Augmentation of rotator cuff repair with gelatin-resorcin-formalin glue: a biomechanical study

Rotator cuff tendons are typically reattached to the proximal humerus using transosseous sutures or suture anchors. Their primary mode of failure is at the tendon-bone interface.

We investigated the addition of an adhesive, gelatin-resorcin-formalin (GRF) glue, to a single-row rotator cuff repair (RCR) on ex vivo sheep models. We hypothesised the addition of GRF glue would increase the repair construct strength. The study consisted of three groups of six sheep infraspinatus tendons with an inverted-mattress stitch, tension-band configuration. Group 1 was the control group where no glue was applied. Group 2 involved applying 2 × 2 cm of GRF glue to the infraspinatus footprint and a 2-min curing time. Group 3 allowed for a 15-min cure time.

Failure occurred at the tendon-bone-suture interface in 6/6 of the control group, and 4/6 from groups 2 and 3. Failure occurred via the suture pulling out of the anchor in 2/6 of groups 2 and 3. No significant differences were noted between all three groups in ultimate failure load, repair stiffness or total energy to failure (p > 0.05).

The addition of GRF glue to the tendon-bone-suture interface did not enhance RCR strength in an ovine model.