title: Tissue fixation security in transosseous rotator cuff repairs: a mechanical comparison of simple versus mattress sutures.
abstract: The primary purpose of this investigation was to compare tissue fixation security by simple sutures versus mattress sutures in transosseous rotator cuff repair. These two repair techniques were each performed in 17 human cadaver shoulders, with two bone tunnels being used for the repair by two simple sutures and two other bone tunnels being used for the repair by one mattress suture. The repairs were loaded to failure in a servohydraulic materials test system. Rotator cuff repair by simple sutures was found to be significantly stronger than repair by mattress sutures (P = .0007). The average ultimate load to failure for the simple suture construct (189.62 N) was 39.72% greater than that for the mattress suture construct (135.71 N). Most of the failures occurred by suture breakage at the knot. Load-sharing by multiple suture tails and multiple knots in the simple suture configuration likely contributed to its superior strength characteristics compared with the mattress suture configuration.
authors.affiliation: University of Texas Health Science Center at San Antonio, Texas, USA.
authors.forename: S S
authors.initials: SS
authors.lastname: Burkhart
authors.forename: S P
authors.initials: SP
authors.lastname: Fischer
authors.forename: W M
authors.initials: WM
authors.lastname: Nottage
authors.forename: J C
authors.initials: JC
authors.lastname: Esch
authors.forename: F A
authors.initials: FA
authors.lastname: Barber
authors.forename: D
authors.initials: D
authors.lastname: Doctor
authors.forename: J
authors.initials: J
authors.lastname: Ferrier
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D017006:Rotator Cuff / Q000502:physiology / Q000601:surgery*; D013536:Suture Techniques; D013537:Sutures; D013718:Tensile Strength