Mechanical Strength of Arthroscopic Rotator Cuff Repair Techniques

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Presentation transcript:

Mechanical Strength of Arthroscopic Rotator Cuff Repair Techniques by Alberto G. Schneeberger, Andreas von Roll, Fabian Kalberer, Hilaire A.C. Jacob, and Christian Gerber J Bone Joint Surg Am Volume 84(12):2152-2160 December 1, 2002 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Modified Mason-Allen stitch (Reprinted, with permission, from: Gerber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. Modified Mason-Allen stitch (Reprinted, with permission, from: Gerber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994;76:374). Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

The anchors tested in this study included the 5 The anchors tested in this study included the 5.0-mm Bio-Statak (1), the PANALOK RC absorbable anchor (2), the 5.0-mm Statak (3), the Revo screw (4), and the Mitek Rotator Cuff anchor (5). The anchors tested in this study included the 5.0-mm Bio-Statak (1), the PANALOK RC absorbable anchor (2), the 5.0-mm Statak (3), the Revo screw (4), and the Mitek Rotator Cuff anchor (5). In the scale at bottom, the distance between the lines represents 1 mm. Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Experimental setup for the simulation of arthroscopic insertion of anchors and fixation of tendons, showing the cannulae (1) attached with rubber bands to metal bars (2), the humeral head with about 3 cm of the proximal part of the shaft fixed with screws (... Experimental setup for the simulation of arthroscopic insertion of anchors and fixation of tendons, showing the cannulae (1) attached with rubber bands to metal bars (2), the humeral head with about 3 cm of the proximal part of the shaft fixed with screws (3) and methylmethacrylate (4) to a special fixation device (5) and the bone anchor (6) before insertion into the drill-hole at the greater tuberosity (7). Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Setup for the testing of the bone anchors on the Instron testing machine, showing the special fixation device with the proximal part of the humerus (1), the bone anchor (2), the direction of insertion of the anchors (3), the tangential line (4) over the gre... Setup for the testing of the bone anchors on the Instron testing machine, showing the special fixation device with the proximal part of the humerus (1), the bone anchor (2), the direction of insertion of the anchors (3), the tangential line (4) over the greater tuberosity (5), and the superior part of the humeral head (6), the axis of the humeral shaft (7), the direction of the pullout tests (8), the bar for fixation of the sutures (9), and the crosshead of the testing machine (10). Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

View of a left (L) and right (R) humeral head, showing the greater tuberosity (1) and the lesser tuberosity (2). View of a left (L) and right (R) humeral head, showing the greater tuberosity (1) and the lesser tuberosity (2). For heads with three anchors, the anterior (a), middle (m), and posterior (p) sites of insertion were used. For contralateral heads with two anchors, the anterior (a) and posterior (p) positions were used. The asterisks represent a distance of at least 1 cm between the sites of insertion. The order of introduction of the five anchors into the various positions was regularly altered in order to avoid the influence of a difference in bone quality. Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

The suturing devices tested in this study included the ArthroSew (1), Acufex Suture Punch (2), Mini-Straight Caspari Suture Punch System (3), Caspari 4-mm slotted-jaw Suture Punch (4), and the new modification of the slotted-jaw Caspari Suture Punch with a ... The suturing devices tested in this study included the ArthroSew (1), Acufex Suture Punch (2), Mini-Straight Caspari Suture Punch System (3), Caspari 4-mm slotted-jaw Suture Punch (4), and the new modification of the slotted-jaw Caspari Suture Punch with a longer needle (5). Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Drawing of the testing of the tendon stitches on the Instron machine, showing the special fixation device with the proximal part of the humerus (1), bone anchor (2), tendon sutures (3), supraspinatus tendon (4) grasped by a special clamp (5), and the crossh... Drawing of the testing of the tendon stitches on the Instron machine, showing the special fixation device with the proximal part of the humerus (1), bone anchor (2), tendon sutures (3), supraspinatus tendon (4) grasped by a special clamp (5), and the crosshead of the testing machine (6). Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.

Damage of the suture material was caused by the Mini-Straight Caspari Suture Punch System. Alberto G. Schneeberger et al. J Bone Joint Surg Am 2002;84:2152-2160 ©2002 by The Journal of Bone and Joint Surgery, Inc.