Load-to-Failure, Contact Area and Contact Pressure Load-to-Failure, Contact Area and Contact Pressure of Three Rotator Cuff Repair Methods: of Three Rotator Cuff Repair Methods: A Comparative Biomechanical AnalysisA Comparative Biomechanical Analysis

Josianne Lépine and Frédéric Balg, MD, FRCSCJosianne Lépine and Frédéric Balg, MD, FRCSCDepartment of Orthopaedic Surgery, Université de SherbrookeDepartment of Orthopaedic Surgery, Université de Sherbrooke

In collaboration with In collaboration with Denis Rancourt, PhD, Ève Langelier, PhD, and Nicolas Huppé, MScDenis Rancourt, PhD, Ève Langelier, PhD, and Nicolas Huppé, MScDepartment of Mechanical Engineering, Université de SherbrookeDepartment of Mechanical Engineering, Université de Sherbrooke

July 4th, 2009 – COA Annual Meeting

Disclosures : DePuy supplies, FRSQ training award

1- Transosseous

2- Double-row

3-Tendinous tension band

• Time and cost• Less pulling forces on the anchors• Anchors fixed laterally into cortical bone• Convert traction into compression• Better decortication possible

1 - Maximal load tolerated before failure

2 – Tendon-to-bone contact area

3 – Tendon-to-bone contact pressure

Hypothesis for all three :

Tension band = Double-row > Transosseous

• Sawbones ®

• Load applied at 135°

135 °

• Initial immobilization

• Better indicators of healing

• Cadaveric shoulders

• Pressure-sensitive film

• Load of 12kg applied at 80°

80 °

• The tension band suture technique has a lower load to failure.

• The tension band suture technique has a significantly lower contact area and contact pressure.

• The double-row anchor suture technique has significantly higher contact area and contact pressure than the transosseous sutures.

Special thanks to :Special thanks to :

• Dr Frédéric Balg

- Denis Rancourt

• - Ève Langelier

- Nicolas Huppé

• The anatomy laboratory - Denis Bisson - Claudia Beaulieu

• - Elizabeth Tanguay

•