title: Biomechanical study comparing 3 fixation methods for rotator cuff massive tear: Transosseous No. 2 suture, transosseous braided tape, and double-row.
abstract: BACKGROUND
  Important rotator cuff repair failure rates have prompted this study of the techniques and materials used in order to optimize clinical results.
  
  
  OBJECTIVE
  Is the reconstruction of the rotator cuff biomechanically stronger when using: 1) transosseous with 2 mm braided tape suture (TOT), 2) transosseous with multi-strand No. 2 sutures (TOS), or 3) double row suture bridge with suture anchors loaded with No. 2 braided sutures (DRSB)?
  
  
  METHODS
  Twenty-four cadaveric pig shoulders were randomized in the three repair constructs. The infraspinatus muscle was detached to mimic a complete laceration, repaired with one of the three repair groups and tested with a traction machine. Cameras recorded tendon displacement during trials. The ultimate strength (US), failure mode, and tendon displacement, qualified by the bare footprint area (BFA), during cycling phases were compared.
  
  
  RESULTS
  The US for DRSB was 175 ± 82 Newton (N), 91 ± 51 N for TOS, and 147 ± 63 N for TOT. The BFA after 200 cycles was 81 ± 34% for TOS, 57 ± 41% for TOT, and 26 ± 27% for DRSB repairs. No significant difference was observed between the DRSB and TOT results for US or BFA percentage of loss during all the cycling phases. TOS proved to be weaker than TOT and DRSB.
  
  
  CONCLUSIONS
  All the ruptures occurred in the tendon, which seems to be the weakness of rotator cuff repairs. The use of braided tape suture with a transosseous technique seems to be a cost effective, equivalent alternative implant compared to anchor fixation.
authors.affiliation: Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Montreal, QC H4J 1C5, Canada. Electronic address: stephanie.hinse.1@umontreal.ca.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Hinse
authors.affiliation: Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Montreal, QC H4J 1C5, Canada. Electronic address: jeremie.menard@crhsc.rtss.qc.ca.
authors.forename: Jérémie
authors.initials: J
authors.lastname: Ménard
authors.affiliation: Université de Montréal, Montreal, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Montreal, QC H4J 1C5, Canada. Electronic address: dominique.rouleau@umontreal.ca.
authors.forename: Dominique M
authors.initials: DM
authors.lastname: Rouleau
authors.affiliation: Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Montreal, QC H4J 1C5, Canada. Electronic address: fanny.canet@gmail.com.
authors.forename: Fanny
authors.initials: F
authors.lastname: Canet
authors.affiliation: Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Boul. Gouin Ouest, Montreal, QC H4J 1C5, Canada. Electronic address: beauchampmarc@sympatico.ca.
authors.forename: Marc
authors.initials: M
authors.lastname: Beauchamp
mesh_terms: D000818:Animals; D001182:Arthroscopy / Q000379:methods; D001696:Biomechanical Phenomena; D002102:Cadaver; D019637:Orthopedic Procedures / Q000379:methods; D011897:Random Allocation; D012016:Reference Values; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D013314:Stress, Mechanical; D053832:Surgical Tape; D053441:Suture Anchors; D013536:Suture Techniques; D013552:Swine; D013718:Tensile Strength