ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #2001

 

Evaluation of Footprint Contact Pressure and Area in Rotator Cuff Repair Using Conventional Suture-Bridge Technique, Knotless Suture-Bridge Technique, and "Dozen" Knotless Suture-Bridge Technique: Cadaveric Study

Sittan Aimprasittichai, MD, Mueng, Nakhon Pathom THAILAND
Bancha Chernchujit, Prof., Khlong Luang, Pathum Thani THAILAND

Department of Orthopedics, Thammasat University Hospital, Khlong Luang District, Pathum Thani, THAILAND

FDA Status Cleared

Summary

The 'Dozen' knotless suture-bridge technique produces the comparable average pressure to the conventional medial knot-tying technique but provide significantly less pressure on the medial footprint of the rotator cuff and more footprint coverage to the others.

Abstract

Purpose

Among the different 3 technique, Conventional Suture-bridge technique, Knotless (8 limbs of suture) Suture-bridge technique and Dozen (12-limbs of suture) Knotless Suture-bridge technique. To evaluate whether the use of a Dozen knotless suture-bridge technique which no knot tying in both medial row decrease the excessive pressure at the medial area of the footprint after rotator cuff repair than the conventional suture-bridge technique which require knot tying for the medial row. And to compare the pressure distribution after the repair by the different technique.

Methods

A total of 21 cadaveric shoulders were divided into 3 groups. In Group 1; a conventional suture-bridge technique was performed on 7 shoulders. In Group 2; a knotless suture bridge technique was performed on 7 shoulders. In Group 3; a dozen knotless suture bridge technique was performed on 7 shoulders. The contact pressure coverage, the average pressure and the pattern of the pressure between the medial and the lateral footprint were measured using pressure sensitive film (Fuji Prescale Film) by placing at the tendon-footprint interface.

Results

The average pressure on the footprint was no significantly difference between 3 techniques (0.21±0.01 Mpa , 0.19±0.02 MPa and 0.20±0.02 MPa) (P=0.179). The contact pressure distribution at the medial footprint was significantly lesser for the (43.9±4.19 %) than the conventional technique (51.5±5.97 %) (P < 0.05) but no difference from the knotless suture-bridge technique (48.1±3.33 %) (P=0.128) The footprint coverage of the dozen knotless suture-bridge technique (76.5±9.1% of footprint) was significantly superior than the conventional technique (65.1±9.2% of footprint) and the knotless suture-bridge technique (67.6±3.4% of footprint) (P < 0.05)

Conclusions

The dozen knotless suture-bridge technique produces the comparable average pressure to the conventional medial knot-tying technique but provide significantly less pressure on the medial footprint of the rotator cuff and more footprint coverage from the more limbs of suture. This technique is effective to decrease the rate of re-tear at musculotendinous junction (Type II re-tear) after the rotator cuff repair from the excessive pressure on the junction.