Effect of Suture Absorbability on Rotator Cuff Healing in a Rabbit Rotator Cuff Repair Model

2018 ◽  
Vol 46 (11) ◽  
pp. 2743-2754 ◽  
Author(s):  
Wei Su ◽  
Wenxiao Qi ◽  
Xiaoxi Li ◽  
Song Zhao ◽  
Jia Jiang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Biomechanical Testing ◽  
Histological Evaluation ◽  
Suture Materials ◽  
Greater Tuberosity ◽  
Bone Interface ◽  
Supraspinatus Tear ◽  
Absorbable Sutures ◽  
Cuff Repair

Background: Various suture materials can be clinically used for rotator cuff repair (RCR). RCR with high-strength nonabsorbable sutures may not be ideal, because it may cause stress shielding, which may hinder enthesis regeneration and maturation in the tendon-bone interface. RCR with strength-decreasing sutures (ie, absorbable sutures) may be a better choice. However, the effects of suture absorbability on enthesis regeneration and maturation have not been investigated. Hypothesis: The use of absorbable sutures in RCR would produce a better tendon-bone connection structure, which provides histological and biomechanical advantages over the use of nonabsorbable sutures. Study Design: Controlled laboratory study. Methods: A supraspinatus tear was created on the right shoulder in 108 of 120 skeletally mature male rabbits. The animals were randomly divided into 3 groups, with 36 rabbits in each group, to undergo RCR individually with total absorbable, partial absorbable, and nonabsorbable sutures (TAS, PAS, and NAS). Twelve animals in each group were sacrificed at 4, 8, and 12 weeks after surgery, with 6 operated shoulders used for histological evaluation to detect enthesis regeneration and maturation and the other 6 for biomechanical testing. The remaining 12 animals without supraspinatus tear were used as control. Results: At 12 weeks, in the tendon-bone interface, enthesis regeneration was detected in the TAS group but not in the NAS group. A mature enthesis appeared in the TAS group but not in the NAS group. In the PAS group, enthesis regeneration was also observed; however, the fibrocartilage was not abundant and the enthesis maturity not good as compared with the TAS group. Biomechanical testing showed that the rotator cuff–greater tuberosity connection structure in the TAS and PAS groups had greater values of ultimate load to failure, stiffness, and stress than the NAS group at all time points. Conclusion: In RCR in an acute rabbit rotator cuff tear model, the use of sutures with absorbability lead to enthesis regeneration, increased maturity of rotator cuff insertion, and enhanced rotator cuff–greater tuberosity connection. Clinical Relevance: Compared with the use of NAS, the use of TAS or PAS might be a better choice for RCR.

Small Subchondral Drill Holes Improve Marrow Stimulation of Rotator Cuff Repair in a Rabbit Model of Chronic Rotator Cuff Tear

2020 ◽  
Vol 48 (3) ◽  
pp. 706-714 ◽  
Author(s):  
Yucheng Sun ◽  
Jae-Man Kwak ◽  
Erica Kholinne ◽  
Youlang Zhou ◽  
Jun Tan ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Large Diameter ◽  
Biomechanical Testing ◽  
Rabbit Model ◽  
Small Diameter ◽  
Histological Evaluation ◽  
Control Group ◽  
Greater Tuberosity ◽  
Cuff Repair

Background: Microfracture of the greater tuberosity has been proved effective for enhancing tendon-to-bone healing after rotator cuff repair. However, no standard diameter for the microfracture has been established. Purpose/Hypothesis: This study aimed to assess treatment with large- and small-diameter microfractures to enhance healing during rotator cuff repair surgery in a rabbit model of chronic rotator cuff tear. It was hypothesized that a small-diameter microfracture had advantages in terms of tendon-to-bone integration, bone-tendon interface maturity, microfracture healing, and biomechanical properties compared with a large-diameter microfracture. Study Design: Controlled laboratory study. Methods: Bilateral supraspinatus tenotomy from the greater tuberosity was performed on 21 New Zealand White rabbits. Bilateral supraspinatus repair was performed 6 weeks later. Small-diameter (0.5 mm) microfracture and large-diameter microfracture (1 mm) were performed on the left side and right side, respectively, in 14 rabbits as a study group, and simple repair without microfracture was performed in 7 rabbits as a control group. At 12 weeks later, 7 of 14 rabbits in the study group were sacrificed for micro–computed tomography evaluation and biomechanical testing. Another 6 rabbits were sacrificed for histological evaluation. In the control group, 3 of the 7 rabbits were sacrificed for histological evaluation and the remaining rabbits were sacrificed for biomechanical testing. Results: Significantly better bone-to-tendon integration was observed in the small-diameter microfracture group. Better histological formation and maturity of the bone-tendon interface corresponding to better biomechanical results (maximum load to failure and stiffness) were obtained on the small-diameter microfracture side compared with the large-diameter side and the control group. The large-diameter microfracture showed worse radiographic and histological properties for healing of the microfracture holes on the greater tuberosity. Additionally, the large-diameter microfracture showed inferior biomechanical properties but similar histological results compared with the control group. Conclusion: Small-diameter microfracture showed advantages with enhanced rotator cuff healing for biomechanical, histological, and radiographic outcomes compared with large-diameter microfracture, and large-diameter microfracture may worsen the rotator cuff healing. Clinical Relevance: This animal study suggested that a smaller diameter microfracture may be a better choice to enhance healing in clinical rotator cuff repair surgery in humans.

