The Optimum Tension for Bridging Sutures in Transosseous-Equivalent Rotator Cuff Repair

Park, Ji Soon; McGarry, Michelle H.; Campbell, Sean T.; Seo, Hyuk Jun; Lee, Yeon Soo; Kim, Sae Hoon; Lee, Thay Q.; Oh, Joo Han

doi:10.1177/0363546515590596

Cited by 21 publications

(31 citation statements)

References 24 publications

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“…This suggests surgical technique was only one of the factors determining a successful outcome following surgery. Age, tissue quality, the size of the tear, retraction and muscle atrophy, and other patient related factors such as smoking, bone quality, chronic Vitamin D deficiency and diabetes were also shown to influence the healing outcome [5,32].…”

Section: Elongation/gap Formationmentioning

confidence: 99%

“…Initial fixation plays an important role and may be critical in achieving successful healing [2,5]. Numerous surgical techniques have been described for the repair of rotator cuff injuries, including fixation using single-or double-row suture anchor techniques, transosseous tunnels, or newer configurations such as transosseous equivalent (TOE) or knotless techniques [1].…”

Section: Introductionmentioning

confidence: 99%

“…Failure modes between these two groups were not significantly different. To our knowledge, this is the first systematic review with meta-analysis comparing single -and double-row repair techniques with respect to the resulting biomechanical properties, such as load to failure, gap formation, and failure mode.Studies have shown that stable fixation at the bone-tendon interface is one of the key factors in the early stages of healing[5]. Hughes & An have calculated forces for the supraspinatus tendon during abduction, adduction, internal rotation, and external…”

mentioning

confidence: 99%

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Single- versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies

Hohmann

König

Kat

et al. 2017

Eur J Orthop Surg Traumatol

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Section: Elongation/gap Formationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Single- versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies

Hohmann

König

Kat

et al. 2017

Eur J Orthop Surg Traumatol

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“…The 2 medial row anchors were inserted just along the articular margin of humeral head in a 45° angle [9] with the distance of 12.5 mm between two anchors in anteroposterior direction [10]. …”

Section: Surgical Proceduresmentioning

confidence: 99%

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

Zhang

et al. 2016

BioMed Research International

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Purpose. To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair. Methods. Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB), the medially Untied Suture Bridge (USB), and the Modified Suture Bridge (MSB). Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded. Results. The MSB technique had the significantly greatest load to failure (515.6 ± 78.0 N, P = 0.04 for KSB group; P < 0.001 for USB group), stiffness (58.0 ± 10.7 N/mm, P = 0.005 for KSB group; P < 0.001 for USB group), and lowest elongation (1.49 ± 0.39 mm, P = 0.009 for KSB group; P = 0.001 for USB group) among 3 groups. The KSB repair had significantly higher ultimate load (443.5 ± 65.0 N) than USB repair (363.5 ± 52.3 N, P = 0.024). However, there was no statistical difference in stiffness and elongation between KSB and USB technique (P = 0.396 for stiffness and P = 0.242 for elongation, resp.). The failure mode for all specimens was suture pulling through the cuff tendon. Conclusions. Our modified suture bridge technique (MSB) may provide enhanced biomechanical properties when compared with medially knotted or knotless repair. Clinical Relevance. Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair.

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“…Specimens were preloaded to 10 N for 60 seconds, after which they were cyclically loaded to 100 N at a rate of 15 mm/s for 30 cycles, consistent with testing conditions in previous studies. 12 , 13 HD allografts were again measured for length, width, and thickness after testing concluded. Linear stiffness values were calculated by the MTS software and were recorded at cycles 1, 15, and 30.…”

Section: Methodsmentioning

confidence: 99%

Suture Tape–Reinforced Human Dermal Allograft Used for Superior Capsule Reconstruction Demonstrates Improved Ability to Withstand Elongation

Lee

Reddy

Scott

et al. 2020

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To investigate the potential for a suture tape–reinforcement technique to prevent elongation with repetitive use of a human dermal (HD) allograft traditionally used for superior capsule reconstruction in a biomechanical model. Methods Using 8 scapulae and humeri Sawbones models, the standard superior capsule reconstruction was performed using 8 HD allografts. Four grafts were tested in the native state, whereas 4 were tested using reinforcement. Allografts were reinforced using suture tape in a running 360° fashion around the allograft borders, maintaining 5 mm of space from the edges. Allografts were measured pre- and postdynamic testing for length, width, and thickness. All specimens were affixed to a materials testing machine that allowed for allograft orientation in a longitudinal plane throughout testing. Specimens were preloaded to 10 N and then cyclically loaded to 100 N at a rate of 15 mm/s for 30 cycles. Results After dynamic, cyclic loading, suture tape–reinforced allografts experienced a significantly smaller percent change in anterior length (6.36% vs 14.50%, P = .013), posterior length (6.00% vs 13.68%, P = .002), medial width (5.80% vs 21.05%, P = .001), lateral width (5.45% vs 19.29%, P < .001), medial thickness (4.38% vs 17.93%, P = .005), central thickness (7.03% vs 16.11%, P = .026), and lateral thickness (4.55% vs 20.80%, P < .001). Linear stiffness values obtained for suture tape –reinforced allografts were significantly greater than those for native allografts when measured at cycles 1 (21.18 ± 1.03 N/mm vs 17.69 ± 1.91 N/mm, P = .02), 15 (29.90 ± 1.45 vs 24.93 ± 2.79, P = .03), and 30 (32.13 ± 1.98 N/mm vs 25.72 ± 3.01 N/mm, P = .01) of dynamic testing Conclusions The suture tape–reinforcement technique described decreased HD allograft elongation, maintained graft thickness, and improved linear stiffness values following uniplanar cyclic loading in a biomechanical Sawbones model. Clinical relevance Suture tape reinforcement of the HD allograft could serve as one strategy to overcome the issue of allograft elongation with time following superior capsule reconstruction.

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The Optimum Tension for Bridging Sutures in Transosseous-Equivalent Rotator Cuff Repair

Abstract: Considering the risks of overtensioning bridging sutures, it may be clinically more beneficial to keep bridging suture tension below 90 N.

Cited by 21 publications

References 24 publications

Single- versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies

Single- versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair

Suture Tape–Reinforced Human Dermal Allograft Used for Superior Capsule Reconstruction Demonstrates Improved Ability to Withstand Elongation

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