Download PDF
CC BY-NC-ND 4.0 · Revista Chilena de Ortopedia y Traumatología 2021; 62(01): 019-026
DOI: 10.1055/s-0041-1728736
Original Article | Artículo Original

Presión en la reparación de manguito rotador con suturas transóseas y Mason-Allen modificado

Article in several languages: español | English
Julio José Contreras Fernández
1   Instituto Traumatológico, Santiago, Región Metropolitana, Chile
,
Oscar Sepúlveda Osses
2   Hospital del Trabajador, Santiago, Región Metropolitana, Chile
,
Nicolás Prado Esper
2   Hospital del Trabajador, Santiago, Región Metropolitana, Chile
,
Ricardo Guzmán Silva
1   Instituto Traumatológico, Santiago, Región Metropolitana, Chile
,
Rodrigo Liendo Verdugo
3   Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
,
Francisco Soza Rex
3   Pontificia Universidad Católica de Chile, Santiago, Región Metropolitana, Chile
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Resumen

Objetivo Comparar el promedio de curva de presión de contacto y el porcentaje de presión de contacto residual final en la interfase tendón-huella de una reparación transósea (TO) realizada con nudos cruzados y una configuración Mason-Allen modificada (MAM).

Métodos Se utilizaron ocho hombros de cordero para simular una rotura de manguito rotador. Se midió la presión con un sensor digital. Se registró la presión basal durante la aplicación de carga cíclica y al final de la intervención. Se compararon dos reparaciones: dos túneles TOs con nudos cruzados (TOCs) (n = 4) y dos puntos MAMs (n = 4) utilizando suturas MaxBraid #2 (Zimmer Biomet, Warsaw, IN, EEUU). Se realizaron 1.000 ciclos, con una frecuencia de 2 Hz y una carga de 30 N. Se utilizó el test de t de Student, y se consideraron significativos valores de p < 0,05.

Resultados El promedio de curva de presión de contacto en las piezas que fueron reparadas con suturas TOCs fue de 86,01 ±  8,43%, mientras que con MAM fue de 73,28 ±  12,01% (p < 0,0004). El promedio del porcentaje residual al final del ciclado fue de 71,57% para suturas TOCs y de 51,19% para MAM (p < 0,05).

Conclusión La reparación TOC presenta mayor promedio de curva de presión de contacto y mayor porcentaje de presión de contacto residual final en la interfase tendón-huella que la reparación con sutura MAM luego de carga cíclica estandarizada, lo que podría traducirse en una mejor cicatrización del tendón.

Nivel de Evidencia Estudio de ciencia básica.

Palabras Clave

manguito de los rotadores - presión - sutura - técnicas de sutura - traumatismos de los tendones - tendones


Publication History

Received: 28 June 2020

Accepted: 21 January 2021

Article published online:
02 June 2021

© 2021. Sociedad Chilena de Ortopedia y Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referencias

