Biomechanical Comparison of 4 Double-Row Suture-Bridging Rotator Cuff Repair Techniques Using Different Medial-Row Configurations

Pauly, Stephan; Kieser, Bettina; Schill, Alexander; Gerhardt, Christian; Scheibel, Markus

doi:10.1016/j.arthro.2010.02.013

Cited by 74 publications

(104 citation statements)

References 39 publications

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“…Besides biomechanical improvements (Lorbach et al, 2008;Mahar et al, 2007;Pauly et al, 2010), recent approaches have suggested an influence of growth factors on tendon cell behaviour and their potential value in rotator cuff repair.…”

Section: Discussionmentioning

confidence: 99%

“…These markers were COL-I (main component of extracellular tendon matrix (Blevins et al, 1997;Kannus, 2000)), COL-III (increased in early tendon healing (Takahasih et al, 2002) and experimentally in chronic tears (Yokota et al, 2005)), decorin (most important proteoglycan in tendon (Rahaman and Mao, 2005;Yoon and Halper, 2005)) and biglycan (a proteoglycan present in tendon, cartilage and bone (Yoon and Halper, 2005)), aggrecan (a proteoglycan, present in cartilage as well as in compressed tendon regions (Rees et al, 2000), and tenascin C (a glycoprotein, part of tendon cell adaptation to compression (Martin et al, 2003)). …”

Section: Characterization Of Tendon Cell Cultures Of the Human Rotatomentioning

confidence: 99%

“…To improve outcome results, biomechanical approaches for new surgical techniques have led to increased use of strong synthetic materials in order to reattach the torn tendon stump (Mahar et al, 2007;Lorbach et al, 2008;Pauly et al, 2010). However, the assumption of tissue damage and tendon strangulation through strong tissue adaption to the bony insertion is possible and might even deteriorate regeneration (Gerber et al, 1994;Flatow, 1996).…”

Section: Introductionmentioning

confidence: 99%

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Characterization of tendon cell cultures of the human rotator cuff

Pauly

Klatte²,

Strobel³

et al. 2010

eCM

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Rotator cuff tears are common soft tissue injuries of the musculoskeletal system that heal by formation of repair tissue and may lead to high retear rates and joint dysfunction. In particular, tissue from chronic, large tendon tears is of such degenerative nature that it may be prone to retear after surgical repair. Besides several biomechanical approaches, biologically based strategies such as application of growth factors may be promising for increasing cell activity and production of extracellular tendon matrix at the tendon-to-bone unit. As a precondition for subsequent experimental growth factor application, the aim of the present study was to establish and characterize a human rotator cuff tendon cell culture.Long head biceps (LHB)-and supraspinatus muscle (SSP)-tendon samples from donor patients undergoing shoulder surgery were cultivated and examined at the RNA level for expression of collagen type-I, -II and -III, biglycan, decorin, tenascin-C, aggrecan, osteocalcin, tenomodulin and scleraxis (by Real-time PCR). Finally, results were compared to chondrocytes and osteoblasts as control cells.An expression pattern was found which may reflect a human rotator cuff tenocyte-like cell culture. Both SSP and LHB tenocyte-like cells differed from chondrocyte cell cultures in terms of reduced expression of collagen type-II (p≤0.05) and decorin while higher levels of collagen type-I were seen (p≤0.05). With respect to osteoblasts, tenocytelike cells expressed lower levels of osteocalcin (p≤0.05) as well as tenascin C, biglycan and collagen type-III. Expression of scleraxis, tenomodulin and aggrecan was similar between all cell types.This study represents a characterization of tenocytelike cells from the human rotator cuff as close as possible. It helps analyzing their biological properties and allows further studies to improve production of tendon matrix and osteofibroblastic integration at the tendon-bone unit following tendon repair.

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Section: Discussionmentioning

confidence: 99%

Section: Characterization Of Tendon Cell Cultures Of the Human Rotatomentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Characterization of tendon cell cultures of the human rotator cuff

Pauly

Klatte²,

Strobel³

et al. 2010

eCM

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show abstract

“…To address the importance of the medial row knots in a suture bridge configuration, different suture bridge configurations of the medial row have been introduced. Pauly et al [36] conducted a biomechanical comparison of four different suture bridge configurations, each of which differ by modifying the medial row suture grasping configuration (i.e. single-mattress, doublemattress, cross-stitch and double-pulley techniques).…”

Section: Biomechanical Characteristics Of Medial Mattress Suture On Smentioning

confidence: 99%

Current Biomechanical Concepts of Suture Bridge Repair Technique for Rotator Cuff Tear

Yeh

Hong

et al. 2015

International Journal of Orthopaedics

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Rotator cuff tears are one of the most common disorders of the shoulder and can have significant effects on daily activities as a result of pain, loss of motion and strength. The goal of rotator cuff repair is aimed at anatomic restoration of the rotator cuff tendon to reduce pain and improve the joint function. Recently, arthroscopic repair has been widely accepted for treatment of rotator cuff tears due to its equal or better results than those from open repair. In 2006, a transosseousequivalent (TOE) or "suture bridge" technique was introduced by Park et al. This technique maximizes the utility of the conventional double-row technique by using the suture limbs to form the media mattress sutures to bridge and compress the repaired tendon. This technique has been proven to provide biomechanical properties that are superior to other arthroscopic repair techniques regarding the initial fixation strength, contact area and contact pressure at the tendon-bone interface. Since suture bridge techniques have been evolving over time, further biomechanical investigations have been carried out. These studies include examination of the effects of dynamic humeral external rotation on the mechanic stability of the repaired tendon construct, the effects of various modifications of the suture bridge configurations on the biomechanical characteristics of the medial mattress suture, biomechanical implications of medial row failure, and biomechanical performance of the repaired constructs over time. In this review, the biomechanical concepts behind the suture bridge technique for rotator cuff repair were reviewed and discussed.

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“…Recently introduced suture bridge technique has the added advantage not only of increasing surface contact and mean pressure between bone and tendon but also resistance to shear and rotational force. 1,2) This is the arthroscopic version of open transosseous repair, initially introduced as medial-row single-mattress suturebridge repair technique. 3) In the original technique, the medial row was tied by horizontal mattress suture to grasp the medial rotator cuff and resultant suture strand after tying was used for suture bridging.…”

Section: Introductionmentioning

confidence: 99%

Minimal Medial-row Tie with Suture-bridge Technique for Medium to Large Rotator Cuff Tears

Lee

Ryu²,

Shim

et al. 2015

Clinics in Shoulder and Elbow

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Background: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration (2×2 anchor with 4×4 suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2×2 anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medialrow stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre-and postoperative MRI. Results: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. Conclusions: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears. (Clin Shoulder Elbow 2015;18(4):197-205)

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Biomechanical Comparison of 4 Double-Row Suture-Bridging Rotator Cuff Repair Techniques Using Different Medial-Row Configurations

Cited by 74 publications

References 39 publications

Characterization of tendon cell cultures of the human rotator cuff

Characterization of tendon cell cultures of the human rotator cuff

Current Biomechanical Concepts of Suture Bridge Repair Technique for Rotator Cuff Tear

Minimal Medial-row Tie with Suture-bridge Technique for Medium to Large Rotator Cuff Tears

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