Rotator Cuff Repair: a Biomechanical Comparison of Three Techniques

Waltrip RL, Zheng N, Dugas JR, Andrews JR. Rotator cuff repair: a biomechanical comparison of three techniques. The American Journal of Sports Medicine 31(4):493-497, 2003

The most common complication of rotator cuff repair is structural failure at the repair site. A single-layer repair does not adequately reproduce the anatomic insertion and may not optimize fixation strength.

Methods

Twelve fresh-frozen matched pairs of cadaveric shoulders were repaired by dual-site fixation with both suture anchors and transosseous tunnels on one side (technique 1). Fixation was achieved by using suture anchors with horizontal mattress sutures and bone tunnels with modified Mason-Allen sutures. Half of the contralateral matched shoulders underwent fixation with suture anchors and simple sutures to simulate commonly used arthroscopic methods (technique 2). For the remaining shoulders, fixation was achieved by using transosseous tunnels and modified Mason-Allen sutures (technique 3).

Results

The mean number of cycles of failure with technique 1 (3694 ą 1980 cycles) was significantly greater than that with either technique 2 (1414 ą 1888 cycles) or technique 3 (528 ą 683 cycles). Failure was predominantly through bone. The initial fixation strength of double-layer repair exceeds that of isolated single-layer repairs with either suture anchors or transosseous tunnels.