Influence of the initial rupture size and tendon subregion on three-dimensional biomechanical properties of single-row and double-row rotator cuff reconstructions

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2012-11, Vol.20 (11), p.2139-2147
• Main Authors: Lorbach, O., Pape, D., Raber, F., Busch, L. C., Kohn, D., Kieb, M.
• Format: Article
• Language: English
• Subjects: Analysis; Biomechanical Phenomena; Biomechanics; Biomechanics (sports techniques); Bone surgery; Cadaver; Cadavers; Hernia; Humans; Measurement; Medicine; Medicine & Public Health; Orthopedics; Radiostereometric Analysis; Rotator cuff; Rotator Cuff - pathology; Rotator Cuff - surgery; Rotator Cuff Injuries; Shoulder; Shoulders; Sports; Surgery; Suture Techniques; Sutures; Tendons; Weight-Bearing
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-012-1892-y

Purpose Influence of the initial rotator cuff tear size and of different subregions of the SSP tendon on the cyclic loading behavior of a modified single-row reconstruction compared to a suture-bridging double-row repair. Methods Artificial tears (25 and 35 mm) were created in the rotator cuff of 24 human cadaver shoulders. The reconstructions were performed as a single-row repair (SR) using a modified suture configuration or a suture-bridge double-row repair (DR). Radiostereometric analysis was used under cyclic loading (50 cycles, 10–180 N, 10–250 N) to calculate cyclic displacement in three different planes (anteroposterior (x), craniocaudal (y) and mediolateral (z) level). Cyclic displacement was recorded, and differences in cyclic displacement of the anterior compared to the posterior subregions of the tendon were calculated. Results In small-to-medium tears (25 mm) and medium-to-large tears (35 mm), significant lower cyclic displacement was seen for the SR-reconstruction compared to the DR-repair at 180 N ( p  ≤ 0.0001; p  = 0.001) and 250 N ( p  = 0.001; p  = 0.007) in the x -level. These results were confirmed in the y -level at 180 N ( p  = 0.001; p  = 0.0022) and 250 N ( p  = 0.005; p  = 0.0018). Comparison of the initial tear sizes demonstrated significant differences in cyclic displacement for the DR technique in the x -level at 180 N ( p  = 0.002) and 250 N ( p  = 0.004). Comparison of the anterior versus the posterior subregion of the tendon revealed significant lower gap formation in the posterior compared to the anterior subregions in the x -level for both tested rotator cuff repairs ( p  ≤ 0.05). Conclusions The tested single-row repair using a modified suture configuration achieved superior results in three-dimensional measurements of cyclic displacement compared to the tested double-row suture-bridge repair. The results were dependent on the initial rupture size of the rotator cuff tear. Furthermore, significant differences were found between tendon subregions of the rotator cuff with significantly higher gap formation for the anterior compared to the posterior subregions.