PURPOSE: The purpose of this study was to determine biomechanical differences in cyclic elongation and ultimate strength between double-row rotator cuff repair and single-row repair for partial rotator cuff repairs. METHODS: We randomly assigned 18 immature bovine specimens (aged 12 to 16 weeks) to 3 repair groups (6 per group). A 1 x 2-cm defect was created at the infraspinatus tendon insertion site. Two suture anchors were implanted 1 cm apart at the anatomic insertion area for the lateral row. Two suture anchors were implanted 1 cm medial to the lateral row and 1 cm apart from each other for the medial row. Repair groups were constructed as follows: single-row repair with double-loaded suture anchors (group 1), double-row repair with single-loaded medial row and double-loaded lateral row (group 2), and double-row repair with single-loaded medial row and single-loaded lateral row (group 3). Specimens were cyclically loaded from 10 N to 90 N for 500 cycles and then loaded at 0.5 mm/s to failure. Data for cyclic elongation, with loads at 3 mm, 5 mm, and 10 mm, were analyzed via a 1-way analysis of variance (P < .05). RESULTS: There were no significant differences for peak elongation after cyclic loading between groups. There were no significant differences between repair groups for loads at 3 mm, 5 mm, and 10 mm of elongation. Constructs typically failed by knot slippage (83%), with a single sample having tendon-suture failure (17%). CONCLUSIONS: Double-row repair did not show a biomechanical advantage compared with single-row repair. With this result in mind, the theoretic advantage of a potentially larger footprint must be balanced against the added surgical time, complexity, and cost of double-row repair. CLINICAL RELEVANCE: Arthroscopic surgeons should choose the best form of fixation for a given patient, without undue emphasis on single-row repair versus double-row repair. The clinical and biologic impact of footprint restoration was not addressed in this study.
RCT Entities:
PURPOSE: The purpose of this study was to determine biomechanical differences in cyclic elongation and ultimate strength between double-row rotator cuff repair and single-row repair for partial rotator cuff repairs. METHODS: We randomly assigned 18 immature bovine specimens (aged 12 to 16 weeks) to 3 repair groups (6 per group). A 1 x 2-cm defect was created at the infraspinatus tendon insertion site. Two suture anchors were implanted 1 cm apart at the anatomic insertion area for the lateral row. Two suture anchors were implanted 1 cm medial to the lateral row and 1 cm apart from each other for the medial row. Repair groups were constructed as follows: single-row repair with double-loaded suture anchors (group 1), double-row repair with single-loaded medial row and double-loaded lateral row (group 2), and double-row repair with single-loaded medial row and single-loaded lateral row (group 3). Specimens were cyclically loaded from 10 N to 90 N for 500 cycles and then loaded at 0.5 mm/s to failure. Data for cyclic elongation, with loads at 3 mm, 5 mm, and 10 mm, were analyzed via a 1-way analysis of variance (P < .05). RESULTS: There were no significant differences for peak elongation after cyclic loading between groups. There were no significant differences between repair groups for loads at 3 mm, 5 mm, and 10 mm of elongation. Constructs typically failed by knot slippage (83%), with a single sample having tendon-suture failure (17%). CONCLUSIONS: Double-row repair did not show a biomechanical advantage compared with single-row repair. With this result in mind, the theoretic advantage of a potentially larger footprint must be balanced against the added surgical time, complexity, and cost of double-row repair. CLINICAL RELEVANCE: Arthroscopic surgeons should choose the best form of fixation for a given patient, without undue emphasis on single-row repair versus double-row repair. The clinical and biologic impact of footprint restoration was not addressed in this study.
Authors: Olaf Lorbach; Mike H Baums; Tanja Kostuj; Stephan Pauly; Markus Scheibel; Andrew Carr; Nasim Zargar; Maristella F Saccomanno; Giuseppe Milano Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-01-09 Impact factor: 4.342
Authors: Mina Abdelshahed; Siddharth A Mahure; Daniel J Kaplan; Brent Mollon; Joseph D Zuckerman; Young W Kwon; Andrew S Rokito Journal: Arthrosc Tech Date: 2016-11-14
Authors: Werner Anderl; Philipp R Heuberer; Brenda Laky; Bernhard Kriegleder; Roland Reihsner; Josef Eberhardsteiner Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-02-26 Impact factor: 4.342
Authors: Mike H Baums; G Spahn; H Steckel; A Fischer; W Schultz; H-M Klinger Journal: Knee Surg Sports Traumatol Arthrosc Date: 2009-03-21 Impact factor: 4.342