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Supplementation of Rotator Cuff Repair with a Bioresorbable Scaffold

Jason L. Koh, MD^,, Zoltan Szomor, MD, George A. C. Murrell, MD, PhD and Russell F. Warren, MD^||

Department of Orthopaedic Surgery, Northwestern University Medical School, Chicago, Illinois
Sports Medicine and Shoulder Service and Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Sydney, Australia
^|| Cornell University Medical School and the Hospital for Special Surgery, New York, New York

Presented at the interim meeting of the AOSSM, Orlando, Florida, March 2000.

Address correspondence and reprint requests to Jason L. Koh, MD, Department of Orthopaedic Surgery, 645 North Michigan Avenue, Suite 910, Northwestern University Medical School, Chicago, IL 60611

Background: Repair of a torn rotator cuff should have sufficient initial strength of the fixation to permit appropriate rehabilitation.

Hypothesis: Augmentation with a woven polylactic acid scaffold strengthens repairs of the rotator cuff.

Study Design: Controlled laboratory study.

Methods: In the suture-anchor model, 10 pairs of sheep infraspinatus tendons were detached and repaired to suture anchors. In half of the matched specimens, the repair was reinforced with a woven poly-lactic acid scaffold repaired with the tendon to bone. In the bone-bridge model, sutures were passed through a trough and over a bone bridge distal to the greater tuberosity; half were reinforced by the scaffold. The repairs were tested to failure with a hydraulic testing machine.

Results: The mean ultimate strength of suture-anchor repairs augmented with the scaffold (167.3 ± 53.9 N) was significantly greater than that of nonaugmented fixation (133.2 ± 38.2 N). Failure occurred when the tendon pulled through the sutures; the scaffold remained intact. Scaffold reinforcement of the bone bridge significantly increased the ultimate strength from 374.6 ± 117.6 N to 480.9 ± 89.2 N, and the scaffold remained intact in 8 of 10 specimens.

Conclusions: The scaffold significantly increased the initial strength of rotator cuff repair by approximately 25%.

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