Biomechanical comparison between single-row with triple-loaded suture anchor and suture-bridge double-row rotator cuff r
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RESEARCH ARTICLE
Open Access
Biomechanical comparison between singlerow with triple-loaded suture anchor and suture-bridge double-row rotator cuff repair He-Bei He1†, Yong Hu1†, Chuan Li2, Cheng-Guo Li1, Min-Cong Wang1, Hui-Feng Zhu1, Zhi-Wen Yan3, Cheng-Long Pan1* and Tao Wang1*
Abstract Background: Numerous biomechanical and clinical studies comparing different techniques for rotator cuff repair have been reported, yet universal consensus regarding the superior technique has not achieved. A medially-based singlerow with triple-loaded suture anchor (also referred to as the Southern California Orthopedic Institute [SCOI] row) and a suture-bridge double-row (SB-DR) with Push-Locks have been shown to result in comparable improvement in treating rotator cuff tear, yet the biomechanical difference is unknown. The purpose of the current study was to determine whether a SCOI row repair had comparable initial biomechanical properties to a SB-DR repair. Methods: Six matched pairs of fresh-frozen cadaveric shoulders with full-thickness supraspinatus tendon tears we created were included. Two different repairs were performed for each pair (SCOI row and SB-DR methods). Specimens were mounted on a material testing machine to undergo cyclic loading, which was cycled from 10 to 100 N at 1 Hz for 500 cycles. Construct gap formation was recorded at an interval of 50 cycles. Samples were then loaded to failure and modes of failure were recorded. Repeated-measures analysis of variance and pair-t test were used for statistical analyses. Results: The construct gap formation did not differ between SCOI row and SB-DR repairs (P = 0.056). The last gap displacement was 1.93 ± 0.37 mm for SCOI row repair, and 1.49 ± 0.55 mm for SB-DR repair. The tensile load for 5 mm of elongation and ultimate failure were higher for SCOI row repair compared to SB-DR repair (P = 0.011 and 0.028, respectively). The ultimate failure load was 326.34 ± 11.52 N in the SCOI row group, and 299.82 ± 27.27 N in the SB-DR group. Rotator cuff repair with the SCOI row method failed primarily at the suture- tendon interface, whereas pullout of the lateral row anchors was the primary mechanism of failure for repair with the SB-DR method. Conclusion: Rotator cuff repair with the SCOI row method has superior biomechanical properties when compared with the SB-DR method. Therefore, SCOI row repair using a medially-based single-row technique with triple-loaded suture anchor is recommended to improve the initial strength in treating full-thickness rotator cuff tears. Keywords: Rotator cuff tear, Single-row, Triple-loaded suture anchor, Suture bridge, Biomechanical testing
* Correspondence: [email protected]; [email protected] † He-Bei He and Yong Hu contribute equally as co-first authors. 1 Department of Orthopaedic Surgery, The Fifth Affiliated Hospital of Southern Medical University, Guangzhou City, Guangdong Province, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Co
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