title: Healing disturbance with suture bridge configuration repair in rabbit rotator cuff tear.
abstract: BACKGROUND
  Medial row failure has been reported in the suture bridge technique of rotator cuff repair. This study compared the healing response of suture bridge configuration repair (SBCR) and parallel type transosseous repair (PTR).
  
  
  METHODS
  Acute rotator cuff repair was performed in 32 rabbits. Both shoulders were repaired using PTR or SBCR. In PTR, simple PTR was performed through 2 parallel transosseous tunnels created using a microdrill. In SBCR, 2 additional crisscross transosseous tunnels were added to mimic arthroscopic SBCR. At 1, 2, and 5 weeks postoperatively, comparative biomechanical testing was performed in 8 rabbits, and histologic analysis, including immunohistochemical staining for CD31, was performed in 4 rabbits.
  
  
  RESULTS
  Failure loads at 1 week (38.12 ± 20.43 N vs 52.00 ± 27.23 N; P = .284) and 5 weeks (97.93 ± 48.35 N vs 119.60 ± 60.81 N; P = .218) were not statistically different between the SBCR and PTR groups, respectively, but were significantly lower in the SBCR group than in the PTR group (23.56 ± 13.56 N vs. 44.25 ± 12.53 N; P = .009), respectively, at 2 weeks. Markedly greater fibrinoid deposition was observed in the SBCR group than in the PTR group at 2 weeks. For vascularization, there was a tendency that more vessels could be observed in PTR than in SBCR at 2 weeks (15.9 vs 5.6, P = .068).
  
  
  CONCLUSIONS
  In a rabbit acute rotator cuff repair model, SBCR exhibited inferior mechanical strength, and fewer blood vessels were observed at the healing site at 2 weeks postoperatively. Medial row tendon failure was more common in SBCR. Surgeons should consider the clinical effect of SBCR when performing rotator cuff repair.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea. Electronic address: drjacobkim@gmail.com.
authors.forename: Sae Hoon
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Jangwoo
authors.initials: J
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hwa-Ryeong
authors.initials: HR
authors.lastname: Lee
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D008297:Male; D018919:Neovascularization, Physiologic; D019637:Orthopedic Procedures / Q000379:methods*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D011817:Rabbits; D017006:Rotator Cuff / Q000098:blood supply / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000601:surgery; D012785:Shoulder Joint / Q000503:physiopathology*; D013536:Suture Techniques / Q000009:adverse effects; D013708:Tendon Injuries / Q000601:surgery*; D014945:Wound Healing
chemical_list: D019408:Platelet Endothelial Cell Adhesion Molecule-1
keywords: Rotator cuff tear; parallel type transosseous repair; suture bridge configuration repair; tendon ischemia; tendon strangulation