Arthroscopic Knots and Strength Sutures for Rotator Cuff Repair

Longo, Umile Giuseppe; Buchmann, Stefan; Berton, Alessandra; Maffulli, Nicola; Denaro, Vincenzo

doi:10.1097/jsa.0b013e3182199373

Cited by 19 publications

(23 citation statements)

References 79 publications

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“…The clinically available arthroscopic suture materials for RCR can be classified into 3 types: total absorbable, partial absorbable, and nonabsorbable sutures (TAS, PAS, and NAS). 1,27 The effects of suture absorbability on enthesis regeneration and maturation have not been completely studied in vivo, particularly regarding the time-dependent changes in the rotator cuff–greater tuberosity (RC-GT) complex. In our pilot study, we discovered that RCR with absorbable suture alone, with no other tendon-bone healing enhancement approaches, could result in an enthesis-like structure at the RC-GT connection site (J. Zhao, MD, unpublished data, June 2015).…”

mentioning

confidence: 99%

Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model

et al. 2018

Am J Sports Med

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mentioning

confidence: 99%

Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model

et al. 2018

Am J Sports Med

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“…Tissue engineering application to synthetic scaffolds may increase their mechanical properties, such as synthetic scaffolds seeded with bone marrow stem cells or tenocytes. However, clinical evidence in this field is scanty [27,28,46,[72][73][74][75][76][77][78][79][80][81][82][83][84][85][86].…”

Section: Discussionmentioning

confidence: 97%

Synthetic Augmentation in Massive Rotator Cuff Tears

et al. 2011

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Massive rotator cuff tears represent a great challenge in orthopaedic. They are associated with persistent defects, weakness, and poor outcomes and can cause an uncoupling of forces across the glenohumeral joint, with unstable shoulder kinematics. In the last few years, a notable interest has emerged to develop new treatment strategies that provide effective mechanical reinforcement of rotator cuff repair and stimulate and enhance the patient's intrinsic healing potential. Tissue engineering techniques using novel scaffold materials offer potential alternatives for managing massive irreparable rotator cuff tears. Synthetic scaffolds, manufactured from chemical compounds, have gained much interest to bridge massive rotator cuff tears. Preliminary studies support the idea that synthetic scaffolds can provide an alternative for rotator cuff augmentation with an enormous therapeutic potential. Despite the growing clinical use of synthetic scaffold devices for rotator cuff repair, there are numerous questions related to their indication, surgical application, safety, mechanism of action, and efficacy that remain to be clarified or addressed. We review the current basic science and clinical understanding of synthetic scaffolds for massive rotator cuff repair, reporting the preclinical and clinical studies carried out to date in this field. We underline the benefits and limitations of the available synthetic scaffolds for augmentation of rotator cuff tears, and discuss the implications of these literature data on the future directions for the use of these scaffolds in tendon repair procedures.

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“…Taking the rotator cuff repair as an example, each suture needed to withstand a maximal 40-60 N under physiological conditions. 38 The failure force of P/U ¼ 75/25 was higher than 60 N. However, the breakage happened after it had been stretched 300 times under 0-60 N due to the high percentage of PCL. Therefore, attention should be paid to suture with a high percentage of PCL for high load-bearing tendons/ ligaments repair.…”

Section: Tensile Propertiesmentioning

confidence: 90%

Polycaprolactone/ultra-high molecular weight polyethylene partially absorbable suture with improved mechanical performances for tendon and ligament repair

Zhang

Luan

et al. 2020

Textile Research Journal

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Orthopedic suture, as an implantable surgical device for skeletal and soft tissue connection, is vital in tendon or ligament injury repair. Resorbable therapy approaches exhibit excellent biocompatibility in the field of suture materials but lack a long-term fixation effect in orthopedic treatment. Herein, this study focused on a series of partially absorbable orthopedic sutures, which were composed of absorbable polycaprolactone (PCL) multifilament and non-absorbable ultra-high molecular weight polyethylene (UHMWPE) multifilament. Comprehensive in vitro mechanical evaluations were conducted to probe the relationship between material composition and mechanical properties of the sutures. The results showed that the partially absorbable sutures, especially P/U = 50/50 and P/U = 25/75, exhibited significant improvements in mechanical properties compared to single-material sutures. The tensile strength of P/U = 50/50 and P/U = 25/75 was 180.99 and 210.91 N, respectively, which was about two times higher than that of absorbable PCL suture P/U = 100/0 (62.42 N). Furthermore, their suture-to-suture friction force was 1.89 times and 2.51 times that of non-absorbable UHMWPE suture P/U = 0/100, respectively, which guaranteed good knot security. Compared with the clinically used orthopedic suture Ethibond (110 N), P/U = 50/50 and P/U = 25/75 also presented superior tensile properties. Notably, P/U = 50/50 and P/U = 25/75 had similar tensile curves to that of the native tendon/ligament, which might be beneficial to tissue healing. Moreover, the R2 of Eyring's model to simulate the creep curves of each suture was higher than 0.99, which indicated that Eyring's model could be used in predicting the long-term creep behavior of the sutures.

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Arthroscopic Knots and Strength Sutures for Rotator Cuff Repair

Cited by 19 publications

References 79 publications

Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model

Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model

Synthetic Augmentation in Massive Rotator Cuff Tears

Polycaprolactone/ultra-high molecular weight polyethylene partially absorbable suture with improved mechanical performances for tendon and ligament repair

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