title: Suture Anchor Biomechanics After Rotator Cuff Footprint Decortication.
abstract: OBJECTIVE
  To identify the biomechanical consequences of violating the cortical shelf when preparing the greater tuberosity for suture anchor repair.
  
  
  METHODS
  Demographic information and bone mineral density were obtained for 20 fresh-frozen human humeri (10 matched pairs). Suture anchors were placed at a predetermined location in decorticated and non-decorticated settings after randomization. Anchors were tested under cyclic loads followed by load-to-failure testing. The number of cycles, failure mode, stiffness, and final pullout strength were recorded.
  
  
  RESULTS
  Nineteen specimens met the inclusion criteria for final testing. A significant difference in mean ultimate load to failure was seen between the non-decorticated specimens (244.04 ± 89.06 N/mm) and the decorticated humeri (62.84 ± 38.04 N/mm, P < .0001). Regression analysis showed positive correlations with female gender and decreased bone mineral density (P = .008 and P = .0005, respectively).
  
  
  CONCLUSIONS
  Decortication of the rotator cuff footprint significantly decreases the pullout strength of the suture anchor. Gender and bone mineral density also play a significant role in bone-anchor biomechanics and should be considered during repair.
  
  
  CONCLUSIONS
  Caution should be exercised when preparing the rotator cuff footprint before suture anchor placement because of the significant risk of early repair failure at the bone-anchor interface.
authors.affiliation: Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, U.S.A.. Electronic address: adamhyatt1@gmail.com.
authors.forename: Adam E
authors.initials: AE
authors.lastname: Hyatt
authors.affiliation: Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, U.S.A.
authors.forename: Kyle
authors.initials: K
authors.lastname: Lavery
authors.affiliation: Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, U.S.A.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mino
authors.affiliation: Department of Orthopaedic Surgery, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, U.S.A.
authors.forename: Aman
authors.initials: A
authors.lastname: Dhawan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002102:Cadaver; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008422:Materials Testing / Q000379:methods*; D008875:Middle Aged; D017006:Rotator Cuff / Q000503:physiopathology / Q000601:surgery*; D053441:Suture Anchors; D013536:Suture Techniques / Q000295:instrumentation*