CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2021; 62(03): e159-e167
DOI: 10.1055/s-0041-1740546
Artículo Original | Original Article

Increased Pressure and Contact Area in Rotator Cuff Crossed versus Simple Transosseous Repair

Article in several languages: español | English
Julio José Contreras
1  Instituto Traumatológico, Santiago, RM, Chile
Rodrigo Liendo
2  Pontificia Universidad Católica de Chile, Santiago, RM, Chile
Francisco Soza
2  Pontificia Universidad Católica de Chile, Santiago, RM, Chile
› Author Affiliations


Objective To compare the pressure and contact area at the tendon-footprint interface of a repair performed with simple and crossed transosseous sutures.

Methods Twelve lamb shoulders were used to simulate a rotator cuff tear. The contact area at the tendon-footprint interface was measured with pressure-sensitive films; then, the pressure was measured with a digital sensor. The baseline pressure was recorded during the application of a cyclic load and at the end of the intervention. A total of 2 repairs were compared: 2 transosseous sutures with single knots (STO; n = 6) and 2 transosseous sutures with crossed knots (TOC; n = 6) using FiberWire #2. In total, 1,400 cycles were performed, with a frequency of 2.5 Hz and a load of 5 N. The Mann-Whitney test was used. Values of p < 0.05 were considered significant.

Results The TOS repair presented 50.9 ± 12.7% of pressure distribution compared to 72.2 ± 5.3% in the TOC repair (p < 0.009). The mean pressure in the TOS repair was of 0.7 ± 0.1 MPa compared to 1.1 ± 0.2 MPa in the TOC repair (p < 0.007). The TOS repair registered a basal pressure of 5.3 ± 5.3 N, a final pressure of 3.8 ± 4.6 N, and a variation of 51.7 ± 38%. The TOC repair registered a basal pressure of 10.7 ± 1.8 N, a final pressure of 12.9 ± 8.7 N, and a variation of 114.9 ± 65.9% (p < 0.044; p < 0.022; and p < 0.017 respectively).

Conclusion The TOC repair presents higher pressure at the tendon-bone interface, less loss of contact force under cyclic loads, and a better distribution of force on the footprint when compared with the TOS repair, which could translate into better tendon healing.

Level of Evidence Basic Science Study.

Publication History

Received: 28 June 2020

Accepted: 06 August 2021

Publication Date:
22 December 2021 (online)

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