BACKGROUND: The tissue-suture interface remains the most common site of failure in rotator cuff repairs. Improving stitch strengths may lead to lower failure rates. PURPOSE: To compare biomechanical properties of 3 self-cinching stitches to the simple, mattress, modified Mason-Allen, and massive cuff stitches. STUDY DESIGN: Controlled laboratory study. METHODS: In sum, 336 sheep infraspinatus tendon grafts were randomized among 7 stitches. Each graft was cyclically loaded on a mechanical testing system from 5 to 30 N for 20 cycles and then loaded to failure. A mixed-effect multivariate regression model was used to test significance of suture type on cyclic elongation, peak-to-peak displacement, and ultimate load. Estimated means and standard deviations are reported from the regression model. RESULTS: Ultimate load for the simple stitch was significantly lower than for the other stitches. The lasso-loop and mattress stitch demonstrated similar ultimate loads. The double-cinch had a higher ultimate load than the lasso-loop or mattress stitch, although it was significantly weaker than the modified Mason-Allen, lasso-mattress, and massive cuff. The lasso-mattress had a superior ultimate load to the modified Mason-Allen and a similar ultimate load to the massive cuff stitch. One significant difference was found in cyclic elongation (1.42 mm for the simple to 1.80 mm for the double-cinch), and the cinching mechanism accounted for 0.2-mm higher elongation. CONCLUSION: Self-cinching stitches lead to superior tissue-holding strength at the tissue-suture interface when compared with equivalent non-self-cinching stitches. Self-cinching stitches have greater elongation values. How these differences in cyclic elongation clinically influence gap formation at the repair site is unknown. The greater displacement seen in the self-cinching stitches is a potential concern because minimal gap formation is desired for a strong repair. CLINICAL RELEVANCE: The lasso-loop stitch is a stronger alternative to a simple stitch, and the double-cinch and lasso-mattress stitches are stronger alternatives to a mattress stitch.
BACKGROUND: The tissue-suture interface remains the most common site of failure in rotator cuff repairs. Improving stitch strengths may lead to lower failure rates. PURPOSE: To compare biomechanical properties of 3 self-cinching stitches to the simple, mattress, modified Mason-Allen, and massive cuff stitches. STUDY DESIGN: Controlled laboratory study. METHODS: In sum, 336 sheep infraspinatus tendon grafts were randomized among 7 stitches. Each graft was cyclically loaded on a mechanical testing system from 5 to 30 N for 20 cycles and then loaded to failure. A mixed-effect multivariate regression model was used to test significance of suture type on cyclic elongation, peak-to-peak displacement, and ultimate load. Estimated means and standard deviations are reported from the regression model. RESULTS: Ultimate load for the simple stitch was significantly lower than for the other stitches. The lasso-loop and mattress stitch demonstrated similar ultimate loads. The double-cinch had a higher ultimate load than the lasso-loop or mattress stitch, although it was significantly weaker than the modified Mason-Allen, lasso-mattress, and massive cuff. The lasso-mattress had a superior ultimate load to the modified Mason-Allen and a similar ultimate load to the massive cuff stitch. One significant difference was found in cyclic elongation (1.42 mm for the simple to 1.80 mm for the double-cinch), and the cinching mechanism accounted for 0.2-mm higher elongation. CONCLUSION: Self-cinching stitches lead to superior tissue-holding strength at the tissue-suture interface when compared with equivalent non-self-cinching stitches. Self-cinching stitches have greater elongation values. How these differences in cyclic elongation clinically influence gap formation at the repair site is unknown. The greater displacement seen in the self-cinching stitches is a potential concern because minimal gap formation is desired for a strong repair. CLINICAL RELEVANCE: The lasso-loop stitch is a stronger alternative to a simple stitch, and the double-cinch and lasso-mattress stitches are stronger alternatives to a mattress stitch.
Authors: Christian Konrads; Sebastian Jovic; Kilian Rueckl; Annabel Fenwick; Thomas Barthel; Maximilian Rudert; Piet Plumhoff Journal: J Orthop Date: 2018-05-07
Authors: Philipp R Heuberer; Leo Pauzenberger; Michael S Gruber; Bernhard Kriegleder; Roman C Ostermann; Brenda Laky; Werner Anderl Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-05-06 Impact factor: 4.342
Authors: Masato Takao; Kentaro Matsui; James W Stone; Mark A Glazebrook; John G Kennedy; Stephane Guillo; James D Calder; Jon Karlsson Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-05-16 Impact factor: 4.342
Authors: Alberto Naoki Miyazaki; Marcelo Fregoneze; Pedro Doneux Santos; Luciana Andrade da Silva; Guilherme do Val Sella; Luiz Antonio Zanotelli Zanella; João Caron La Salvia; Sergio Luiz Checchia Journal: Rev Bras Ortop Date: 2014-10-16