2017 ISAKOS Biennial Congress ePoster #2258
Bridging Suture Makes Consistent And Secure Fixation In Double-Row Rotator Cuff Repair
Tetsutaro Fukuhara, MD, Ashiya, Hyogo JAPAN
Teruhisa Mihata, MD, PhD, Takatsuki, Osaka JAPAN
Masashi Neo, MD, PhD, Prof., Takatsuki, Osaka JAPAN
Osaka Medical College, Takatsuki, Osaka, JAPAN
FDA Status Not Applicable
Bridging sutures facilitate consistent and secure fixation in double-row rotator cuff repairs. During double-row repair of rotator cuff tears, bridging sutures may be beneficial for distributing tension equally among all sutures.
Inconsistent tension distribution, a risk factor for repair failure, decreases the biomechanical properties of the rotator cuff tendon after double-row repair. The purpose of this study was to compare the tension distribution along the repaired rotator cuff tendon among three double-row repair techniques.
In each of 42 fresh-frozen porcine shoulders, a simulated infraspinatus tendon tear was repaired by using 1 of 3 double-row techniques: (1) conventional double-row repair (no bridging suture); (2) transosseous-equivalent repair (bridging suture alone); and (3) compression double-row repair (which combined conventional double-row and bridging sutures). Each specimen underwent cyclic testing at a simulated shoulder abduction angle of 0° or 40° on a material-testing machine. Gap formation and tendon strain were measured during the 1st and 30th cycles. To evaluate tension distribution after cuff repair, difference in gap and tendon strain between the superior and inferior fixations were compared among three double-row techniques.
At an abduction angle of 0°, gap formation after either transosseous-equivalent or compression double-row repair was significantly less than that after conventional double-row repair (P < .01). During the 30th cycle, both transosseous-equivalent repair (P = .02) and compression double-row repair (P = .01) at 0° abduction had significantly less difference in gap formation between the superior and inferior fixations than did conventional double-row repair. After the 30th cycle, the difference in longitudinal strain between the superior and inferior fixations at 0° abduction was significantly less with compression double-row repair (2.7% ± 2.4%) than with conventional double-row repair (8.6% ± 5.5%, P = .03).
The double-row rotator cuff repair techniques that included bridging sutures (that is, transosseous-equivalent and compression techniques) had smaller differences in gap formation between the superior and inferior fixation sites and less tendon strain than did conventional double-row repair. These results suggest that bridging sutures promote balanced fixation in double-row rotator cuff repairs and may be beneficial for distributing stress evenly when rotator cuff repairs require 4 or more suture anchors, as for medium or large tears.