Tight medial knot tying may increase retearing risk after transosseous equivalent repair of rotator cuff tendon.

Abstract:

BACKGROUND:Retearing mechanism after transosseous equivalent (TOE) rotator cuff repair has not been fully clarified yet. OBJECTIVE:The purposes of this study were to compare the stress distribution pattern in the tendon stump between knotted and knotless TOE repair and to investigate the role of suture tension applied during medial knot tying using a 3-dimensional finite element (3D-FE) method. METHODS:Both knotted and knotless TOE repairs were simulated on the 3D-FE human rotator cuff tear model. Elastic analysis was performed to compare the stress distribution pattern inside the tendon between the two models. The amount of compressive load applied to the medial-row sutures was then changed as 0, 20, 40, 60, 80, and 100 N in the knotted model. RESULTS:Knotted model demonstrated more distinct stress concentration inside the tendon around medial-row sutures than the knotless model. Mean von Mises equivalent stress in this area in the 0, 20, 40, 60, 80, and 100 N models was 0.26, 0.35, 0.50, 0.70, 1.11, and 1.14 MPa, respectively. CONCLUSIONS:In the knotted TOE repair, tight medial knot tying might cause a high stress concentration around medial knots, which may constitute one of the pathogenetic factors of postoperative retearing at this site.

journal_name

Biomed Mater Eng

authors

Sano H,Tokunaga M,Noguchi M,Inawashiro T,Irie T,Abe H,Yokobori AT

doi

10.3233/BME-171673

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

267-277

issue

3

eissn

0959-2989

issn

1878-3619

pii

BME1673

journal_volume

28

pub_type

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