Rotator cuff tendon tissue cut-through comparison between 2 high-tensile strength sutures

Abstract

Background: High-tensile strength sutures are known to cut through tendon tissue when used for rotator cuff and other tendon repairs, resulting in mechanical failure. The purpose of this study was to test a new suture and compare it with an established suture in a controlled laboratory setting.

Methods: Two sutures, Dynacord and FiberWire, both USP size No. 2, were passed through fresh infraspinatus tendons from 7 matched pairs of ovine shoulders (14 shoulders). Samples underwent cyclic testing for 1000 cycles, and the amount of cheese-wire tissue damage (tendon cut-through) was recorded. A clinical failure was defined as greater than 5 mm of tissue cut-through.

Results: The mean amount of tendon cut-through was 3.72 ± 1.14 mm in the FiberWire specimens and 2.69 ± 1.02 mm in the Dynacord group. The difference was statistically significant (P = .012). In the matched-pair analysis, more tendon cut-through was noted with FiberWire in 13 specimens whereas a greater amount was found in only 1 Dynacord specimen. The FiberWire specimens showed 2 instances of tissue tendon cut-through exceeding 5 mm, defined as a clinical failure.

Conclusions: In this cadaveric ovine rotator cuff tendon model, we found less tendon cut-through from Dynacord suture compared with FiberWire. In addition, 2 of the FiberWire specimens showed complete tendon cut-through. Future studies focusing on patient-reported outcomes and healing rates with different types of suture materials are needed.

Keywords: Dynacord; FiberWire; Tissue cut-through; biomechanics; rotator cuff tear; suture choice.