Single-Row RC-Repair Using A Modified Suture Configuration Versus a Suturebridge Double-Row Repair: Comparable Biomechanical Results and Complete Footprint Coverage Independent of the Initial Tear Size (SS-20)

Abstract

Introduction Influence of the initial tear size and repair technique of single-row and double-row repairs on the biomechanical properties and footprint coverage. Methods 25 (Bateman grade II) and 35mm (Bateman grade III) artificial defects were created in the rotator cuff of 24 human cadaver shoulders. The reconstructions were performed as either a single-row repair using triple-loaded suture anchors (2-3) and a modified suture configuration or a modified suturebridge double-row repair (4-6). Reconstructions were cyclically loaded from 10-60N. The load was stepwise increased up to 100, 180, and 250N. Cyclic displacement and load-to-failure were determined. Furthermore, footprint widths were quantified before and after the repair. Results In the 25mm rupture, 533±107N were achieved for the SR-repair and 681±250N were measured for the DR-suturebridge technique. In the 35mm artificial tear, ultimate failure load was 792±122N for the SR-reconstruction and 891±174N for the DR-reconstruction. There were no differences in load-to-failure between the tested repairs (p>.05). Cyclic displacement showed no significant differences between the tested configurations at 60, 100, 180 und 250N (p>.05) for the 25mm tear. In the reconstruction of the 35mm RC tear, significant lower gap formation was found for the SR-reconstruction at 180N (p=.037) and 250N (p=.020). No significant differences were found at 60 and 100N (p>.05). A significantly greater footprint width was seen with the double-row technique compared to the single-row repair. However, both reconstructions were able to achieve a complete footprint coverage compared to the initial footprint. Conclusion The single-row repair technique using a modified suture configuration showed similar results in load-to-failure and cyclic displacement compared to the modified double-row suturebridge technique independent of the initial size of the rupture. The double-row repair consistently restored a larger footprint than the single-row method. However, both repair techniques achieved complete footprint coverage.