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Biomechanical comparison of suture anchor versus margin convergence plus suture anchor for rotator cuff repair.
MedLine Citation:
PMID:  22009773     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Objective:  To evaluate results of margin convergence versus suture anchors in rotator cuff repair, and to determine which method is mechanically superior. Methods:  Eighteen kangaroo shoulders were randomly divided into three groups (n = 6). A full thickness tendon defect 1.0 cm × 1.5 cm in size was created in the supraspinatus tendon at humeral insertion, simulating a massive rotator cuff tear. Three different techniques were employed for rotator cuff repair: (i) Mitek GII suture anchor alone (Group 1); (ii) margin convergence alone (Group 2); and (iii) margin convergence plus Mitek GII suture anchor (Group 3). Combined loads were applied to each specimen. After completion of cyclic loading, the construct was loaded to failure. ANOVA and LSD (Least Significant Difference) multiple comparisons of the means were applied to results. Results:  Cyclic load testing showed progressive gap formation in each repaired specimen with increasing cycles. Group 1 reached 50% failure at an average of 34 cycles, Group 2 at 75 cycles and Group 3 at 73 cycles. There were significant difference between Groups 1 and 2, and Groups 1 and 3 (P ≤ 0.001). After 100 loading cycles, the average gap size was 6.8 mm, 6.1 mm and 4.7 mm in Groups 1, 2 and 3, respectively. There was a significant difference between Groups 1 and 3 (P ≤ 0.015). All specimens eventually reached failure. Conclusion:  Rotator cuff repairs with margin convergence +/- suture anchor were far stronger than suture anchor alone, both in gap formation and ultimate failure load. However, progressive gap formation with cyclic loading seems inevitable after cuff repair, which may facilitate clinical understanding of the phenomena of re-tear or residual defect.
Authors:
Shi-Yi Chen; Hilary L Malcarney; George A C Murrell
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Orthopaedic surgery     Volume:  1     ISSN:  1757-7853     ISO Abbreviation:  Orthop Surg     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2011-10-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101501666     Medline TA:  Orthop Surg     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  1-5     Citation Subset:  IM    
Copyright Information:
© 2009 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.
Affiliation:
Department of Sports Medicine and Arthroscopy Surgery, Fudan University Sports Medicine Center, Huashan Hospital, Shanghai, China; and The Sports Medicine and Shoulder Service, Orthopaedic Research Institute, St. George Hospital Level 2, Sydney, New South Wales, Australia.
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