Why the study?
Does a novel weave technique for ePTFE patch repair provide comparable biomechanical properties to a multiple mattress technique in an ovine rotator cuff tear model?
Does a novel weave technique for ePTFE patch repair provide comparable biomechanical properties to a multiple mattress technique in an ovine rotator cuff tear model?
In an ex vivo ovine model, a novel weave technique for ePTFE patch repair of rotator cuff tears had slightly lower failure loads than a multiple mattress technique, though both failed primarily by suture button-holing.
Multiple mattress suture may be preferred in this ovine model; leaves open clinical viability of weave technique for rotator cuff repair.
Introduction: Massive rotator cuff tears are difficult to manage. A treatment option is the use of a synthetic patch as an interpositional bridge to restore continuity of the cuff defect. The patches can be inserted arthroscopically, but the procedure involves multiple knot tying, which is often tedious. The aims of this paper is to describe a new arthroscopic technique to attach the patch to the native tendon that involves only 1 arthroscopic knot tying, and to compare the biomechanical properties of 2 types of repairs at the patch to tendon interface. Methods: Surgical Technique: Two arthroscopic repair techniques at the patch to tendon interface are presented: the multiple mattress suture technique and the weave suture technique. Biomechanical: An ovine chronic rotator cuff tear ex vivo model was developed in 44 ovine infraspinatus tendons paired to represent a retorn supraspinatus tendon. The tendon was then repaired with a synthetic ePTFE (expanded polytetrafluoroethylene, Gore-Tex; W.L. Gore & Associates, Flagstaff, AZ) patch using multiple mattress technique (n=11) or a novel weave technique (n=11). Pull to failure testing was performed to each tendon repair using an Instron 8874 (Instron Ltd, UK) mechanical tensile testing machine. Results: Biomechanical: The majority of failures occurred by sutures button-holing through the patch in both patch reconstruction repairs (7/11 per repair group). The ePTFE patch to tendon repair with the multiple mattress suture technique had higher failure loads (327±17 N), compared with the weave technique (265±18 N; P=0.02). No difference in repair stiffness, peak energy to failure, and total energy to failure were noted between the 2 patch suturing techniques. Conclusions: Presented were 2 repair techniques at the patch to tendon interface for the repair of massive irreparable rotator cuff tears. When tested on ovine rotator cuff model, majority of failures for both repair techniques occurred by button-holing through the patch. Repairs of the tendon to patch interface with the weave technique had high failure load properties, although slightly less than repairs composed with a multiple mattress technique at the patch to tendon interface.
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Ronquillo et al. (2013) studied this question.
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