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. 2023 Feb;19(1):44-52.
doi: 10.1177/15563316221114135. Epub 2022 Jul 28.

Biomechanical Comparison of Synthetic Polytetrafluoroethylene (PTFE) vs Human Dermal Allograft (HDA), 2 vs 3 Glenoid Anchors, and Suture vs Minitape in Superior Capsule Reconstruction

Ryan S Ting  1   2   3 , Allen A Guo  1   2 , Ron Rosenthal  2 , Hilal S A Al-Housni  2 , Patrick H Lam  1   2 , George A C Murrell  1   2
Affiliations

Biomechanical Comparison of Synthetic Polytetrafluoroethylene (PTFE) vs Human Dermal Allograft (HDA), 2 vs 3 Glenoid Anchors, and Suture vs Minitape in Superior Capsule Reconstruction

Ryan S Ting et al. HSS J. 2023 Feb.

Abstract

Background: Superior capsule reconstruction (SCR) is an option for the treatment of massive, irreparable rotator cuff tears. However, which materials yield the strongest constructs remains undetermined. Purposes: We sought to investigate whether SCR with polytetrafluoroethylene (PTFE) or human dermal allograft (HDA), 2 or 3 glenoid anchors, and suture or minitape resulted in better failure load properties at the patch-glenoid interface. Methods: We conducted a biomechanical study in 30 glenoid-sided SCR repairs in Sawbones models divided into 5 groups. Each was pulled to failure to assess mode of failure, peak load (N), stiffness (N/mm), yield load (N), peak energy (N m), and ultimate energy (N m). The 5 groups were as follows: group 1-PTFE, 2 anchors, and suture; group 2-PTFE, 2 anchors, and minitape; group 3-HDA, 2 anchors, and suture; group 4-HDA, 2 anchors, and minitape; group 5-PTFE, 3 anchors, and minitape. Results: Repairs failed by button-holing of suture/minitape. Group 5 had greater peak load, stiffness, yield load, and peak energy (384 ± 62 N; 24 ± 3 N/mm; 343 ± 42 N; 4 ± 2 N m) than group 3 (226 ± 67 N; 16 ± 4 N/mm; 194 ± 74 N; 2 ± 1 N m) or group 4 (274 ± 62 N; 17 ± 4 N/mm; 244 ± 50 N; 2 ± 1 N m) and greater ultimate energy (8 ± 3 N m) than all other groups. Conclusions: This biomechanical study of SCR repairs in Sawbones models found that yield load was greater in PTFE than HDA, 3 anchors were better than 2, and minitape was no better than suture.

Keywords: arthroscopy; biomechanics; irreparable rotator cuff tear; superior capsular reconstruction; synthetic.

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Conflict of interest statement

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: George A.C. Murrell, MD, DPhil, reports relationships with Smith & Nephew, the Journal of Shoulder and Elbow Surgery, and Shoulder and Elbow. The other authors declare no potential conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Schema of superior capsule reconstruction repair groups 1–5; n = 6 for each group. PTFE polytetrafluoroethylene, HDA human dermal allograft.
Fig. 2.
Fig. 2.
Template used for the preparation of (a) 2-anchor and (b) 3-anchor repairs.
Fig. 3.
Fig. 3.
Modes of failure: (a) avulsion of Sawbones, (b) button-holing at the right suture human dermal allograft interface, (ci) suture cutout through Sawbones and (cii) eventual suture pullout from anchors.
Fig. 4.
Fig. 4.
Peak failure load (N) for groups 1–5. PTFE polytetrafluoroethylene, HDA human dermal allograft. *P < .05 calculated with 1-way analysis of variance using the Tukey multiple comparisons test.
Fig. 5.
Fig. 5.
Stiffness (N/mm) for groups 1–5. PTFE polytetrafluoroethylene, HDA human dermal allograft. *P < .05 calculated with 1-way analysis of variance using the Tukey multiple comparisons test.
Fig. 6.
Fig. 6.
Yield load (N) for groups 1–5. PTFE polytetrafluoroethylene, HDA human dermal allograft. *P < .05 calculated with 1-way analysis of variance using the Tukey multiple comparisons test.
Fig. 7.
Fig. 7.
(a) Peak energy (N m) and (b) ultimate energy for groups 1–5. PTFE polytetrafluoroethylene, HDA human dermal allograft. *P < .05 calculated with 1-way analysis of variance using the Tukey multiple comparisons test.
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References

    1. Andres BM, Lam PH, Murrell GAC. Tension, abduction, and surgical technique affect footprint compression after rotator cuff repair in an ovine model. J Shoulder Elbow Surg. 2010;19(7):1018–1027. 10.1016/j.jse.2010.04.005. - DOI - PubMed
    1. Badhe SP, Lawrence TM, Smith FD, Lunn PG. An assessment of porcine dermal xenograft as an augmentation graft in the treatment of extensive rotator cuff tears. J Shoulder Elbow Surg. 2008;17(suppl 1):35s–39s. 10.1016/j.jse.2007.08.005. - DOI - PubMed
    1. Badman BL, Baessler AM, Moor M. Short-term clinical outcomes and comparison of ultrasound versus magnetic resonance imaging of superior capsular reconstruction. Arthrosc Sports Med Rehab. 2020;2(3):e229–e235. 10.1016/j.asmr.2020.02.006. - DOI - PMC - PubMed
    1. Barber FA, Burns JP, Deutsch A, Labbé MR, Litchfield RB. A prospective, randomized evaluation of acellular human dermal matrix augmentation for arthroscopic rotator cuff repair. Arthroscopy. 2012;28(1):8–15. 10.1016/j.arthro.2011.06.038. - DOI - PubMed
    1. Bektaşer B, Oçgüder A, Solak S, Gönen E, Yalçın N, Kılıçarslan K. Free coracoacromial ligament graft for augmentation of massive rotator cuff tears treated with mini-open repair. Acta Orthop Traumatol Turc. 2010;44(6):42630–42634. 10.3944/aott.2010.2423. - DOI - PubMed