Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery

Abstract Background The number of revision rotator cuff cases is increasing. The literature is lacking guidance or biomechanical evaluation for fixation strength in a revision case scenario. Therefore, the aim of the study was to provide biomechanical data investigating primary fixation strength of...

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Main Authors: Felix Dyrna, Andreas Voss, Leo Pauzenberger, Elifho Obopilwe, Augustus D. Mazzocca, Alessandro Castagna, Cory Edgar
Format: Article
Language:English
Published: BMC 2018-07-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-018-2089-4
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author Felix Dyrna
Andreas Voss
Leo Pauzenberger
Elifho Obopilwe
Augustus D. Mazzocca
Alessandro Castagna
Cory Edgar
author_facet Felix Dyrna
Andreas Voss
Leo Pauzenberger
Elifho Obopilwe
Augustus D. Mazzocca
Alessandro Castagna
Cory Edgar
author_sort Felix Dyrna
collection DOAJ
description Abstract Background The number of revision rotator cuff cases is increasing. The literature is lacking guidance or biomechanical evaluation for fixation strength in a revision case scenario. Therefore, the aim of the study was to provide biomechanical data investigating primary fixation strength of a transosseous technique after anchor pullout failure of a single row reconstruction. It was hypothesized that an arthroscopic transosseous repair system as a procedure for rotator cuff revisions is providing equivalent stability compared to a primary single row suture anchor fixation due to change of fixation site. Methods Eight matched pairs (n = 16) of fresh frozen human shoulders were tested. The paired specimen shoulders were randomly divided into two repair groups (A single row and B primary transosseous repair). The potted specimens were mounted onto the Servohydraulic test system. Both groups were tested under cyclic loading followed by load to failure testing. Suture anchor repair shoulders (group A) that were tested to failure underwent a revision transosseous repair and were subsequently tested again using the same setup and protocol (group C). Results The mean native footprint areas did not show a significant difference between groups. The reconstructed footprint area showed a significantly greater coverage in favor of the transosseous repair. Ultimate load to failure of reconstructions with the primary anchor fixation (344.73 N ± 63.19) and the primary transosseous device (375.36 N ± 70.27) was not significantly higher compared to the revision repair (332.19 N ± 119.01 p = 0.45, p = 0.53). Conclusion The tested transosseous anchor device is a suitable option to widely used suture anchors, providing equivalent fixation properties even in a revision case scenario. Level of evidence Basic Science Study, Biomechanics.
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spelling doaj.art-a93541124ca0432ba0c7a5c85749e36e2022-12-22T02:10:16ZengBMCBMC Musculoskeletal Disorders1471-24742018-07-011911710.1186/s12891-018-2089-4Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgeryFelix Dyrna0Andreas Voss1Leo Pauzenberger2Elifho Obopilwe3Augustus D. Mazzocca4Alessandro Castagna5Cory Edgar6Department of Orthopaedic Sports Medicine, Technical UniversityDepartment of Orthopaedic Sports Medicine, Technical UniversityDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Orthopaedic Surgery, University of ConnecticutDepartment of Shoulder and Elbow IRCCS Humanitas InstituteDepartment of Orthopaedic Surgery, University of ConnecticutAbstract Background The number of revision rotator cuff cases is increasing. The literature is lacking guidance or biomechanical evaluation for fixation strength in a revision case scenario. Therefore, the aim of the study was to provide biomechanical data investigating primary fixation strength of a transosseous technique after anchor pullout failure of a single row reconstruction. It was hypothesized that an arthroscopic transosseous repair system as a procedure for rotator cuff revisions is providing equivalent stability compared to a primary single row suture anchor fixation due to change of fixation site. Methods Eight matched pairs (n = 16) of fresh frozen human shoulders were tested. The paired specimen shoulders were randomly divided into two repair groups (A single row and B primary transosseous repair). The potted specimens were mounted onto the Servohydraulic test system. Both groups were tested under cyclic loading followed by load to failure testing. Suture anchor repair shoulders (group A) that were tested to failure underwent a revision transosseous repair and were subsequently tested again using the same setup and protocol (group C). Results The mean native footprint areas did not show a significant difference between groups. The reconstructed footprint area showed a significantly greater coverage in favor of the transosseous repair. Ultimate load to failure of reconstructions with the primary anchor fixation (344.73 N ± 63.19) and the primary transosseous device (375.36 N ± 70.27) was not significantly higher compared to the revision repair (332.19 N ± 119.01 p = 0.45, p = 0.53). Conclusion The tested transosseous anchor device is a suitable option to widely used suture anchors, providing equivalent fixation properties even in a revision case scenario. Level of evidence Basic Science Study, Biomechanics.http://link.springer.com/article/10.1186/s12891-018-2089-4Rotator cuffCuff repairRevisionTransosseous repairArthroscopic repair
spellingShingle Felix Dyrna
Andreas Voss
Leo Pauzenberger
Elifho Obopilwe
Augustus D. Mazzocca
Alessandro Castagna
Cory Edgar
Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
BMC Musculoskeletal Disorders
Rotator cuff
Cuff repair
Revision
Transosseous repair
Arthroscopic repair
title Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
title_full Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
title_fullStr Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
title_full_unstemmed Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
title_short Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
title_sort biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery
topic Rotator cuff
Cuff repair
Revision
Transosseous repair
Arthroscopic repair
url http://link.springer.com/article/10.1186/s12891-018-2089-4
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