The primary factor for suture conŞguration at rotator cuff repair: Width of mattress or distance from tear edge

Abstract

Objectives: The aims of this study wasŞrst to investigate whether the bite size or the bite distance fromthe tear edge is of primary importance in mattress suture conŞguration for rotator cuff repair. Secondly,whether the use of a 450 left side bent Arthro-Pierce(TM) (Smith & Nephew, Andover, USA) during suturepassage can be more effective on the strength of the conŞguration compared to a straight ArthroPierce(TM).Materials and methods: Twenty-eight bovine infraspinatus muscle tendons were randomized into fourgroups. Group 1; 5 mm wide'bite size' 15 mm length 'distance from the tear edge's mattress'; Group 2:7.5 mm 10 mm; Group 3: 15 mm 5 mm 'using straight Arthro-Pierce(TM)' and Group 4: 5 mm 15 mmusing left sided 450 bent Arthro-Pierce(TM). The repair specimens underwent cyclic loading prior to loadingthe failure testing. Cyclic elongation (mm), peak-to-peak displacement (mm), ultimate load (N), stiffness(N/mm) and failure mode were recorded for each specimen.Results: The mean ultimate load in Group 1 was higher compared to group 3. The peak to peakdisplacement was higher in Group 4 compared to Group 1 (p< 0.05). The predominant failure mode inGroups 1, 2 and 4 was suture rupture. The Group 3 most specimens failed due to suture cut through thetendon.Conclusion: Bite size from the edge of the tendon seems to be more important than the width of themattress. The curve of the suture passing device may also have an effect on the strength of the suturetendon interface.© 2016 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V. This isan open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)