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. 2020 May;11(Suppl 3):S378-S382.
doi: 10.1016/j.jcot.2020.02.007. Epub 2020 Feb 21.

Is it necessary to tie the medial row in rotator cuff repair double-row constructs when using suture tape?

Michael R Mijares  1 , Andrew Hiller  2 , Ali Alhandi  3 , David Kaimrajh  3 , Ted Milne  3 , Loren Latta  3   4 , Michael G Baraga  5
Affiliations

Is it necessary to tie the medial row in rotator cuff repair double-row constructs when using suture tape?

Michael R Mijares et al. J Clin Orthop Trauma. 2020 May.

Erratum in

  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1169-1171. doi: 10.1016/j.jcot.2020.09.032. Epub 2020 Sep 26. J Clin Orthop Trauma. 2020. PMID: 33013141 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2020 Nov-Dec;11(6):1172-1174. doi: 10.1016/j.jcot.2020.10.044. Epub 2020 Oct 23. J Clin Orthop Trauma. 2020. PMID: 33192025 Free PMC article.
  • Erratum regarding previously published articles.
    [No authors listed] [No authors listed] J Clin Orthop Trauma. 2021 Aug 5;21:101560. doi: 10.1016/j.jcot.2021.101560. eCollection 2021 Oct. J Clin Orthop Trauma. 2021. PMID: 34414073 Free PMC article.

Abstract

Purpose: To evaluate the selected biomechanical differences of a double-row trans-osseous equivalent rotator cuff repair with a knotless versus knot-tying medial row using suture tape in regard to repair displacement, stiffness, and ultimate load to failure.

Methods: In 16 fresh-frozen human shoulders (8 matched pairs), double-row rotator cuff repairs were performed with medial-row mattress knots (MK) on one side, the other without (NK). Two DVRT (Differential Variable Reluctance Transducer) sensors were attached between the humerus and 3 mm above the repair site and were used to measure the displacement across the repair during cycling. The biomechanical parameters measured were repair displacement, stiffness, and ultimate load to failure. The supraspinatus was loaded in a similar fashion to previously described protocol using cyclic loading and load to failure testing.1.

Results: All data from paired specimens were compared using paired Student t tests. No statistically significant difference (SSD) in displacement across the repair over the 200 cycles of the test was noted between the two groups (MK = 0.591 ± 0.501 mm; NK = 0.439 ± 0.417 mm, p = 0.618). No SSD in stiffness was noted between the two groups (MK = 32.87 ± 6.31 N/mm; NK = 27.98 ± 9.69 N/mm, p = 0.120). No SSD in ultimate load to failure was noted between the two groups (MK = 501.2 ± 126.1 N; NK = 416.8 ± 120.0 N, p = 0.116).

Conclusion: There was no statistically significant different between knotless versus knotted medial row double row rotator cuff repair constructs using suture tape in regard to displacement across the repair site, stiffness and ultimate load to failure. Despite previous evidence suggesting inferiority of knotless medial row technique using suture constructs, this evidence may support the biomechanical equivalency of knotless medial row technique using suture tape.

Keywords: Double row; Knotless fixation; Rotator cuff; Suture tape.

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Figures

Fig. 1
Fig. 1
Placement of double row suture tape and medial row configuration at the medial footprint.
Fig. 2
Fig. 2
Medial-row knotted double row repair spanning the artificial cut.
Fig. 3
Fig. 3
Samples were secured on a material testing machine (Instron E3000 – Instron Corp., Norwood, MA) using a variable angle vice, oriented such that the direction of pull was 45° to the long axis of the humerus to replicate the physiologic pull of the rotator cuff superiorly. The muscle belly of the supraspinatus was secured to a clamp. To augment and ensure reproducibility, a 1 mm metal bead was implanted in the humerus and a radio-opaque surgical staple was secured to the soft tissue 3 mm above the repair site.
See this image and copyright information in PMC

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