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A biodegradable button to augment suture attachment in rotator cuff repair
Jonathan T Bravman1, Dan Guttman, Andrew S Rokito
1NYU-Hospital for Joint Diseases Department of Orthopaedic Surgery, 15th Floor, 301 East 17th Street, New York, New York 10003, USA.
Bulletin (Hospital for Joint Diseases (New York, N.Y.))
|August 2, 2006
Summary
Adding a bioabsorbable button to rotator cuff tear (RCT) repair significantly improves fixation strength. This augmentation enhances suture-tendon interface integrity, potentially reducing repair failures in patients undergoing rotator cuff surgery.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
- Biomechanics
Background:
- Suture anchors in rotator cuff tear (RCT) repair can lead to "weak link" failure at the suture-tendon interface.
- Tendon pull-through by sutures is a common mode of failure in RCT repair.
Purpose of the Study:
- To evaluate the impact of a suture augmentation button on the fixation strength of rotator cuff tendon repairs.
- To compare the biomechanical performance of augmented versus standard suture anchor repairs for RCTs.
Main Methods:
- Cadaveric supraspinatus tendons (7 pairs) underwent standardized rotator cuff defects.
- Repairs were performed using suture anchors, with one side augmented with bioabsorbable buttons and the other serving as a control.
- Specimens were subjected to cyclic loading to assess gap formation and then tested to ultimate failure.
Main Results:
- Button-augmented repairs demonstrated significantly higher resistance to gap formation (0.75 cm and 1.5 cm) compared to unaugmented repairs (p < 0.05).
- Augmented repairs sustained more loading cycles before reaching critical gap sizes, indicating enhanced fixation strength.
- All specimens eventually failed by suture pull-through, but the augmentation delayed this failure mode.
Conclusions:
- In vitro, suture augmentation with a low-profile bioabsorbable button significantly enhances the fixation strength of rotator cuff tendon repairs using suture anchors.
- This button augmentation may serve as a valuable adjunct to improve the outcomes of rotator cuff repair procedures.
- The findings suggest a potential method to mitigate suture pull-through failures in rotator cuff surgery.