Impact of suture configuration and fixation type on biomechanical strength of rotator cuff repair:A factorial design study
10.3969/j.issn.1000-6710.2025.09.005
- VernacularTitle:基于析因设计探讨肩袖缝合技术与固定类型对缝合修复强度的影响
- Author:
Yinzhe CUI
1
;
Zheng YAN
;
Jia MA
;
Zhefeng JIN
;
Jiawen ZHAN
;
Minshan FENG
;
Guangwei LIU
;
Jie YU
;
Xu WEI
;
Jiangtao SI
;
Minghui ZHUANG
;
Tao HAN
;
Jianguo LI
;
ZHANGKAIRUI
;
Liguo ZHU
Author Information
1. 中国中医科学院望京医院(北京 100102)
- Publication Type:Journal Article
- Keywords:
rotator cuff repair;
biomechanics;
transosseous suture;
suture anchor;
factorial
- From:
Chinese Journal of Sports Medicine
2025;44(9):729-737
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the impact of suture configuration and fixation type on the biome-chanical strength of rotator cuff repair,using a factorial design study.Methods Sixteen fresh-frozen porcine shoulder samples were randomized into an anchorless double-row suture bridge transosseous su-tures(DS)group,an anchored double-row suture bridge transosseous-equivalent(DE)group,an an-chorless X-BOX construct transosseous sutures(XS)group,and an anchored X-BOX construct transos-seous-equivalent(XE)group,each of four,according to suture configuration(double-row suture bridge,traditional X-BOX construct)and fixation type(suture anchors,transosseous sutures).Then,their fatigue resistance(first-cycle excursion,gap length difference ratio,and the percentage of ex-posed footprints)and the failure strength(the maximum failure load and the re-tear type)were mea-sured using a biomechanical material testing machine.Results Different suture configurations affected failure strength(F=39.559,P<0.001),with the double-row suture bridge groups(693.07±58.35 N,746.76±138.57 N)showing significantly higher failure strength,compared to the traditional X-BOX groups(462.90±18.91 N,421.43±90.76 N).However,the fixation type did not significantly im-pact failure strength(F=1.161,P=0.302).Moreover,the suture configuration influenced the gap differ-ence ratio(F=7.781,P=0.016),but had no significant correlation with other fatigue resistance indica-tors(P>0.05).Meanwhile,failure strength and fatigue resistance were not correlated with fixation type,and the interaction between suture and fixation type(P>0.05).The incidence of failure types for the four suture configurations was as follows:Type I tendon tear:XS>XE>DS=DE;type II tendon tear:DS>XE>XS=DE;fixing material-related failure:DE>DS=XE=XS.Conclusion The failure strength and gap formation ratio in rotator cuff repair under fatigue loading are influenced by suture configuration,whereas no significant association has been observed with respect to fixation method,whether using transosseous sutures or suture anchors.
