Current Biomechanical Concepts of Suture Bridge Repair Technique for Rotator Cuff Tear

Abstract

Rotator cuff tears are one of the most common disorders of the shoulder and can have significant effects on daily activities as a result of pain, loss of motion and strength. The goal of rotator cuff repair is aimed at anatomic restoration of the rotaotr cuff tendon to reduce pain and improve the joint function. Recently, arthroscopic repair has been widely accepted for treatment of rotator cuff tears due to its equal or better results than those from open repair. In 2006, a transosseous-equivalent (TOE) or "suture bridge" technique was introduced by Park et al. This technique maximizes the utility of the conventional double-row technique by using the suture limbs to form the medial mattress sutures to bridge and compress the repaired tendon. This technique has been proven to provide biomechanical properties that are superior to other arthroscopic repair techniques regarding the initial fixation strength, contact area and contact pressure at the tendon-bone interface. Since suture bridge techniques have been envolving over time, further biomechanical investigations have been carried out. These studies include examination of the effect of dynamic humeral external rotation on the mechanical stability or the repaired tendon construct, the effects of various midifications of the suture bridge configurations on the biomechanical characteristics of the medial mattress suture, biomechanical implication of medial row failure, and biomechanical performance of the repaired construct over time. In this review, the biomechanical concepts behind the suture bridge technique for rotator cuff repair were reviewed and discussed.