Abstract
Two fixation devices for rotator cuff repair were compared in a sheep model. Surgical transection of the supra-spinatus tendon insertion was repaired using metallic OBL suture anchors or Suretac II anchors. Twelve weeks postoperatively the repair site was assessed using histology, polarized light microscopy and biomechanical testing. No important differences were found between these two repair methods.
The purpose of this study was to compare traditional rotator cuff fixation devices with bioabsorbable press-fit tacks.
Sixteen sheep were assigned to OBL (n=8) or Suretac (n=8) treatment groups. Four sheep shoulder joints were used as unoperated controls. Treated sheep underwent general anesthesia and a lateral arthrotomy using aseptic technique to allow transection of the supraspinatus tendon insertion. The tendon-bone interface was repaired with two fixation devices according to the manufacturer’s directions. After recovery from anesthesia the sheep were maintained in small pens for twelve weeks. After sacrifice, muscle-tendon-bone blocks were prepared for mechanical testing. The specimen underwent a preload of 25N, followed by cyclic loading (10–50N x10), then loading at 480mm/min until failure. The remaining bone-tendon interface was fixed, embedded in plastic and 100μ undecalcified histological sections were cut, polished and stained.
All tendons had healed to the humerus and the repair site was two to three times larger than unoperated controls. There were no significant differences between the two treatment groups with respect to maximum load, modulus, and energy per unit area. Histological analysis is ongoing.
These data suggest that these two fixation methods are functionally equivalent in this model. Press-fit fixation devices do not knot tying and they can be inserted arthroscopically so they are a convenient fixation method.
This study confirms that press fit anchors and metallic anchors with sutures are equivalent for repair of bone-tendon interfaces.
Funding: Smith & Nephew supplied the fixation devices for this project. Thanks to Deb McWade for technical assistance.
Correspondence should be addressed to Cynthia Vezina, Communications Manager, COA, 4150-360 Ste. Catherine St. West, Westmount, QC H3Z 2Y5, Canada
