Pullout strength of cement-augmented and wide-suture transosseous fixation in the greater tuberosity

Brendan Y. Shi, Miguel Diaz, Stephen M Belkoff, Uma Srikumaran

Research output: Contribution to journalArticle

Abstract

Background Obtaining strong fixation in low-density bone is increasingly critical in surgical repair of rotator cuff tears because of the aging population. To evaluate two new methods of improving pullout strength of transosseous rotator cuff repair in low-density bone, we analyzed the effects of 1) using 2-mm suture tape instead of no. 2 suture and 2) augmenting the lateral tunnel with cement. Methods Eleven pairs of osteopenic or osteoporotic cadaveric humeri were identified by dual-energy x-ray absorptiometry. One bone tunnel and one suture were placed in the heads of 22 specimens. Five randomly selected pairs were repaired with no. 2 suture; the other six pairs were repaired with 2-mm suture tape. One side of each pair received lateral tunnel cement augmentation. Specimens were tested to suture pullout. Data were fitted to multivariate models that accounted for bone mineral density and other specimen characteristics. Findings Two specimens were excluded because of knot-slipping during testing. Use of suture tape versus no. 2 suture conferred a 75-N increase (95% CI: 37, 113) in pullout strength (P < 0.001). Cement augmentation conferred a 42-N improvement (95% CI: 10, 75; P = 0.011). Other significant predictors of pullout strength were age, sex, and bone mineral density. Interpretation We show two methods of improving the fixation strength of transosseous rotator cuff repairs in low-density bone: using 2-mm suture tape instead of no. 2 suture and augmenting the lateral tunnel with cement. These methods may improve the feasibility of transosseous repairs in an aging patient population.

Original languageEnglish (US)
Pages (from-to)154-159
Number of pages6
JournalClinical Biomechanics
Volume50
DOIs
StatePublished - Dec 1 2017

Keywords

  • Bone mineral density
  • Cement augmentation
  • Pullout strength
  • Rotator cuff tears
  • Suture tape
  • Transosseous rotator cuff repair

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine

Fingerprint Dive into the research topics of 'Pullout strength of cement-augmented and wide-suture transosseous fixation in the greater tuberosity'. Together they form a unique fingerprint.

  • Cite this