A Novel Surgical Technique for Interpositional ePTFE Patch Repair of Massive Irreparable Rotator Cuff Tears

Abstract

Massive rotator cuff tears constitute 10% to 40% of rotator cuff tears. Surgical repair is challenging, with high retear rates (20% to 90%). The aim of this study was to develop a new surgical technique to perform an interpositional expanded polytetrafluoroethylene (ePTFE) patch repair for massive and/or irreparable rotator cuff tears that minimizes arthroscopic knot tying without compromising repair strength. (1) Twelve 30×50 mm ePTFE patches and no.2 sutures (450 mm length) were either sterilized in an autoclave for 15 minutes at 130°C and 120 kPa, or left unsterilized. The sutures and patches were then pulled to failure in an Instron Materials Testing System to verify the effect of sterilization on the biomechnical properties. (2) A “Slide and Grip” technique was developed for synthetic patch interpositional repair and compared with our standard “Weave” technique. Autoclaving had no effect on patches (486±15 N vs. 491±15 N; mean±SEM) or sutures. Both “Weave” and “Slide and Grip” techniques had similar repair strengths (279±22 vs. 248±15 N). However, the “Slide and Grip” technique was much faster to perform than the (12.3±1.0; vs. 21.5±1.0 min; mean±SEM) (P<0.0001). A novel technique for the ePTFE patch repair of massive rotator cuff tears provided 40% reduction in operative time with similar pullout strength compared with the “Weave” technique.