  • 1 Jancuska J, Matthews J, Miller T, Kluczynski MA, Bisson LJ. A Systematic Summary of Systematic Reviews on the Topic of the Rotator Cuff. Orthop J Sports Med 2018; 6 (09) 2325967118797891
    Search in Google Scholar
  • 2 Collin P, Colmar M, Thomazeau H. et al. Clinical and MRI Outcomes 10 Years After Repair of Massive Posterosuperior Rotator Cuff Tears. J Bone Joint Surg Am 2018; 100 (21) 1854-1863
    CrossrefPubMedSearch in Google Scholar
  • 3 Collin P, Thomazeau H, Walch G. et al. Clinical and structural outcome twenty years after repair of isolated supraspinatus tendon tears. J Shoulder Elbow Surg 2019; 28 (01) 196-202
    CrossrefPubMedSearch in Google Scholar
  • 4 Piper CC, Hughes AJ, Ma Y, Wang H, Neviaser AS. Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: a systematic review and meta-analysis. J Shoulder Elbow Surg 2018; 27 (03) 572-576
    CrossrefPubMedSearch in Google Scholar
  • 5 Rossi LA, Rodeo SA, Chahla J, Ranalletta M. Current Concepts in Rotator Cuff Repair Techniques: Biomechanical, Functional, and Structural Outcomes. Orthop J Sports Med 2019; 7 (09) 2325967119868674
    Search in Google Scholar
  • 6 Chona DV, Lakomkin N, Lott A. et al. The timing of retears after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 2017; 26 (11) 2054-2059
    CrossrefPubMedSearch in Google Scholar
  • 7 Haque A, Pal Singh H. Does structural integrity following rotator cuff repair affect functional outcomes and pain scores? A meta-analysis. Shoulder Elbow 2018; 10 (03) 163-169
    CrossrefPubMedSearch in Google Scholar
  • 8 Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 2004; 86 (02) 219-224
    CrossrefPubMedSearch in Google Scholar
  • 9 Caldow J, Richardson M, Balakrishnan S, Sobol T, Lee PV, Ackland DC. A cruciate suture technique for rotator cuff repair. Knee Surg Sports Traumatol Arthrosc 2015; 23 (02) 619-626
    CrossrefPubMedSearch in Google Scholar
  • 10 Desmoineaux P. Failed rotator cuff repair. Orthop Traumatol Surg Res 2019; 105 (1S): S63-S73
    CrossrefPubMedSearch in Google Scholar
  • 11 Cicak N, Klobucar H, Bicanic G, Trsek D. Arthroscopic transosseous suture anchor technique for rotator cuff repairs. Arthroscopy 2006; 22 (05) 565.e1-565.e6
    CrossrefPubMedSearch in Google Scholar
  • 12 Park MC, Cadet ER, Levine WN, Bigliani LU, Ahmad CS. Tendon-to-bone pressure distributions at a repaired rotator cuff footprint using transosseous suture and suture anchor fixation techniques. Am J Sports Med 2005; 33 (08) 1154-1159
    CrossrefPubMedSearch in Google Scholar
  • 13 Hohmann E, König A, Kat CJ, Glatt V, Tetsworth K, Keough N. Single- versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies. Eur J Orthop Surg Traumatol 2018; 28 (05) 859-868
    CrossrefPubMedSearch in Google Scholar
  • 14 Apreleva M, Ozbaydar M, Fitzgibbons PG, Warner JJ. Rotator cuff tears: the effect of the reconstruction method on three-dimensional repair site area. Arthroscopy 2002; 18 (05) 519-526
    CrossrefPubMedSearch in Google Scholar
  • 15 Ma R, Chow R, Choi L, Diduch D. Arthroscopic rotator cuff repair: suture anchor properties, modes of failure and technical considerations. Expert Rev Med Devices 2011; 8 (03) 377-387
    CrossrefPubMedSearch in Google Scholar
  • 16 Kowalsky MS, Dellenbaugh SG, Erlichman DB, Gardner TR, Levine WN, Ahmad CS. Evaluation of suture abrasion against rotator cuff tendon and proximal humerus bone. Arthroscopy 2008; 24 (03) 329-334
    CrossrefPubMedSearch in Google Scholar
  • 17 Ntalos D, Huber G, Sellenschloh K. et al. All-suture anchor pullout results in decreased bone damage and depends on cortical thickness. Knee Surg Sports Traumatol Arthrosc 2020; •••
    CrossrefPubMedSearch in Google Scholar
  • 18 Godry H, Jettkant B, Seybold D, Venjakob AJ, Bockmann B. Pullout strength and failure mode of industrially manufactured and self-made all-suture anchors: a biomechanical analysis. J Shoulder Elbow Surg 2020; 29 (07) 1479-1483
    CrossrefPubMedSearch in Google Scholar
  • 19 Imam MA, Abdelkafy A. Outcomes following arthroscopic transosseous equivalent suture bridge double row rotator cuff repair: a prospective study and short-term results. SICOT J 2016; 2: 7
    CrossrefPubMedSearch in Google Scholar
