Joo Y Sunwoo1,2, Patrick H Lam1,2, George A C Murrell1,2. 1. 1Orthopaedic Research Institute, Research and Education Centre (Level 2), St. George Hospital Campus, St. George Hospital, 4-10 South Street, Kogarah, Sydney, NSW 2217 Australia. 2. 2University of New South Wales, Sydney, Australia.
Abstract
BACKGROUND: Interpositional synthetic patch repairs are a novel method of treating massive irreparable rotator cuff tears. However, surgeons experience difficulty in the arthroscopic insertion of these patches. QUESTIONS/PURPOSES: We compared two methods of arthroscopic interpositional synthetic patch repair: the newly devised slide-and-grip technique, using pre-loaded sliding knots and no arthroscopic knots, and the weave technique, using less arthroscopic knot tying than the earlier mattress technique. Study questions were as follows: (1) Would the slide-and-grip technique take less time than the weave technique? (2) Would the biomechanical strength of the two methods be comparable? METHODS: Fourteen paired ovine infraspinatus tendon ex vivo models of the degenerative human rotator cuff underwent timed repair with a synthetic polytetrafluoroethylene (PTFE) patch, using either the weave technique (n = 7) or the slide-and-grip technique (n = 7). Each was pulled to failure using a tensile testing machine, the Instron 8874. RESULTS: The time to complete the slide-and-grip repairs was shorter (12 ± 0.9 min) than that of the weave repairs (23 ± 1 min). Ultimate load to failure was comparable for the slide-and-grip and weave techniques (211 ± 27 N vs. 295 ± 35 N, respectively), and the slide-and-grip was less stiff (14 ± 1 N/mm vs. 19 ± 1 N/mm). CONCLUSIONS: The slide-and-grip technique took less time than the weave technique for the interpositional patch repair of massive irreparable rotator cuff tears and when correctly performed had comparable biomechanical strength.
BACKGROUND: Interpositional synthetic patch repairs are a novel method of treating massive irreparable rotator cuff tears. However, surgeons experience difficulty in the arthroscopic insertion of these patches. QUESTIONS/PURPOSES: We compared two methods of arthroscopic interpositional synthetic patch repair: the newly devised slide-and-grip technique, using pre-loaded sliding knots and no arthroscopic knots, and the weave technique, using less arthroscopic knot tying than the earlier mattress technique. Study questions were as follows: (1) Would the slide-and-grip technique take less time than the weave technique? (2) Would the biomechanical strength of the two methods be comparable? METHODS: Fourteen paired ovine infraspinatus tendon ex vivo models of the degenerative human rotator cuff underwent timed repair with a synthetic polytetrafluoroethylene (PTFE) patch, using either the weave technique (n = 7) or the slide-and-grip technique (n = 7). Each was pulled to failure using a tensile testing machine, the Instron 8874. RESULTS: The time to complete the slide-and-grip repairs was shorter (12 ± 0.9 min) than that of the weave repairs (23 ± 1 min). Ultimate load to failure was comparable for the slide-and-grip and weave techniques (211 ± 27 N vs. 295 ± 35 N, respectively), and the slide-and-grip was less stiff (14 ± 1 N/mm vs. 19 ± 1 N/mm). CONCLUSIONS: The slide-and-grip technique took less time than the weave technique for the interpositional patch repair of massive irreparable rotator cuff tears and when correctly performed had comparable biomechanical strength.
Authors: Leesa M Galatz; Craig M Ball; Sharlene A Teefey; William D Middleton; Ken Yamaguchi Journal: J Bone Joint Surg Am Date: 2004-02 Impact factor: 5.284