Rotator cuff tears

PURPOSE: To quantitatively determine the 3-dimensional (3-D) area of the original supraspinatus insertion and compare it with the repair-site area after 4 reconstructions of a simulated supraspinatus tear. TYPE OF STUDY: Ex vivo biomechanical study. METHODS: The outline of the original supraspinatus insertion was obtained in 10 human cadaveric shoulders using a 3-D digitizer. A supraspinatus tear was created and 4 repair techniques were evaluated: transosseous simple suture (TOS), transosseous mattress suture (TOM), suture-anchor simple suture (SAS), suture-anchor mattress suture (SAM). The 3-D outlines of the reconstructed supraspinatus insertion were digitized after each repair. The outlines of the original supraspinatus insertion and repair areas were superimposed onto humeral geometry obtained from a laser scanner, and surface areas were calculated. RESULTS: The original supraspinatus insertion area was larger than any of the repair-site areas (P <.05). On average, TOS provided a 20% larger repair-site area than the other repairs (P <.05). Repair-site areas were not different among TOM, SAS, or SAM repairs (P >.05) and covered 67% of the original supraspinatus insertion. CONCLUSIONS: None of the tested repairs restored the area of the original supraspinatus insertion. The larger repair-site area of the TOS repair suggests that this technique provides better potential for healing and, ultimately, greater strength of repair.