Tendon–bone contact pressure and biomechanical evaluation of a modified suture-bridge technique for rotator cuff repair

The aim of the study was to evaluate the time-zero mechanical and footprint properties of a suture-bridge technique for rotator cuff repair in an animal model. Thirty fresh-frozen sheep shoulders were randomly assigned among three investigation groups: (1) cyclic loading, (2) load-to-failure testing...

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Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2010-07, Vol.18 (7), p.992-998
Main Authors: Baums, Mike H., Geyer, Michael, Büschken, Meike, Buchhorn, Gottfried H., Spahn, Gunter, Klinger, Hans-Michael
Format: Article
Language:English
Subjects:
Animals
Biomechanical Phenomena
Biomechanics
Biomechanics (sports techniques)
Cadaver
Equipment Failure Analysis
Failure
Medicine
Medicine & Public Health
Orthopedics
Recovery
Rotator cuff
Rotator Cuff - physiology
Rotator Cuff - surgery
Sheep
Shoulder
Shoulders
Strength
Stress
Surgery
Suture Anchors
Suture Techniques
Sutures
Tendons
Tensile Strength
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Summary:The aim of the study was to evaluate the time-zero mechanical and footprint properties of a suture-bridge technique for rotator cuff repair in an animal model. Thirty fresh-frozen sheep shoulders were randomly assigned among three investigation groups: (1) cyclic loading, (2) load-to-failure testing, and (3) tendon–bone interface contact pressure measurement. Shoulders were cyclically loaded from 10 to 180 N and displacement to gap formation of 5- and 10-mm at the repair site. Cycles to failure were determined. Additionally, the ultimate tensile strength and stiffness were verified along with the mode of failure. The average contact pressure and pressure pattern were investigated using a pressure-sensitive film system. All of the specimens resisted against 3,000 cycles and none of them reached a gap formation of 10 mm. The number of cycles to 5-mm gap formation was 2,884.5 ± 96.8 cycles. The ultimate tensile strength was 565.8 ± 17.8 N and stiffness was 173.7 ± 9.9 N/mm. The entire specimen presented a unique mode of failure as it is well known in using high strength sutures by pulling them through the tendon. We observed a mean contact pressure of 1.19 ± 0.03 MPa, applied on the footprint area. The fundamental results of our study support the use of a suture-bridge technique for optimising the conditions of the healing biology of a reconstructed rotator cuff tendon. Nevertheless, an individual estimation has to be done if using the suture-bridge technique clinically. Further investigation is necessary to evaluate the cell biological healing process in order to achieve further sufficient advancements in rotator cuff repair.
ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-009-0941-7