The use of suture-tape and suture-wire in arthroscopic rotator cuff repair: A comparative biomechanics study

Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair c...

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Published inInjury Vol. 49; no. 11; pp. 2047 - 2052
Main Authors Huntington, Lachlan, Coles-Black, Jasamine, Richardson, Martin, Sobol, Tony, Caldow, Jonathon, Chuen, Jason, Ackland, David C.
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.11.2018
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Abstract Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair construct contact area. The objective of this study was to compare contact pressure, area as well as the mechanical fatigue strength between suture-wire and suture-tape Suture-bridge repair constructs in an ovine model. Sixty lamb infraspinatus tendons were harvested and randomly allocated to three- and four-anchor Suture-bridge repairs performed using either suture-wire or suture-tape. Thirty-two specimens were cyclically loaded for 200 cycles in an Instron testing machine, while tendon gap formation was recorded using a high speed digital motion analysis system. Loading to failure was then performed to evaluate construct ultimate tensile strength and stiffness. The remaining 28 specimens were assessed for repair contact pressure and area using pressure-sensitive film. There was a significantly greater average tendon contact pressure (mean difference: 0.064 MPa, p = 0.04) and area (mean difference: 2.71 mm2, p = 0.03) in fiber-tape repair constructs compared to those in fiber-wire constructs for the three-anchor Suture-bridge configuration. The four-anchor suture-tape constructs had a significantly larger ultimate tensile strength than that of the four-anchor suture-wire constructs (mean difference: 56.4 N, p = 0.04). There were no significant differences in gap formation or stiffness between suture-tape and suture-wire constructs (p > 0.05). Suture-tape offers greater pressurised tendon-bone contact than suture-wire in three-anchor Suture-bridge repairs, while greater mechanical strength is achieved with the use of suture-tape in four-anchor Suture-bridge constructs.
AbstractList BACKGROUNDRotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair construct contact area. The objective of this study was to compare contact pressure, area as well as the mechanical fatigue strength between suture-wire and suture-tape Suture-bridge repair constructs in an ovine model.METHODSSixty lamb infraspinatus tendons were harvested and randomly allocated to three- and four-anchor Suture-bridge repairs performed using either suture-wire or suture-tape. Thirty-two specimens were cyclically loaded for 200 cycles in an Instron testing machine, while tendon gap formation was recorded using a high speed digital motion analysis system. Loading to failure was then performed to evaluate construct ultimate tensile strength and stiffness. The remaining 28 specimens were assessed for repair contact pressure and area using pressure-sensitive film.RESULTSThere was a significantly greater average tendon contact pressure (mean difference: 0.064 MPa, p = 0.04) and area (mean difference: 2.71 mm2, p = 0.03) in fiber-tape repair constructs compared to those in fiber-wire constructs for the three-anchor Suture-bridge configuration. The four-anchor suture-tape constructs had a significantly larger ultimate tensile strength than that of the four-anchor suture-wire constructs (mean difference: 56.4 N, p = 0.04). There were no significant differences in gap formation or stiffness between suture-tape and suture-wire constructs (p > 0.05).CONCLUSIONSuture-tape offers greater pressurised tendon-bone contact than suture-wire in three-anchor Suture-bridge repairs, while greater mechanical strength is achieved with the use of suture-tape in four-anchor Suture-bridge constructs.
Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair construct contact area. The objective of this study was to compare contact pressure, area as well as the mechanical fatigue strength between suture-wire and suture-tape Suture-bridge repair constructs in an ovine model. Sixty lamb infraspinatus tendons were harvested and randomly allocated to three- and four-anchor Suture-bridge repairs performed using either suture-wire or suture-tape. Thirty-two specimens were cyclically loaded for 200 cycles in an Instron testing machine, while tendon gap formation was recorded using a high speed digital motion analysis system. Loading to failure was then performed to evaluate construct ultimate tensile strength and stiffness. The remaining 28 specimens were assessed for repair contact pressure and area using pressure-sensitive film. There was a significantly greater average tendon contact pressure (mean difference: 0.064 MPa, p = 0.04) and area (mean difference: 2.71 mm , p = 0.03) in fiber-tape repair constructs compared to those in fiber-wire constructs for the three-anchor Suture-bridge configuration. The four-anchor suture-tape constructs had a significantly larger ultimate tensile strength than that of the four-anchor suture-wire constructs (mean difference: 56.4 N, p = 0.04). There were no significant differences in gap formation or stiffness between suture-tape and suture-wire constructs (p > 0.05). Suture-tape offers greater pressurised tendon-bone contact than suture-wire in three-anchor Suture-bridge repairs, while greater mechanical strength is achieved with the use of suture-tape in four-anchor Suture-bridge constructs.
Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon healing. Flat-braided suture-tape is an alternative suture material to traditional suture-wire that has potential to reproduce a larger repair construct contact area. The objective of this study was to compare contact pressure, area as well as the mechanical fatigue strength between suture-wire and suture-tape Suture-bridge repair constructs in an ovine model. Sixty lamb infraspinatus tendons were harvested and randomly allocated to three- and four-anchor Suture-bridge repairs performed using either suture-wire or suture-tape. Thirty-two specimens were cyclically loaded for 200 cycles in an Instron testing machine, while tendon gap formation was recorded using a high speed digital motion analysis system. Loading to failure was then performed to evaluate construct ultimate tensile strength and stiffness. The remaining 28 specimens were assessed for repair contact pressure and area using pressure-sensitive film. There was a significantly greater average tendon contact pressure (mean difference: 0.064 MPa, p = 0.04) and area (mean difference: 2.71 mm2, p = 0.03) in fiber-tape repair constructs compared to those in fiber-wire constructs for the three-anchor Suture-bridge configuration. The four-anchor suture-tape constructs had a significantly larger ultimate tensile strength than that of the four-anchor suture-wire constructs (mean difference: 56.4 N, p = 0.04). There were no significant differences in gap formation or stiffness between suture-tape and suture-wire constructs (p > 0.05). Suture-tape offers greater pressurised tendon-bone contact than suture-wire in three-anchor Suture-bridge repairs, while greater mechanical strength is achieved with the use of suture-tape in four-anchor Suture-bridge constructs.
Author Caldow, Jonathon
Ackland, David C.
Huntington, Lachlan
Richardson, Martin
Chuen, Jason
Coles-Black, Jasamine
Sobol, Tony
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Issue 11
Keywords Reconstruction
Rotator cuff tear
Repair construct
Surgery
Shoulder
Fatigue
Stiffness
Language English
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Snippet Rotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and tendon...
BACKGROUNDRotator cuff repair surgery aims to create a secure, pressurized tendon-bone footprint to permit re-establishment of the fibrovascular interface and...
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StartPage 2047
SubjectTerms Animals
Arthroscopy - methods
Biomechanical Phenomena
Fatigue
Models, Animal
Pressure
Reconstruction
Repair construct
Rotator Cuff - surgery
Rotator Cuff Injuries - surgery
Rotator cuff tear
Sheep
Shoulder
Stiffness
Surgery
Suture Anchors
Suture Techniques
Sutures
Tendons - surgery
Tensile Strength
Title The use of suture-tape and suture-wire in arthroscopic rotator cuff repair: A comparative biomechanics study
URI https://dx.doi.org/10.1016/j.injury.2018.09.004
https://www.ncbi.nlm.nih.gov/pubmed/30224178
https://search.proquest.com/docview/2109332650
Volume 49
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