title: Biomechanical evaluation of a single-row versus double-row repair for complete subscapularis tears.
abstract: The purpose of the study was to compare a single-row repair and a double-row repair technique for the specific characteristics of a complete subscapularis lesion. Ten pairs of human cadaveric shoulder human shoulder specimens were tested for stiffness and ultimate tensile strength of the intact tendons in a load to failure protocol. After a complete subscapularis tear was provoked, the specimens were assigned to two treatment groups: single-row repair (1) and a double-row repair using a "suture bridge" technique (2). After repair cyclic loading a subsequent load to failure protocol was performed to determine the ultimate tensile load, the stiffness and the elongation behaviour of the reconstructions. The intact subscapularis tendons had a mean stiffness of 115 N/mm and a mean ultimate load of 720 N. The predominant failure mode of the intact tendons was a tear at the humeral insertion site (65%). The double-row technique restored 48% of the ultimate load of the intact tendons (332 N), while the single-row technique revealed a significantly lower ultimate load of 244 N (P = 0.001). In terms of the stiffness, the double-row technique showed a mean stiffness of 81 N/mm which is significantly higher compared to the stiffness of the single-row repairs of 55 N/mm (P = 0.001). The double-row technique has been shown to be stronger and stiffer when compared to a conventional single-row repair. Therefore, this technique is recommended from a biomechanical point of view irrespectively if performed by an open or arthroscopic approach.
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna von Borries Str. 1-6, 30625 Hannover, Germany. wellmann.mathias@web.de
authors.forename: Mathias
authors.initials: M
authors.lastname: Wellmann
authors.forename: Philipp
authors.initials: P
authors.lastname: Wiebringhaus
authors.forename: Ina
authors.initials: I
authors.lastname: Lodde
authors.forename: Hazibullah
authors.initials: H
authors.lastname: Waizy
authors.forename: Christoph
authors.initials: C
authors.lastname: Becher
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Raschke
authors.forename: Wolf
authors.initials: W
authors.lastname: Petersen
mesh_terms: D001696:Biomechanical Phenomena; D002102:Cadaver; D006801:Humans; D018482:Muscle, Skeletal / Q000293:injuries / Q000601:surgery*; D000070599:Shoulder Injuries; D053441:Suture Anchors; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D013718:Tensile Strength
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