title: Biomechanical Comparison of Standard and Linked Single-Row Rotator Cuff Repairs in a Human Cadaver Model.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the time zero cyclic and failure loading properties of a linked single-row rotator cuff repair compared with a standard simple suture single-row repair using triple-loaded suture anchors.
  
  
  METHODS
  Eighteen human cadaveric shoulders from 9 matched pairs were dissected, and full-thickness supraspinatus tears were created. The tendon cross-sectional area was recorded. In each pair, one side was repaired with a linked single-row construct and the other with a simple suture single-row construct, both using 2 triple-loaded suture anchors. After preloading, specimens were cycled to 1 MPa of effective stress at 1 Hz for 500 cycles, and gap formation was recorded with a digital video system. Samples were then loaded to failure, and modes of failure were recorded.
  
  
  RESULTS
  There was no statistical difference in peak gap formation between the control and linked constructs (3.6 ± 0.9 mm and 3.6 ± 1.2 mm, respectively; P = .697). Both constructs averaged below a 5-mm cyclic failure threshold. There was no statistical difference in ultimate load to failure between the control and linked repair (511.1 ± 139.0 N and 561.2 ± 131.8 N, respectively; P = .164), and both groups reached failure at loads similar to previous studies. Constructs failed predominantly via tissue tearing parallel to the medial suture line.
  
  
  CONCLUSIONS
  The linked repair performed similarly to the simple single-row repair. Both constructs demonstrated high ultimate load to failure and good resistance to gap formation with cyclic loading, validating the time zero strength of both constructs in a human cadaveric model.
  
  
  CONCLUSIONS
  The linked repair provided equivalent resistance to gap formation and failure loads compared with simple suture single-row repairs with triple-loaded suture anchors. This suggests that the linked repair is a simplified rip-stop configuration using the existing suture that may perform similarly to current rotator cuff repair techniques.
authors.affiliation: Southern California Orthopedic Institute, Van Nuys, California, U.S.A.
authors.forename: Adam F
authors.initials: AF
authors.lastname: Meisel
authors.affiliation: Departments of Orthopaedics and Bioengineering, University of Utah, Salt Lake City, Utah, U.S.A.
authors.forename: Heath B
authors.initials: HB
authors.lastname: Henninger
authors.affiliation: Plano Orthopedics Sports Medicine and Spine Center, Plano, Texas, U.S.A.
authors.forename: F Alan
authors.initials: FA
authors.lastname: Barber
authors.affiliation: Southern California Orthopedic Institute, Van Nuys, California, U.S.A.. Electronic address: docmhg@gmail.com.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Getelman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001178:Arthroplasty; D001696:Biomechanical Phenomena; D002102:Cadaver; D003430:Cross-Sectional Studies; D006801:Humans; D022125:Lacerations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011312:Pressure; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D000070656:Rotator Cuff Tear Arthropathy; D012782:Shoulder / Q000601:surgery; D053441:Suture Anchors; D013536:Suture Techniques; D013537:Sutures; D013710:Tendons / Q000473:pathology / Q000601:surgery; D055815:Young Adult