Improved strength of early versus late supraspinatus tendon repair: a study in the rabbit

Hypothesis The optimal timing for surgical repair of the supraspinatus (SSP) tendon after full-substance tear has not been established. The objectives of this prospective investigation of SSP tendon repair delayed by 1, 2, or 3 months followed by a 3-month postoperative course were to (1) determine...

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Published in:Journal of shoulder and elbow surgery 2012-06, Vol.21 (6), p.828-834
Main Authors: Trudel, Guy, MD, MSc, Ramachandran, Nanthan, MEng, Ryan, Stephen E., MD, PhD, Rakhra, Kawan, MD, Uhthoff, Hans K., MD
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
computed tomography
Diseases of the osteoarticular system
Male
mechanical testing
Medical sciences
Orthopedics
Rabbits
Recurrence
Rotator cuff
Rotator Cuff - surgery
Rotator Cuff Injuries
Rupture
supraspinatus
surgery
Tendon Injuries - surgery
Tensile Strength
Time Factors
Tomography, X-Ray Computed
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Summary:Hypothesis The optimal timing for surgical repair of the supraspinatus (SSP) tendon after full-substance tear has not been established. The objectives of this prospective investigation of SSP tendon repair delayed by 1, 2, or 3 months followed by a 3-month postoperative course were to (1) determine the site of failure, (2) measure the tensile strength and stiffness, and (3) assess the ability of computed tomography to predict mechanical strength. Materials and Methods We transected 1 SSP tendon in 36 rabbits and then repaired it with transosseous sutures after a delay of 1, 2, or 3 months. We compared the results with 36 intact shoulders from 18 age-matched control rabbits. Results Experimental specimens failed at the tendon (n = 26) more often than at the enthesis (n = 10) ( P  < .05). The mean peak loads to failure 3 months after repair delayed by 1 month and delayed by 2 months were significantly greater than their respective control values ( P < .05 for both); there was no difference after a delay of 3 months. There was no association between the presence of hypoattenuation on computed tomography and repair strength ( P > .05). Conclusions Our findings indicate better mechanical results with earlier repair (1 or 2 months) after SSP tendon than after a delay of 3 months. Early surgical repair may lower the risk of tendon retear.
ISSN:1058-2746
1532-6500
DOI:10.1016/j.jse.2011.10.005