Abstract
Objective To compare the pressure and contact area at the tendon-footprint interface of a repair
performed with simple and crossed transosseous sutures.
Methods Twelve lamb shoulders were used to simulate a rotator cuff tear. The contact area
at the tendon-footprint interface was measured with pressure-sensitive films; then,
the pressure was measured with a digital sensor. The baseline pressure was recorded
during the application of a cyclic load and at the end of the intervention. A total
of 2 repairs were compared: 2 transosseous sutures with single knots (STO; n = 6)
and 2 transosseous sutures with crossed knots (TOC; n = 6) using FiberWire #2. In
total, 1,400 cycles were performed, with a frequency of 2.5 Hz and a load of 5 N.
The Mann-Whitney test was used. Values of p < 0.05 were considered significant.
Results The TOS repair presented 50.9 ± 12.7% of pressure distribution compared to 72.2 ± 5.3%
in the TOC repair (p < 0.009). The mean pressure in the TOS repair was of 0.7 ± 0.1 MPa compared to 1.1 ± 0.2
MPa in the TOC repair (p < 0.007). The TOS repair registered a basal pressure of 5.3 ± 5.3 N, a final pressure
of 3.8 ± 4.6 N, and a variation of 51.7 ± 38%. The TOC repair registered a basal pressure
of 10.7 ± 1.8 N, a final pressure of 12.9 ± 8.7 N, and a variation of 114.9 ± 65.9%
(p < 0.044; p < 0.022; and p < 0.017 respectively).
Conclusion The TOC repair presents higher pressure at the tendon-bone interface, less loss of
contact force under cyclic loads, and a better distribution of force on the footprint
when compared with the TOS repair, which could translate into better tendon healing.
Level of Evidence Basic Science Study.
Keywords
rotator cuff - pressure - suture - suture techniques - tendon injuries - tendons
