A Biomechanical Comparison of Transosseous–Suture Anchor and Suture Bridge Rotator Cuff Repairs in Cadavers

BACKGROUND: Several biomechanical studies comparing open and arthroscopic rotator cuff repair methods have shown inferior performance of arthroscopic repairs. Suture anchor-augmented transosseous repairs and suture bridge repairs have shown superior biomechanical performance when compared with other methods, but these 2 repair methods have not been directly compared. HYPOTHESIS: There will be no difference in the biomechanical performance of the transosseous-suture anchor and suture bridge techniques. STUDY DESIGN: Controlled laboratory study. METHODS: Eight paired cadaveric shoulder specimens (16 specimens) had creation followed by repair of a complete tear of the supraspinatus, with the first member of each pair undergoing repair by a transosseous-suture anchor technique and the second member undergoing repair by the suture bridge technique. Specimens were then cycled from 10 to 180 N for 200 cycles, followed by testing to failure at 33 mm/s. Elongation was measured during cyclic testing, and failure load and stiffness were obtained during load-to-failure testing. Failure method was recorded. RESULTS: There was no significant difference between transosseous-suture anchor repairs and suture bridge repairs for elongation (4.0 +/- 1.60 mm vs 3.5 +/- 1.1 mm, P = .31), failure load (408 +/- 93 N vs 419 +/- 62 N, P = .70), or stiffness (58 +/- 10 N/mm vs 58 +/- 14 N/mm, P = .94). The most common mode of failure with each method was suture cutting through tendon. CONCLUSION: The suture bridge repair exhibited similar biomechanical performance during cyclic and load-to-failure testing as a transosseous-suture anchor repair, which historically has been performed in open or mini-open fashion. CLINICAL RELEVANCE: Arthroscopic rotator cuff repairs can be performed that are as strong as open or mini-open repairs.