期刊论文详细信息
BMC Musculoskeletal Disorders
A biomechanical and histological comparison of the suture bridge and conventional double-row techniques of the repair of full-thickness rotator cuff tears in a rabbit model
Weichun Guo1  Wenyong Fei1 
[1] Department of Orthopaedics, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei, China
关键词: Rabbit;    Double-row;    Suture bridge;    Rotator cuff tear;    Full-thickness;   
Others  :  1227747
DOI  :  10.1186/s12891-015-0601-7
 received in 2014-11-24, accepted in 2015-05-27,  发布年份 2015
PDF
【 摘 要 】

Background

The suture bridge (SB) technique and conventional double-row (DR) are both effective in repair of full-thickness rotator cuff tears . However, increasing numbers of scholars believe that the SB technique produces better results than conventional DR because of the higher bone-tendon contact area and pressure. However, The clinical outcomes have been mixed and little direct evidence has been supplied in vivo. This study was designed using the SB and DR techniques to determine which is the better technique.

Methods

Sixty-four New Zealand white rabbits were randomly divided into 2 groups, the SB group and DR group. SB and DR were then used to repair their rotator cuff tears. Rabbits were then sacrificed at the 2nd, 4th, or 8th week after surgery and a histological comparison was made. The biomechanical comparison was made at the 8th week.

Results

The load to failure of the SB group was 134.59 ± 17.69 N at the 8th postoperative week, and that was significantly higher than in the DR group (103.83 ± 6.62, P = 0.001), but both repair groups remained lower than in the control group (199.25 ± 14.81). Histological evaluation showed that both the SB and DR groups healed at the bone-tendon interface. But there were subtle differences between the two groups in the structure and morphology of collagen fibers and cartilage cells at bone-tendon interface. In general, the collagen fibers of the SB group were more compact than those of the DR group at all times tested. At the 4th and 8th weeks, the collagen fibers and cartilage cells in the SB group were arranged in a column modality, but those in the DR group were distributed horizontally.

Conclusion

The SB technique facilitated healing more effectively than the conventional DR technique. The difference in morphology of collagen fibers and cartilage cells may be related to the difference in bone-tendon contact pressure.

【 授权许可】

   
2015 Fei and Guo.

【 预 览 】
附件列表
Files Size Format View
20150929034047138.pdf 2144KB PDF download
Fig. 7. 74KB Image download
Fig. 6. 94KB Image download
Fig. 5. 91KB Image download
Fig. 4. 49KB Image download
Fig. 3. 26KB Image download
Fig. 2. 26KB Image download
Fig. 1. 37KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

Fig. 3.

Fig. 4.

Fig. 5.

Fig. 6.

Fig. 7.

