Load response and gap formation in a single‐row cruciate suture rotator cuff repair

• Published in: ANZ journal of surgery Vol. 87; no. 6; pp. 483 - 487
• Main Authors: Huntington, Lachlan, Richardson, Martin, Sobol, Tony, Caldow, Jonathon, Ackland, David C.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.06.2017; Blackwell Publishing Ltd
• Subjects: Animals; Biomechanical Phenomena; Biomechanics; Construction methods; Cost-Benefit Analysis; Costs; Disease Models, Animal; Equivalence; Failure; fatigue; Healing; High speed; Integrity; Longevity; Maintenance; Male; Operative Time; Orthopedics; reconstruction; Repair; Rotator Cuff - pathology; Rotator Cuff - physiopathology; Rotator Cuff - surgery; Rotator Cuff Injuries - economics; Rotator Cuff Injuries - surgery; Sheep; Shoulder; Shoulder Joint - surgery; Stiffness; surgery; Suture Techniques - instrumentation; Suture Techniques - utilization; Sutures - trends; Sutures - utilization; tendon; Tendon Injuries - surgery; Tendons; Tendons - physiopathology; Tendons - surgery; Tensile strength; Tensile Strength - physiology; Tension; Ultimate tensile strength; reconstruction; fatigue; tendon; shoulder; stiffness; surgery
• DOI: 10.1111/ans.13875
• ISSN: 1445-1433

Background Double‐row rotator cuff tendon repair techniques may provide superior contact area and strength compared with single‐row repairs, but are associated with higher material expenses and prolonged operating time. The purpose of this study was to evaluate gap formation, ultimate tensile strength and stiffness of a single‐row cruciate suture rotator cuff repair construct, and to compare these results with those of the Mason‐Allen and SutureBridge repair constructs. Methods Infraspinatus tendons from 24 spring lamb shoulders were harvested and allocated to cruciate suture, Mason‐Allen and SutureBridge repair groups. Specimens were loaded cyclically between 10 and 62 N for 200 cycles, and gap formation simultaneously measured using a high‐speed digital camera. Specimens were then loaded in uniaxial tension to failure, and construct stiffness and repair strength were evaluated. Results Gap formation in the cruciate suture repair was significantly lower than that of the Mason‐Allen repair (mean difference = 0.6 mm, P = 0.009) and no different from that of the SutureBridge repair (P > 0.05). Both the cruciate suture repair (mean difference = 15.7 N/mm, P = 0.002) and SutureBridge repair (mean difference = 15.8 N/mm, P = 0.034) were significantly stiffer than that of the Mason‐Allen repair; however, no significant differences in ultimate tensile strength between repair groups were discerned (P > 0.05). Conclusion The cruciate suture repair construct, which may represent a simple and cost‐effective alternative to double‐row and double‐row equivalent rotator cuff repairs, has comparable biomechanical strength and integrity with that of the SutureBridge repair, and may result in improved construct longevity and tendon healing compared with the Mason‐Allen repair.