Bridging suture makes consistent and secure fixation in double-row rotator cuff repair

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Sports Medicine

Background:

• Inconsistent tension distribution after rotator cuff repair can compromise biomechanical properties and lead to failure.
• Double-row repair techniques aim to improve tendon healing but may suffer from uneven tension distribution.

Purpose of the Study:

• To compare tension distribution across three double-row rotator cuff repair techniques.
• To evaluate the biomechanical outcomes of conventional, transosseous-equivalent, and compression double-row repairs.

Main Methods:

• 42 porcine shoulders underwent simulated infraspinatus tendon tears repaired with three techniques: conventional, transosseous-equivalent, or compression double-row.
• Cyclic testing was performed at 0° and 40° abduction to measure gap formation and tendon strain.
• Differences in gap and strain between superior and inferior fixations were analyzed to assess tension distribution.

Main Results:

• At 0° abduction, transosseous-equivalent and compression repairs showed significantly less gap formation than conventional repair.
• Both transosseous-equivalent and compression repairs demonstrated a smaller difference in gap formation between superior and inferior fixations at 0° abduction after 30 cycles.
• Compression double-row repair resulted in significantly less difference in longitudinal strain between fixations at 0° abduction after 30 cycles.

Conclusions:

• Bridging sutures are crucial for achieving consistent and secure fixation in double-row rotator cuff repairs.
• The use of bridging sutures appears beneficial for achieving more equal tension distribution among all sutures in double-row rotator cuff repairs.