Three-dimensional evaluation of the cyclic loading behavior of different rotator cuff reconstructions

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Rotator cuff tears are common injuries requiring surgical repair.
• The biomechanical integrity of rotator cuff repairs is crucial for successful outcomes.
• Comparing different surgical techniques, such as single-row versus double-row repairs, is essential for optimizing treatment strategies.

Purpose of the Study:

• To biomechanically compare single-row rotator cuff repairs with modified suture configurations against double-row repairs.
• To evaluate the efficacy of radiostereometric analysis (RSA) in quantifying rotator cuff repair stability.

Main Methods:

• Utilized 40 porcine cadaveric shoulders, marking the infraspinatus tendon and humerus with tantalum beads for RSA.
• Intact tendons underwent cyclic loading, followed by single-row (modified Mason-Allen, double mattress, inclined mattress) and double-row (modified Mason-Allen, suture bridge) repairs.
• Repaired constructs were cyclically loaded (10-100 N), with 3D displacements measured using RSA and compared with video extensometry.

Main Results:

• High correlation (0.87) was found between RSA and video extensometer measurements.
• Significant differences in gap formation were observed in the craniocaudal and mediolateral planes at higher loads (P < .0001 and P <= .05, respectively).
• The double-row Mason-Allen repair showed the least gap formation, but single-row double-mattress repairs were comparable, with no significant differences in the anteroposterior plane.

Conclusions:

• Modified single-row rotator cuff repairs (Mason-Allen, double-mattress) can achieve biomechanical results comparable to double-row repairs.
• Single-row repairs may offer cost benefits while maintaining comparable stability.
• RSA provides valuable 3D force data, potentially aiding in reducing rerupture rates in rotator cuff reconstructions.