A Biomechanical Comparison of 2 Transosseous-Equivalent Double-Row Rotator Cuff Repair Techniques Using Bioabsorbable Anchors: Cyclic Loading and Failure Behavior

Purpose: A novel double-row configuration was compared with a traditional double-row configuration for rotator cuff repair. Methods: In 10 matched-pair sheep shoulders in vitro repair was performed with either a double-row technique with corkscrew suture anchors for the medial row and insertion anchors for the lateral row (group A) or a double-row technique with a new tape-like suture material with insertion anchors for both the medial and lateral rows (group B). Each specimen underwent cyclic loading from 10 to 150 N for 100 cycles, followed by unidirectional failure testing. Gap formation and strain within the repair area for the first and last cycles were analyzed with a video digitizing system, and stiffness and failure load were determined from the load-elongation curve. Results: The results were similar for the 2 repair types. There was no significant difference between the ultimate failure loads of the 2 techniques (421 ± 150 N in group A and 408 ± 66 N in group B, P = .31) or the stiffness of the 2 techniques (84 ± 26 N/mm in group A and 99 ± 20 N/mm in group B, P = .07). In addition, gap formation was not different between the repair types. Strain over the repair area was also not different between the repair types. Conclusions: Both tested rotator cuff repair techniques had high failure loads, limited gap formation, and acceptable strain patterns. No significant difference was found between the novel and conventional double-row repair types. Clinical Relevance: Two double-row techniques-one with corkscrew suture anchors for the medial row and insertion anchors for the lateral row and one with insertion anchors for both the medial and lateral rows-provided excellent biomechanical profiles at time 0 for double-row repairs in a sheep model. Although the sheep model may not directly correspond to in vivo conditions, all-insertion anchor double-row constructs are worthy of further investigation.