Literature DB >> 29079260

Biomechanical Comparison of Transosseous Knotless Rotator Cuff Repair Versus Transosseous Equivalent Repair: Half The Anchors With Equivalent Biomechanics?

Robert Z Tashjian1, Robert W Hoy2, Joel R Helgerson2, Andrew D Guss3, Heath B Henninger3, Robert T Burks3.   

Abstract

PURPOSE: To compare the biomechanics of a transosseous equivalent (TOE) repair using medial and lateral anchors with tape to a transosseous knotless (TOK) tape repair with only laterally placed intraosseous anchors.
METHODS: One of 2 different repairs were performed on 8 paired specimens: (1) transosseous equivalent (TOE) tape repair or (2) transosseous knotless (TOK) tape repair. Specimens were mounted on a materials testing machine and loaded in uniaxial tension to measure cyclic construct gap formation, followed by failure testing. Paired t tests were used to compare gapping, ultimate stiffness, and failure loads. Fisher exact test was used to compare modes of failure (soft tissue failure vs construct failure).
RESULTS: Peak cyclic gapping, failure stiffness, and ultimate failure loads did not differ between TOE and TOK repairs (P = .140 for gapping, P = .106 for stiffness, and P = .672 for peak failure loads). All TOK repairs failed via soft tissue failure medial to the medial suture line, with no construct failures. TOE repairs failed more often through construct failure (anchor migration or suture-bone interface cut through) than TOK repairs (P = .026).
CONCLUSION: TOK repairs only failed through soft tissue whereas TOE repairs failed through both soft tissue and the repair construct. Despite 50% fewer suture anchors in the TOK repairs than the TOE repairs, cyclic gapping and ultimate stiffness and failure loads were not significantly different. CLINICAL RELEVANCE: The transosseous knotless construct presented is a 2-anchor construct that is equivalent in biomechanical function to a traditional 4-anchor construct, reducing anchor load in the tuberosity.
Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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Year:  2017        PMID: 29079260     DOI: 10.1016/j.arthro.2017.08.253

Source DB:  PubMed          Journal:  Arthroscopy        ISSN: 0749-8063            Impact factor:   4.772


  7 in total

1.  Assessment of return to play in professional overhead athletes subjected to arthroscopic repair of rotator cuff tears and associated labral injuries using the Italian version of the Kerlan-Jobe Orthopedic Clinic Shoulder and Elbow score.

Authors:  G Merolla; P Paladini; G Porcellini
Journal:  Musculoskelet Surg       Date:  2018-06-11

Review 2.  Graft use in the treatment of large and massive rotator cuff tears: an overview of techniques and modes of failure with MRI correlation.

Authors:  Kyle R Duchman; Dayne T Mickelson; Barrett A Little; Thomas W Hash; Devin B Lemmex; Alison P Toth; Grant E Garrigues
Journal:  Skeletal Radiol       Date:  2018-07-05       Impact factor: 2.199

3.  Rotator cuff failure after surgery: an all-arthroscopic transosseous approach.

Authors:  C Chillemi; L Dei Giudici; M Mantovani; M Osimani; S Gumina
Journal:  Musculoskelet Surg       Date:  2018-10-20

Review 4.  Current Concepts in Rotator Cuff Repair Techniques: Biomechanical, Functional, and Structural Outcomes.

Authors:  Luciano A Rossi; Scott A Rodeo; Jorge Chahla; Maximiliano Ranalletta
Journal:  Orthop J Sports Med       Date:  2019-09-20

5.  True Transosseous Hybrid Rotator Cuff Repair.

Authors:  Brett Sanders
Journal:  Arthrosc Tech       Date:  2019-09-05

Review 6.  Limited Biomechanical Evidence Behind Single Row Versus Double Row Repair of Subscapularis Tears: A Systematic Review.

Authors:  Michelle Xiao; Samuel A Cohen; Emilie V Cheung; Seth L Sherman; Geoffrey D Abrams; Michael T Freehill
Journal:  Arthrosc Sports Med Rehabil       Date:  2022-03-15

7.  Rotator Cuff Repair Technique With Transosseous Knotless Anchor System.

Authors:  Michael M Murphy; Robert Z Tashjian; Robert T Burks
Journal:  Arthrosc Tech       Date:  2018-08-20
  7 in total

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