Rotator cuff tears: the effect of the reconstruction method on three-dimensional repair site area.
OBJECTIVE
To quantitatively determine the 3-dimensional (3-D) area of the original supraspinatus insertion and compare it with the repair-site area after 4 reconstructions of a simulated supraspinatus tear.


METHODS
Ex vivo biomechanical study.


METHODS
The outline of the original supraspinatus insertion was obtained in 10 human cadaveric shoulders using a 3-D digitizer. A supraspinatus tear was created and 4 repair techniques were evaluated: transosseous simple suture (TOS), transosseous mattress suture (TOM), suture-anchor simple suture (SAS), suture-anchor mattress suture (SAM). The 3-D outlines of the reconstructed supraspinatus insertion were digitized after each repair. The outlines of the original supraspinatus insertion and repair areas were superimposed onto humeral geometry obtained from a laser scanner, and surface areas were calculated.


RESULTS
The original supraspinatus insertion area was larger than any of the repair-site areas (P <.05). On average, TOS provided a 20% larger repair-site area than the other repairs (P <.05). Repair-site areas were not different among TOM, SAS, or SAM repairs (P >.05) and covered 67% of the original supraspinatus insertion.


CONCLUSIONS
None of the tested repairs restored the area of the original supraspinatus insertion. The larger repair-site area of the TOS repair suggests that this technique provides better potential for healing and, ultimately, greater strength of repair.
Apreleva
Maria
M
Orthopedic Biomechanics Laboratory, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. maprelev@caregroup.harvard.edu
Ozbaydar
Mehmet
M
Fitzgibbons
Peter G
PG
Warner
Jon J P
JJ
D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D003198:Computer Simulation; D005260:Female; D006801:Humans; D006811:Humerus / Q000473:pathology; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008954:Models, Biological; D017006:Rotator Cuff / Q000473:pathology* / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery; D013536:Suture Techniques