuff and suture anchor repair conditions (P <. 05). Conclusion Transosseous suture repair compared with suture anchor repair demonstrated superior tendon fixation with reduced motion at the tendon-to-tuberosity interface. Clinical Relevance Development of new fixation techniques for arthroscopic and open rotator cuff repairs should attempt to minimize interface motion of the tendon relative to the tuberosity.

Rotator Cuff Repair: An Ex Vivo Analysis of Suture Anchor Repair Techniques on Initial Load to Failure

2005 ◽  
Vol 21 (10) ◽  
pp. 1236-1241 ◽  
Author(s):  
Craig A. Cummins ◽  
Richard C. Appleyard ◽  
Sabrina Strickland ◽  
Pieter-Stijn Haen ◽  
Shiyi Chen ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Ex Vivo ◽  
Initial Load ◽  
Load To Failure ◽  
Cuff Repair ◽  
Suture Anchor Repair ◽  
Repair Techniques

Contact Area, Contact Pressure, and Pressure Patterns of the Tendon-Bone Interface after Rotator Cuff Repair

2005 ◽  
Vol 33 (12) ◽  
pp. 1869-1874 ◽  
Author(s):  
Yilihamu Tuoheti ◽  
Eiji Itoi ◽  
Nobuyuki Yamamoto ◽  
Nobutoshi Seki ◽  
Hidekazu Abe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Contact Pressure ◽  
Contact Area ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Double Row ◽  
Single Row ◽  
Bone Interface ◽  
Significant Difference ◽  
Cuff Repair

Background The contact pressure and contact area at the tendon-bone interface after the most commonly used rotator cuff repair methods have not been investigated. Hypothesis There are no significant differences among the transosseous, the single-row suture anchor, and the double-row suture anchor techniques in terms of contact pressure, contact area, and pressure patterns at the tendon-bone interface. Study Design Controlled laboratory study. Methods After creating a full-thickness supraspinatus tendon tear in 10 cadaveric shoulder specimens, we inserted pressure-sensitive film between the tendon stump and the bone, and we repaired the tear by (1) transosseous, (2) single-row suture anchor, and (3) double-row suture anchor techniques. Results The contact area of the double-row technique was 42% greater than that of the transosseous technique (P <. 0001) and 60% greater than that of the single-row technique. The contact area of the transosseous technique was 31% greater than that of the single-row technique (P =. 0015). The average pressures of the single-row and double-row techniques were 18% (P =. 014) and 16% (P =. 03) greater, respectively, than that of the transosseous technique, but there was no significant difference between the single-row and double-row techniques (P =. 915). Conclusions The double-row technique produced the greatest contact area and the second-highest contact pressure, whereas the single-row technique created the highest contact pressure and the least contact area. The transosseous technique produced the second-greatest contact area and the least contact pressure. Clinical Relevance The double-row suture anchor technique and the transosseous technique may provide a better environment for tendon healing.

Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model

2018 ◽  
Vol 46 (11) ◽  
pp. 2743-2754 ◽  
Author(s):  
Wei Su ◽  
Wenxiao Qi ◽  
Xiaoxi Li ◽  
Song Zhao ◽  
Jia Jiang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Biomechanical Testing ◽  
Histological Evaluation ◽  
Suture Materials ◽  
Greater Tuberosity ◽  
Bone Interface ◽  
Supraspinatus Tear ◽  
Absorbable Sutures ◽  
Cuff Repair

Background: Various suture materials can be clinically used for rotator cuff repair (RCR). RCR with high-strength nonabsorbable sutures may not be ideal, because it may cause stress shielding, which may hinder enthesis regeneration and maturation in the tendon-bone interface. RCR with strength-decreasing sutures (ie, absorbable sutures) may be a better choice. However, the effects of suture absorbability on enthesis regeneration and maturation have not been investigated. Hypothesis: The use of absorbable sutures in RCR would produce a better tendon-bone connection structure, which provides histological and biomechanical advantages over the use of nonabsorbable sutures. Study Design: Controlled laboratory study. Methods: A supraspinatus tear was created on the right shoulder in 108 of 120 skeletally mature male rabbits. The animals were randomly divided into 3 groups, with 36 rabbits in each group, to undergo RCR individually with total absorbable, partial absorbable, and nonabsorbable sutures (TAS, PAS, and NAS). Twelve animals in each group were sacrificed at 4, 8, and 12 weeks after surgery, with 6 operated shoulders used for histological evaluation to detect enthesis regeneration and maturation and the other 6 for biomechanical testing. The remaining 12 animals without supraspinatus tear were used as control. Results: At 12 weeks, in the tendon-bone interface, enthesis regeneration was detected in the TAS group but not in the NAS group. A mature enthesis appeared in the TAS group but not in the NAS group. In the PAS group, enthesis regeneration was also observed; however, the fibrocartilage was not abundant and the enthesis maturity not good as compared with the TAS group. Biomechanical testing showed that the rotator cuff–greater tuberosity connection structure in the TAS and PAS groups had greater values of ultimate load to failure, stiffness, and stress than the NAS group at all time points. Conclusion: In RCR in an acute rabbit rotator cuff tear model, the use of sutures with absorbability lead to enthesis regeneration, increased maturity of rotator cuff insertion, and enhanced rotator cuff–greater tuberosity connection. Clinical Relevance: Compared with the use of NAS, the use of TAS or PAS might be a better choice for RCR.

Supplementation of Rotator Cuff Repair with a Bioresorbable Scaffold

2002 ◽  
Vol 30 (3) ◽  
pp. 410-413 ◽  
Author(s):  
Jason L. Koh ◽  
Zoltan Szomor ◽  
George A. C. Murrell ◽  
Russell F. Warren
Keyword(s):  
Rotator Cuff ◽  
Ultimate Strength ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Testing Machine ◽  
Poly Lactic Acid ◽  
Bone Bridge ◽  
Initial Strength ◽  
Bridge Model ◽  
Cuff Repair

Background Repair of a torn rotator cuff should have sufficient initial strength of the fixation to permit appropriate rehabilitation. Hypothesis Augmentation with a woven polylactic acid scaffold strengthens repairs of the rotator cuff. Study Design Controlled laboratory study. Methods In the suture-anchor model, 10 pairs of sheep infraspinatus tendons were detached and repaired to suture anchors. In half of the matched specimens, the repair was reinforced with a woven poly-lactic acid scaffold repaired with the tendon to bone. In the bone-bridge model, sutures were passed through a trough and over a bone bridge distal to the greater tuberosity; half were reinforced by the scaffold. The repairs were tested to failure with a hydraulic testing machine. Results The mean ultimate strength of suture-anchor repairs augmented with the scaffold (167.3 ± 53.9 N) was significantly greater than that of nonaugmented fixation (133.2 ± 38.2 N). Failure occurred when the tendon pulled through the sutures; the scaffold remained intact. Scaffold reinforcement of the bone bridge significantly increased the ultimate strength from 374.6 ± 117.6 N to 480.9 ± 89.2 N, and the scaffold remained intact in 8 of 10 specimens. Conclusions The scaffold significantly increased the initial strength of rotator cuff repair by approximately 25%.

Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study

2007 ◽  
Vol 15 (11) ◽  
pp. 1375-1381 ◽  
Author(s):  
Jennifer Tucker Ammon ◽  
John Nyland ◽  
Haw Chong Chang ◽  
Robert Burden ◽  
David N. M. Caborn
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Biomechanical Study ◽  
Cuff Repair
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