Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis
Abstract Background The objective of this biomechanical study is to compare two variations of single-row knotless techniques (Knotless repair and Rip-stop Knotless repair) against a single-row double-loaded anchor (DL) repair, focused on evaluating contact pressure and contact area amongst three dif...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-03-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12891-019-2479-2 |
| _version_ | 1818610918584483840 |
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| author | Jair Simmer Filho Andreas Voss Leo Pauzenberger Corey R. Dwyer Elifho Obopilwe Mark P. Cote Augustus D. Mazzocca Felix Dyrna |
| author_facet | Jair Simmer Filho Andreas Voss Leo Pauzenberger Corey R. Dwyer Elifho Obopilwe Mark P. Cote Augustus D. Mazzocca Felix Dyrna |
| author_sort | Jair Simmer Filho |
| collection | DOAJ |
| description | Abstract Background The objective of this biomechanical study is to compare two variations of single-row knotless techniques (Knotless repair and Rip-stop Knotless repair) against a single-row double-loaded anchor (DL) repair, focused on evaluating contact pressure and contact area amongst three different single-row techniques for rotator cuff repairs. Methods A total of 24 fresh frozen human shoulders were tested. Specimens were randomly assigned into one of the three single-row (SR) repair groups: A Knotted single-row double-loaded anchor (DL) repair, a Knotless (K) repair, or a Knotless Rip-Stop (KRS) repair. The footprint was measured after complete detachment of the supraspinatus tendon from the greater tuberosity, introducing pressure sensors between bony footprint and detached rotator cuff, and finally reconstructing it. All specimens were mounted onto a servohydraulic test system to analyze contact variables at 0° and 30° of abduction with 0 N, 30 N and 50 N of tension. Results Groups did not differ significantly in their footprint sizes: DL group 359.75 ± 58.37 mm2, K group 386.5 ± 102.13 mm2, KRS group 415.87 ± 93.80 mm2 (p = 0.84); nor in bone mineral density: DL group 0.25 ± 0.14 g/cm2, K group 0.32 ± 0.19 g/cm2, KRS group 0.32 ± 0.13 g/cm2, (p = 0.75) or average age. The highest mean pressurized contact area measured for the K repair was 248.1 ± 50.9 mm2, which equals a reconstruction of 67.1 ± 19.3% at 0° abduction and a 50 N supraspinatus load. This reconstructed area was significantly greater compared with the DL repair 152.8 ± 73.1 mm2, reconstructing 42.0 ± 18.5% on average when under the same conditions (p = 0.04). The mean contact pressure did not significantly differ amongst groups (p = 1.0): DL group 30.8 ± 17.4 psi, K group 30.9 ± 17.4 psi and KRS group 30.0 ± 10.9 psi. Neither the 30° abduction angle nor the supraspinatus load had a significant influence on the contact pressure in our study. Conclusion Both single-row knotless techniques resulted in significantly higher footprint reconstruction, providing larger contact area and a more uniform pressure distribution when compared with the single-row Knotted techniques. The mean contact pressure did not differ among groups significantly. These knotless techniques may be an alternative if the surgeon decides to perform a single-row rotator cuff repair. Level of evidence Basic Science Study, Biomechanics. |
| first_indexed | 2024-12-16T15:22:04Z |
| format | Article |
| id | doaj.art-6295886afdb64409a20811170c40a75e |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-16T15:22:04Z |
| publishDate | 2019-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-6295886afdb64409a20811170c40a75e2022-12-21T22:26:36ZengBMCBMC Musculoskeletal Disorders1471-24742019-03-012011810.1186/s12891-019-2479-2Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysisJair Simmer Filho0Andreas Voss1Leo Pauzenberger2Corey R. Dwyer3Elifho Obopilwe4Mark P. Cote5Augustus D. Mazzocca6Felix Dyrna7Department of Orthopaedic Surgery, Hospital Estadual de Urgência e Emergência (HEUE)Department of Trauma Surgery, University Hospital RegensburgVienna Shoulder & Sports ClinicDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Orthopaedic Sports Medicine, Technical University of MunichAbstract Background The objective of this biomechanical study is to compare two variations of single-row knotless techniques (Knotless repair and Rip-stop Knotless repair) against a single-row double-loaded anchor (DL) repair, focused on evaluating contact pressure and contact area amongst three different single-row techniques for rotator cuff repairs. Methods A total of 24 fresh frozen human shoulders were tested. Specimens were randomly assigned into one of the three single-row (SR) repair groups: A Knotted single-row double-loaded anchor (DL) repair, a Knotless (K) repair, or a Knotless Rip-Stop (KRS) repair. The footprint was measured after complete detachment of the supraspinatus tendon from the greater tuberosity, introducing pressure sensors between bony footprint and detached rotator cuff, and finally reconstructing it. All specimens were mounted onto a servohydraulic test system to analyze contact variables at 0° and 30° of abduction with 0 N, 30 N and 50 N of tension. Results Groups did not differ significantly in their footprint sizes: DL group 359.75 ± 58.37 mm2, K group 386.5 ± 102.13 mm2, KRS group 415.87 ± 93.80 mm2 (p = 0.84); nor in bone mineral density: DL group 0.25 ± 0.14 g/cm2, K group 0.32 ± 0.19 g/cm2, KRS group 0.32 ± 0.13 g/cm2, (p = 0.75) or average age. The highest mean pressurized contact area measured for the K repair was 248.1 ± 50.9 mm2, which equals a reconstruction of 67.1 ± 19.3% at 0° abduction and a 50 N supraspinatus load. This reconstructed area was significantly greater compared with the DL repair 152.8 ± 73.1 mm2, reconstructing 42.0 ± 18.5% on average when under the same conditions (p = 0.04). The mean contact pressure did not significantly differ amongst groups (p = 1.0): DL group 30.8 ± 17.4 psi, K group 30.9 ± 17.4 psi and KRS group 30.0 ± 10.9 psi. Neither the 30° abduction angle nor the supraspinatus load had a significant influence on the contact pressure in our study. Conclusion Both single-row knotless techniques resulted in significantly higher footprint reconstruction, providing larger contact area and a more uniform pressure distribution when compared with the single-row Knotted techniques. The mean contact pressure did not differ among groups significantly. These knotless techniques may be an alternative if the surgeon decides to perform a single-row rotator cuff repair. Level of evidence Basic Science Study, Biomechanics.http://link.springer.com/article/10.1186/s12891-019-2479-2Rotator cuffCuff repairSingle-rowBiomechanics |
| spellingShingle | Jair Simmer Filho Andreas Voss Leo Pauzenberger Corey R. Dwyer Elifho Obopilwe Mark P. Cote Augustus D. Mazzocca Felix Dyrna Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis BMC Musculoskeletal Disorders Rotator cuff Cuff repair Single-row Biomechanics |
| title | Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis |
| title_full | Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis |
| title_fullStr | Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis |
| title_full_unstemmed | Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis |
| title_short | Footprint coverage comparison between knotted and knotless techniques in a single-row rotator cuff repair: biomechanical analysis |
| title_sort | footprint coverage comparison between knotted and knotless techniques in a single row rotator cuff repair biomechanical analysis |
| topic | Rotator cuff Cuff repair Single-row Biomechanics |
| url | http://link.springer.com/article/10.1186/s12891-019-2479-2 |
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