BACKGROUND: Failure of surgical repair of a rotator cuff tear continues to be a clinical problem. For other tendon repairs, increasing the number of sutures improves both biomechanical performance and clinical outcomes. Several investigators have shown biomechanical advantages of double-row techniques but have used many more sutures than were used with the single-row techniques with which the double-row techniques were compared. The purposes of our study were to establish whether using a greater number of sutures would improve the biomechanical properties of a rotator cuff repair model, and whether using equal numbers of sutures would lead to equivalent results between single and double-row configurations. METHODS: Fresh-frozen sheep infraspinatus tendons underwent single-row repair with two, four, or six mattress sutures and double-row repair with use of four mattress sutures. Specimens were pretensioned at 10 N for one minute, then cycled from 10 to 180 N for 200 cycles at 0.2 Hz; this was followed by load to failure. Cyclic gap formation, failure load, and failure type were recorded. RESULTS: The four-suture single-row and four-suture double-row repairs had similar gap formation during cyclic testing, with no significant differences between them. Cyclic gap formation in the two-suture single-row group was 6.7 and 7.1 mm (97% and 109%) greater than that in the four and six-suture single-row groups after 200 cycles (p < 0.001). The average loads to failure of the two, four, and six-suture single-row groups were 274, 362, and 572 N (p < 0.0001). The average load to failure of the four-suture double-row group was 386 N, which was similar to the value in the four-suture single-row group (p = 0.58). CONCLUSIONS: In an ovine rotator cuff tendon repair model, increasing the number of sutures decreased cyclic gap formation and increased load to failure. Single and double-row repairs are biomechanically equivalent when the number of sutures is kept constant. CLINICAL RELEVANCE: The results of this study support the use of greater numbers of sutures in rotator cuff repair and disagree with the assertion that double-row repairs are biomechanically superior to single-row repairs.
BACKGROUND: Failure of surgical repair of a rotator cuff tear continues to be a clinical problem. For other tendon repairs, increasing the number of sutures improves both biomechanical performance and clinical outcomes. Several investigators have shown biomechanical advantages of double-row techniques but have used many more sutures than were used with the single-row techniques with which the double-row techniques were compared. The purposes of our study were to establish whether using a greater number of sutures would improve the biomechanical properties of a rotator cuff repair model, and whether using equal numbers of sutures would lead to equivalent results between single and double-row configurations. METHODS: Fresh-frozen sheep infraspinatus tendons underwent single-row repair with two, four, or six mattress sutures and double-row repair with use of four mattress sutures. Specimens were pretensioned at 10 N for one minute, then cycled from 10 to 180 N for 200 cycles at 0.2 Hz; this was followed by load to failure. Cyclic gap formation, failure load, and failure type were recorded. RESULTS: The four-suture single-row and four-suture double-row repairs had similar gap formation during cyclic testing, with no significant differences between them. Cyclic gap formation in the two-suture single-row group was 6.7 and 7.1 mm (97% and 109%) greater than that in the four and six-suture single-row groups after 200 cycles (p &lt; 0.001). The average loads to failure of the two, four, and six-suture single-row groups were 274, 362, and 572 N (p &lt; 0.0001). The average load to failure of the four-suture double-row group was 386 N, which was similar to the value in the four-suture single-row group (p = 0.58). CONCLUSIONS: In an ovine rotator cuff tendon repair model, increasing the number of sutures decreased cyclic gap formation and increased load to failure. Single and double-row repairs are biomechanically equivalent when the number of sutures is kept constant. CLINICAL RELEVANCE: The results of this study support the use of greater numbers of sutures in rotator cuff repair and disagree with the assertion that double-row repairs are biomechanically superior to single-row repairs.
Authors: Mehmet Gülecyüz; Hannes Bortolotti; Matthias Pietschmann; Andreas Ficklscherer; Thomas Niethammer; Björn Roßbach; Peter Müller Journal: Int Orthop Date: 2015-10-07 Impact factor: 3.075
Authors: Brian D Dierckman; Jake J Ni; Ronald P Karzel; Mark H Getelman Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-24 Impact factor: 4.342
Authors: Akil Prabhakar; Jeash Narayan Kanthalu Subramanian; P Swathikaa; S I Kumareswaran; K N Subramanian Journal: J Clin Orthop Trauma Date: 2022-02-18
Authors: Carlos Maia Dias; Sérgio B Gonçalves; António Completo; Manuel Ribeiro da Silva; Clara de Campos Azevedo; Jorge Mineiro; Frederico Ferreira; João Folgado Journal: J Exp Orthop Date: 2022-09-19