Tendon-Bone Interface Motion in Transosseous Suture and Suture Anchor Rotator Cuff Repair Techniques

2005 ◽  
Vol 33 (11) ◽  
pp. 1667-1671 ◽  
Author(s):  
Christopher S. Ahmad ◽  
Andrew M. Stewart ◽  
Rolando Izquierdo ◽  
Louis U. Bigliani
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Suture Repair ◽  
Interface Motion ◽  
Bone Interface ◽  
Transosseous Suture ◽  
Supraspinatus Tear ◽  
Cuff Repair ◽  
Suture Anchor Repair

Background Although many studies involving rotator cuff repair fixation have focused on ultimate fixation strength and ability to restore the tendon's native footprint, no studies have characterized the stability of the repair with regard to motion between the tendon and repair site footprint. Hypothesis Suture anchor fixation for rotator cuff repair has greater interface motion between tendon and bone than does transosseous suture fixation. Study Design Controlled laboratory study. Methods Twelve fresh-frozen human cadaveric shoulders were tested in a custom device to position the shoulder in internal and external rotations with simulated supraspinatus muscle loading. Tendon motion relative to the insertional footprint on the greater tuberosity was determined optically using a digital camera rigidly connected to the humerus, with the humerus positioned at 60° of internal rotation and 60° of external rotation. Testing was performed for the intact tendon, a complete supraspinatus tear, a suture anchor repair, and a transosseous tunnel repair. Results Difference in tendon-bone interface motion when compared with the intact tendon was 7.14 ± 3.72 mm for the torn rotator cuff condition, 2.35 ± 1.26 mm for the suture anchor repair, and 0.02 ± 1.18 mm for the transosseous suture repair. The transosseous suture repair demonstrated significantly less motion when compared with the torn rotator cuff and suture anchor repair conditions (P <. 05). Conclusion Transosseous suture repair compared with suture anchor repair demonstrated superior tendon fixation with reduced motion at the tendon-to-tuberosity interface. Clinical Relevance Development of new fixation techniques for arthroscopic and open rotator cuff repairs should attempt to minimize interface motion of the tendon relative to the tuberosity.

Greater Tuberosity Decortication Decreases Load to Failure of All-Suture Anchor Constructs in Rotator Cuff Repair

2018 ◽  
Vol 34 (10) ◽  
pp. 2777-2781 ◽  
Author(s):  
John A. Ruder ◽  
Ephraim Y. Dickinson ◽  
Richard D. Peindl ◽  
Nahir A. Habet ◽  
James E. Fleischli
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Suture Anchor ◽  
Greater Tuberosity ◽  
Load To Failure ◽  
Cuff Repair

scholarly journals Histomorphometric and ultrastructural analysis of the tendon-bone interface after rotator cuff repair in a rat model

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Tomonoshin Kanazawa ◽  
Masafumi Gotoh ◽  
Keisuke Ohta ◽  
Hirokazu Honda ◽  
Hiroki Ohzono ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rat Model ◽  
Rotator Cuff Repair ◽  
Ultrastructural Analysis ◽  
Bone Interface ◽  
Cuff Repair

scholarly journals Ultrasound-guided Arthroscopic Tuberoplasty for Greater Tuberosity Malunion: A Case Report

2020 ◽  
Vol 14 (1) ◽  
pp. 204-208
Author(s):  
Akira Ando ◽  
Kazuaki Suzuki ◽  
Masashi Koide ◽  
Yoshihiro Hagiwara
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
External Rotation ◽  
Ultrasound Images ◽  
Fluoroscopic Guidance ◽  
Greater Tuberosity ◽  
Dynamic Evaluation ◽  
Arthroscopic Excision ◽  
Cuff Repair

Background: Greater Tuberosity (GT) malunion can lead to impingement against the acromion, resulting in pain, stiffness, and weakness of the rotator cuff. For patients with lesser degrees of displacement, partial removal of the GT with rotator cuff repair (tuberoplasty) under fluoroscopic guidance is considered. Case report: A sixty-five year old female fell from a standing height and suffered a minimally displaced isolated GT fracture. She was conservatively managed for four months and referred to our institution due to persisting pain and stiffness. The shoulder motion was severely restricted (anterior elevation: 90°, lateral elevation: 45°, external rotation with the arm at side: 25°, hand behind back: 4th lumber vertebrae) and pain aggravated especially when laterally elevated. Plain radiography and computed tomography showed small superiorly malunited GT and magnetic resonance imaging showed no rotator cuff pathology. Ultrasound images showed impingement of the GT against the acromion when laterally elevated. Arthroscopic excision of the malunited GT and rotator cuff repair along with capsular release and acromioplasty was performed under ultrasound guidance. The ultrasound images were simultaneously delineated to the arthroscopic monitor. Dynamic evaluation of the reshaped GT passing under the acromion was possible. Conclusion: Intraoperative use of ultrasound during arthroscopic tuberoplasty offers advantages over fluoroscopic guidance concerning control of the amount of bone resection and dynamic evaluation between the GT and the acromion in addition to the problems of radiation and space-occupying devices.

Sign in / Sign up

Export Citation Format

Share Document