Arthroscopic ePTFE Patch Repair for Irreparable Rotator Cuff Tears

摘要

Massive rotator cuff tears are difficult to manage. A treatment option is the use of a synthetic patch as an interpositional bridge to restore continuity of the cuff defect. The patches can be inserted arthroscopically, but the procedure involves multiple knot tying, which is often tedious. The aims of this paper is to describe a new arthroscopic technique to attach the patch to the native tendon that involves only 1 arthroscopic knot tying, and to compare the biomechanical properties of 2 types of repairs at the patch to tendon interface. Methods: Surgical Technique: Two arthroscopic repair techniques at the patch to tendon interface are presented: the multiple mattress suture technique and the weave suture technique. Biomechanical: An ovine chronic rotator cuff tear ex vivo model was developed in 44 ovine infraspinatus tendons paired to represent a retorn supraspinatus tendon. The tendon was then repaired with a synthetic ePTFE (expanded polytetrafluoroethylene, Gore-Tex; W.L. Gore & Associates, Flagstaff, AZ) patch using multiple mattress technique (n= 11) or a novel weave technique (n= 11). Pull to failure testing was performed to each tendon repair using an Instron 8874 (Instron Ltd, UK) mechanical tensile testing machine.