Single-row modified mason-allen versus double-row arthroscopic rotator cuff repair: a biomechanical and surface area comparison.
OBJECTIVE
The purpose of this study was to compare the time-zero biomechanical strength and the surface area of repair between a single-row modified Mason-Allen rotator cuff repair and a double-row arthroscopic repair.


METHODS
Six matched pairs of sheep infraspinatus tendons were repaired by both techniques. Pressure-sensitive film was used to measure the surface area of repair for each configuration. Specimens were biomechanically tested with cyclic loading from 20 N to 30 N for 20 cycles and were loaded to failure at a rate of 1 mm/s. Failure was defined at 5 mm of gap formation.


RESULTS
Double-row suture anchor fixation restored a mean surface area of 258.23 +/- 69.7 mm(2) versus 148.08 +/- 75.5 mm(2) for single-row fixation, a 74% increase (P = .025). Both repairs had statistically similar time-zero biomechanics. There was no statistical difference in peak-to-peak displacement or elongation during cyclic loading. Single-row fixation showed a higher mean load to failure (110.26 +/- 26.4 N) than double-row fixation (108.93 +/- 21.8 N). This was not statistically significant (P = .932). All specimens failed at the suture-tendon interface.


CONCLUSIONS
Double-row suture anchor fixation restores a greater percentage of the anatomic footprint when compared with a single-row Mason-Allen technique. The time-zero biomechanical strength was not significantly different between the 2 study groups. This study suggests that the 2 factors are independent of each other.


CONCLUSIONS
Surface area and biomechanical strength of fixation are 2 independent factors in the outcome of rotator cuff repair. Maximizing both factors may increase the likelihood of complete tendon-bone healing and ultimately improve clinical outcomes. For smaller tears, a single-row modified Mason-Allen suture technique may provide sufficient strength, but for large amenable tears, a double row can provide both strength and increased surface area for healing.
Nelson
Cory O
CO
Department of Orthopaedic Surgery, SUNY at Stony Brook University Hospital, Stony Brook, New York, USA.
Sileo
Michael J
MJ
Grossman
Mark G
MG
Serra-Hsu
Frederick
F
D000818:Animals; D001182:Arthroscopy / Q000379:methods*; D066298:In Vitro Techniques; D022125:Lacerations / Q000601:surgery*; D017006:Rotator Cuff / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012756:Sheep; D013529:Surgical Wound Dehiscence / Q000209:etiology; D053441:Suture Anchors / Q000592:standards*; D013536:Suture Techniques / Q000592:standards*; D013537:Sutures; D013718:Tensile Strength; D016474:Weight-Bearing