ArticleActa orthopaedica et traumatologica turcica2025
Biomechanical comparison of rotator cuff repair techniques in osteoporotic conditions: testing a novel technique.
Article in Acta orthopaedica et traumatologica turcica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: This study aimed to compare the biomechanical characteristics of conventional transosseous equivalent (TOE) techniques with those of the novel free independent double-row medial fixation method, using rigid polyurethane (PU) foam blocks to simulate osteoporotic humerus bone. Methods: In this biomechanical study, 4 groups were tested using rigid PU foam blocks with osteoporotic properties and bovine infraspinatus tendons to simulate the rotator cuff. Groups 1 and 2 employed conventional TOE techniques: medial row knotted repair and knotless repair, respectively. Groups 3 and 4 utilized the "free independent double-row medial fixation method," differing in the order of suture tying. Several biomechanical characteristic and pressure parameters were measured. Results: Groups 3 (0.16 ± 0.04 MPa) and 4 (0.17 ± 0.05 MPa) achieved significantly higher initial contact pressure compared to standard TOE techniques (P=.039). While contact area (Group 3: 102.4 ± 55.0 mm², Group 4: 110.4 ± 37.2 mm²) and ultimate failure force (Group 3: 212.0 ± 26.5 N, Group 4: 214.7 ± 30.2 N) were relatively higher, the differences were not statistically significant (P=.135 and P=.3, respectively). The overall failure types included medial anchor pullout (40%) and suture/tendon stripping (32.5%), with no significant differences among groups (P=.260). Conclusion: With superior contact pressure and comparable ultimate failure and contact area measurements, the novel independent double-row medial fixation technique may be a viable alternative to conventional TOE techniques for enhancing medial row stability in osteoporotic conditions. Level of Evidence: N/A.
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