Purpose
To compare tendon-bone interface motion and cyclic loading in a single-row, triple-loaded
anchor repair with a suture-tape, rip-stop, double-row rotator cuff repair.
Methods
Using 18 human shoulders from 9 matched cadaveric pairs, we created 2 groups of rotator
cuff repairs. Group 1 was a double-row, rip-stop, suture-tape construct. Group 2 was
a single-row, triple-loaded construct. Before mechanical testing, the supraspinatus
footprint was measured with calipers. A superiorly positioned digital camera optically
measured the tendon footprint motion during 60° of humeral internal and external rotation.
Specimens were secured at a fixed angle not exceeding 45° in reference to the load.
After preloading, each sample was cycled between 10 N and 100 N for 200 cycles at
1 Hz, followed by destructive testing at 33 mm/s. A digital camera with tracking software
measured the repair displacement at 100 and 200 cycles. Ultimate load and failure
mode for each sample were recorded.
Results
The exposed anterior footprint border (6.5% ± 6%) and posterior footprint border (0.9%
± 1.7%) in group 1 were statistically less than the exposed anterior footprint border
(30.3% ± 17%) and posterior footprint border (29.8% ± 14%) in group 2 (P = .003 and P < .001, respectively). The maximal internal rotation and external rotation tendon
footprint displacements in group 1 (1.6 mm and 1.4 mm, respectively) were less than
those in group 2 (both 3.6 mm) (P = .007 and P = .004, respectively). Mean displacement after 100 cycles for group 1 and group 2
was 2.0 mm and 3.2 mm, respectively, and at 200 cycles, mean displacement was 2.5
mm and 4.2 mm, respectively (P = .02). The mean ultimate failure load in group 1 (586 N) was greater than that in
group 2 (393 N) (P = .02). The suture-tendon interface was the site of most construct failures.
Conclusions
The suture-tape, rip-stop, double-row rotator cuff repair had greater footprint coverage,
less rotational footprint displacement, and a greater mean ultimate failure load than
the triple-loaded, single-row repair on mechanical testing. No double-row or single-row
constructs showed 5 mm of displacement after the first 100 cycles. The most common
failure mode for both constructs was suture tearing through the tendon.
Clinical Relevance
Differences in cuff fixation influence rotational tendon movement and may influence
postoperative healing. Stronger repair constructs still fail at the suture-tendon
interface.
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Article info
Publication history
Published online: May 17, 2012
Accepted:
February 6,
2012
Received:
July 25,
2011
Footnotes
The authors report the following potential conflict of interest or source of funding in relation to this article: This study was supported by a grant from Arthrex, Naples, FL. The anchors were provided and used.
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
