Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 18, Issue 5 , Pages 519-526, May 2002

Rotator cuff tears:☆☆

The effect of the reconstruction method on three-dimensional repair site area

Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center (M.A., P.G.F.), and the Department of Orthopedic Surgery, Massachusetts General Hospital (M.O., J.J.P.W.), Boston, Massachusetts, U.S.A.

Abstract 

Purpose: To quantitatively determine the 3-dimensional (3-D) area of the original supraspinatus insertion and compare it with the repair-site area after 4 reconstructions of a simulated supraspinatus tear. Type of Study: Ex vivo biomechanical study. Methods: The outline of the original supraspinatus insertion was obtained in 10 human cadaveric shoulders using a 3-D digitizer. A supraspinatus tear was created and 4 repair techniques were evaluated: transosseous simple suture (TOS), transosseous mattress suture (TOM), suture-anchor simple suture (SAS), suture-anchor mattress suture (SAM). The 3-D outlines of the reconstructed supraspinatus insertion were digitized after each repair. The outlines of the original supraspinatus insertion and repair areas were superimposed onto humeral geometry obtained from a laser scanner, and surface areas were calculated. Results: The original supraspinatus insertion area was larger than any of the repair-site areas (P < .05). On average, TOS provided a 20% larger repair-site area than the other repairs (P < .05). Repair-site areas were not different among TOM, SAS, or SAM repairs (P > .05) and covered 67% of the original supraspinatus insertion. Conclusions: None of the tested repairs restored the area of the original supraspinatus insertion. The larger repair-site area of the TOS repair suggests that this technique provides better potential for healing and, ultimately, greater strength of repair.

Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 18, No 5 (May-June), 2002: pp 519–526

Keywords:  Rotator cuff tears, Transosseous repair, Suture-anchor repair, Cadaveric model, Computer modeling and visualization

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 This paper received the 2001 Richard O’Connor Award from the Arthroscopy Association of North America.

☆☆ Supported by the Partners Department of Orthopedics.

 Address correspondence and reprint requests to Maria Apreleva, Ph.D., Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center, 330 Brookline Ave, RN 115, Boston, MA 02215, U.S.A. E-mail: maprelev@caregroup.harvard.edu

PII: S0749-8063(02)35661-5

doi:10.1053/jars.2002.32930

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 18, Issue 5 , Pages 519-526, May 2002