  • 20 Flanagin BA, Garofalo R, Lo EY. et al. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair. Int J Shoulder Surg 2016; 10 (01) 3-9
    CrossrefPubMedSearch in Google Scholar
  • 21 Garofalo R, Castagna A, Borroni M, Krishnan SG. Arthroscopic transosseous (anchorless) rotator cuff repair. Knee Surg Sports Traumatol Arthrosc 2012; 20 (06) 1031-1035
    CrossrefPubMedSearch in Google Scholar
  • 22 Benson EC, MacDermid JC, Drosdowech DS, Athwal GS. The incidence of early metallic suture anchor pullout after arthroscopic rotator cuff repair. Arthroscopy 2010; 26 (03) 310-315
    CrossrefPubMedSearch in Google Scholar
  • 23 Chillemi C, Mantovani M. Arthroscopic trans-osseous rotator cuff repair. Muscles Ligaments Tendons J 2017; 7 (01) 19-25
    CrossrefPubMedSearch in Google Scholar
  • 24 Tauber M, Koller H, Resch H. Transosseous arthroscopic repair of partial articular-surface supraspinatus tendon tears. Knee Surg Sports Traumatol Arthrosc 2008; 16 (06) 608-613
    CrossrefPubMedSearch in Google Scholar
  • 25 Campbell TM, Lapner P, Dilworth FJ. et al. Tendon contains more stem cells than bone at the rotator cuff repair site. J Shoulder Elbow Surg 2019; 28 (09) 1779-1787
    CrossrefPubMedSearch in Google Scholar
  • 26 Kida Y, Morihara T, Matsuda K. et al. Bone marrow-derived cells from the footprint infiltrate into the repaired rotator cuff. J Shoulder Elbow Surg 2013; 22 (02) 197-205
    CrossrefPubMedSearch in Google Scholar
  • 27 Burkhart SS, Adams CR, Burkhart SS, Schoolfield JD. A biomechanical comparison of 2 techniques of footprint reconstruction for rotator cuff repair: the SwiveLock-FiberChain construct versus standard double-row repair. Arthroscopy 2009; 25 (03) 274-281
    CrossrefPubMedSearch in Google Scholar
  • 28 Scheibel MT, Habermeyer P. A modified Mason-Allen technique for rotator cuff repair using suture anchors. Arthroscopy 2003; 19 (03) 330-333
    CrossrefPubMedSearch in Google Scholar
  • 29 Lichtenberg S, Siebold R, Habermeyer P. Arthroscopic supraspinatus tendon repair using suture anchors and a modified Mason-Allen technique: an intra-articular approach. Arthroscopy 2004; 20 (09) 1007-1011
    CrossrefPubMedSearch in Google Scholar
  • 30 Lichtenberg S, Liem D, Magosch P, Habermeyer P. Influence of tendon healing after arthroscopic rotator cuff repair on clinical outcome using single-row Mason-Allen suture technique: a prospective, MRI controlled study. Knee Surg Sports Traumatol Arthrosc 2006; 14 (11) 1200-1206
    CrossrefPubMedSearch in Google Scholar
  • 31 Andres BM, Lam PH, Murrell GA. Tension, abduction, and surgical technique affect footprint compression after rotator cuff repair in an ovine model. J Shoulder Elbow Surg 2010; 19 (07) 1018-1027
    CrossrefPubMedSearch in Google Scholar
  • 32 Mahar AT, Moezzi DM, Serra-Hsu F, Pedowitz RA. Comparison and performance characteristics of 3 different knots when tied with 2 suture materials used for shoulder arthroscopy. Arthroscopy 2006; 22 (06) 614.e1-614.e2
    CrossrefPubMedSearch in Google Scholar
  • 33 Wüst DM, Meyer DC, Favre P, Gerber C. Mechanical and handling properties of braided polyblend polyethylene sutures in comparison to braided polyester and monofilament polydioxanone sutures. Arthroscopy 2006; 22 (11) 1146-1153
    CrossrefPubMedSearch in Google Scholar
  • 34 Hinse S, Ménard J, Rouleau DM, Canet F, Beauchamp M. Biomechanical study comparing 3 fixation methods for rotator cuff massive tear: Transosseous No. 2 suture, transosseous braided tape, and double-row. J Orthop Sci 2016; 21 (06) 732-738
    CrossrefPubMedSearch in Google Scholar
  • 35 Williams JF, Patel SS, Baker DK, Schwertz JM, McGwin G, Ponce BA. Abrasiveness of high-strength sutures used in rotator cuff surgery: are they all the same?. J Shoulder Elbow Surg 2016; 25 (01) 142-148
    CrossrefPubMedSearch in Google Scholar
  • 36 Tuoheti Y, Itoi E, Yamamoto N. et al. Contact area, contact pressure, and pressure patterns of the tendon-bone interface after rotator cuff repair. Am J Sports Med 2005; 33 (12) 1869-1874
    CrossrefPubMedSearch in Google Scholar
  • 37 Urita A, Funakoshi T, Horie T, Nishida M, Iwasaki N. Difference in vascular patterns between transosseous-equivalent and transosseous rotator cuff repair. J Shoulder Elbow Surg 2017; 26 (01) 149-156
    CrossrefPubMedSearch in Google Scholar