【 参考文献 】
  • [1]Hirose K, Kondo S, Choi HR, Mishima S, Iwata H, Ishiguro N. Spontaneous healing process of a supraspinatus tendon tear in rabbits. Arch Orthop Trauma Surg. 2004; 124:374-7.
  • [2]Park MC, ElAttrache NS, Tibone JE et al.. Part I: footprint contact characteristics for a transosseous equivalent rotator cuff repair technique compared with a double-row repair te chnique. J Shoulder Elbow Surg. 2007; 16(4):461-8.
  • [3]Park MC, Tibone JE, ElAttrache NS, Ahmad CS, Jun BJ, Lee TQ. Part II: biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique. J Should Elb Surg. 2007; 16:469-76.
  • [4]Mihata T, Fukuhara T, Jun BJ, Watanabe C, Kinoshita M. Effect of shoulder abduction angle on biomechanical properties of the repaired rotator cuff tendons with 3 types of double-row technique. Am J Sports Med. 2011; 39:551-6.
  • [5]Park JY, Lee SY, Chung SW, Zulkifli H, Cho JH, Oh KS. Clinical comparison between double-row and transosseous-equivalent repairs for medium to large size rotator cuff tears. Arch Orthop Trauma Surg. 2013; 133(12):1727-34.
  • [6]Kim DH, Elattrache NS, Tibone JE, Jun BJ, DeLaMora SN, Kvitne RS et al.. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med. 2006; 34(3):407-14.
  • [7]Park MC, Cadet ER, Levine WN, Bigliani LU, Ahmad CS. Tendon-to-bone pressure distributions at a repaired rotator cuff footprint using transosseous suture and suture anchor fixation techniques. Am J Sports Med. 2005; 33(8):1154-9.
  • [8]Ahmad CS, Stewart AM, Izquierdo R, Bigliani LU et al.. Tendon-bone interface motion in transosseous suture and suture anchor rotator cuff repair techniques. Am J Sports Med. 2005; 33(11):1667-71.
  • [9]Meyer DC, Fucentese SF, Koller B, Gerber C. Association of osteopenia of the humeral head with full-thickness rotator cuff tears. J Shoulder Elbow Surg. 2004; 13(3):333-7.
  • [10]Kirchhoff C, Braunstein V, Milz S, Sprecher CM, Fischer F, Tami A et al.. Assessment of bone quality within the tuberosities of the osteoporotic humeral head: relevance for anchor positioni-ng in rotator cuff repair. Am J Sports Med. 2010; 38(3):564-9.
  • [11]Bisson LJ, Manohar LM, Wilkins RD, Gurske-Deperio J, Ehrensberger MT et al.. Influence of suture material on the biomechanical behavior of suture-tendon specimens: a controlled studyin bovine rotator cuff. Am J Sports Med. 2008; 36(5):907-12.
  • [12]Ross D, Maerz T, Lynch J, Norris S, Baker K, Anderson K. Rehabilitation following arthrosco-pic rotator cuff repair: a review of current literature. J Am Acad Orthop Surg. 2014; 22(1):1-9.
  • [13]Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopyically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004; 86-A(2):219-24.
  • [14]Baums MH, Buchhorn GH, Spahn G, Poppendieck B, Schultz W, Klinger HM. Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material. Knee Surg Sports Traumatol Arthrosc. 2008; 16:1052-60.
  • [15]Domb BG, Glousman RE, Brooks A, Hansen M, Lee Q, ElAttrache NS. High-tension double-row footprint repair compared with reduced-tension single-row repair for massive rotator cuff tears. J Bone Joint Surg Am. 2008; 90(suppl 4):35-9.
  • [16]Wang E, Wang L, Gao P, Li Z, Zhou X, et al. Single-versus double-row arthroscopic rotator cuff repair in massive tears. Med Sci Monit. 2015;28(21):1556–61.
  • [17]Lorbach O, Bachelier F, Vees J, Kohn D, Pape D. Cyclic loading of rotator cuff reconstructions: single-row repairs with modified suture configurations versus double-row repair. Am J Sports Med. 2008; 17:1504-10.
  • [18]Ma CB, Comerford L, Wilson J, Puttlitz CM. Biomechanical evaluation of arthroscopic rotator cuff repairs: double-row compared with single-row fixation. J Bone Joint Surg Am. 2006; 88:403-10.
  • [19]Meier SW, Meier JD. The effect of double-row fixation on initial repair strength in rotator cuff repair: a biomechanical study. Arthroscopy. 2006; 22:1168-73.
  • [20]Milano G, Grasso A, Zarelli D, Deriu L, Cillo M, Fabbriciani C. Comparison between single-row and double-row rotator cuff repair: a biomechanical study. Knee Surg Sports Traumatol Arthrosc. 2008; 16:75-80.
  • [21]Smith CD, Alexaner S, Hill AM et al.. A biomechanical comparison of single and double-row fixation in arthroscopic rotator cuff repair. J Bone Joint Surg Am. 2006; 88:2425-31.
  • [22]Lee KW, Seo DW, Bae KW, Choy WS. Clinical and radiological evaluation after arthrosco-pic rotator cuff repair using suture bridgetechnique. Clin Orthop Surg. 2013; 5(4):306-13.
  • [23]Gartsman GM, Drake G, Edwards TB, Elkousy HA, Hammerman SM et al.. Ultrasound evalua-tion of arthroscopic full-thickness supraspinatus rotator cuff repair: single-row versus double-row suture bridge (transosseous equivalent) fixation. Results of a prospective, randomized study. J Shoulder Elbow Surg. 2013; 22(11):1480-7.
  • [24]Park JY, Lhee SH, Oh KS, Moon SG, Hwang JT. Clinical and ultrasonographic outcomes of arthroscopic suture bridge repair for massive rotator cuff tear. Arthroscopy. 2013; 29(2):280-9.
  • [25]Kim KC, Shin HD, Lee WY. Repair integrity and functional outcomes after arthroscopic suture-bridge rotator cuff repair. J Bone Joint Surg Am. 2012; 94(8): Article ID e48
  • [26]Mihata T, Watanabe C, Fukunishi K et al.. Functional and structural outcomes of single-row versus double-row versus combined double-row and suture-bridge repair for rotator cuff tears. Am J Sports Med. 2011; 39:2091-8.
  • [27]Voigt C, Bosse C, Vosshenrich R et al.. Arthroscopic supraspinatus tendon repair with suture-bridging technique: functional outcome and magnetic resonance imaging. Am J Sports Med. 2010; 38:983-91.
  • [28]Kim KC, Shin HD, Lee WY, Han SC. Repair integrity and functional outcome after arthroscopic rotator cuff repair: double-row versus suture-bridge technique. Am J Sports Med. 2012; 40(2):294-9.
  • [29]Otarodifard KA et al.. Rotator cuff repair constructs in the rabbit subscapularis: comparison with human data. Orthopedic Research Society, Las Vegas, NV; 2009.
  • [30]Miyahara H, Takagishi K, Arita C et al.. A morphologic and biomechanical study on the healing of the repaired rotator cuff insertion in dogs: a preliminary report. In: Surgery of the shoulder. Post M, Morrey BF, Hawkins RJ, editors. Mosby, St. Louis; 1990: p.224-7.
  • [31]Gerber C, Schneeberger AG, Perren SM, Nyffeler RW. Experimental rotator cuff repair: a preliminary study. J Bone Joint Surg Am. 1999; 81-A:1281-90.
  • [32]Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus:does the tendon really heal? J Bone Joint Surg Am. 2005; 87:1229-40.
  • [33]Kim HM, Galatz LM, Das R, Havlioglu N, Rothermich SY, Thomopoulos S. The role of transforming growth factor beta isoforms in tendon-to-bone healing. Connect Tissue Res. 2011; 52:87-98.
  • [34]Huijsmans PE, Pritchard MP, Berghs BM, van Rooyen KS, Wallace AL, de Beer JF. Arthroscopic rotator cuff repair with double-row fixation. J Bone Joint Surg Am. 2007; 89:1248-57.
  • [35]Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair: a prospective outcome study. J Bone Joint Surg Am. 2007; 89:953-60.
  文献评价指标  
  下载次数:2次 浏览次数:12次