Pectoralis major tendon repair: a biomechanical study of suture button versus transosseous suture techniques

2.50
Hdl Handle:
http://hdl.handle.net/11287/593951
Title:
Pectoralis major tendon repair: a biomechanical study of suture button versus transosseous suture techniques
Authors:
Thomas, William; Gheduzzi, S.; Packham, I.
Abstract:
PURPOSE: Pectoralis major tendon avulsion injury benefits from surgical repair. The technique used and speed of rehabilitation in this demanding population remains subject to debate. We performed a biomechanical study comparing suture button (Pec Button, Arthrex, Naples, FL) with a transosseous suture technique (FibreWire, Arthrex, Naples, FL). METHODS: Freshly slaughtered porcine humeri were prepared to model a single transosseous suture or suture button repair. A static, tensile load to failure experiment and a cyclic, tensile load experiment to model standard (10,000 cycles) and accelerated rehabilitation (20,000 cycles) philosophies were tested. The mode of failure, yield and ultimate failure load, extension (clinical failure >10 mm) and the resistance to cyclic loading was measured. RESULTS: The mode of failure was suture fracture in all the static load experiments with 10/11 occurring as the suture passed through the button and 7/11 as the suture passed through the bone tunnels. There was a significant difference in yield load, favouring transosseous suture [p = 0.009, suture button (SB) 673.0 N (647.2-691.7 N), transosseous suture (TOS) 855.0 N (750.0-891.4 N)] and median extension, favouring suture button [p = 0.009, SB 8.8 mm (5.0-12.4 mm), TOS 15.2 mm (13.2-17.1 mm)]. 2/3 transosseous suture and 0/3 suture buttons failed before completing 20,000 cycles. The difference in mean number of cycles completed was non-significant. The difference in mean extension was 5.1 mm (SB 6.7 mm, TOS 11.7 mm). CONCLUSIONS: Both techniques show advantages. The difference in extension is likely to be more clinically relevant than load tolerated at failure, which is well above physiological levels. The findings do not support an accelerated rehabilitation model.
Citation:
Knee Surg Sports Traumatol Arthrosc. 2015 Sep;23(9):2617-23.
Publisher:
Springer
Journal:
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
Issue Date:
1-Sep-2015
URI:
http://hdl.handle.net/11287/593951
DOI:
10.1007/s00167-014-3008-3
PubMed ID:
24792073
Additional Links:
http://dx.doi.org/10.1007/s00167-014-3008-3
Type:
Journal Article
Language:
eng
ISSN:
1433-7347
Appears in Collections:
2015 RD&E publications; General Trauma & Orthopaedics

Full metadata record

DC FieldValue Language
dc.contributor.authorThomas, Williamen
dc.contributor.authorGheduzzi, S.en
dc.contributor.authorPackham, I.en
dc.date.accessioned2016-01-19T12:37:53Zen
dc.date.available2016-01-19T12:37:53Zen
dc.date.issued2015-09-01en
dc.identifier.citationKnee Surg Sports Traumatol Arthrosc. 2015 Sep;23(9):2617-23.en
dc.identifier.issn1433-7347en
dc.identifier.pmid24792073en
dc.identifier.doi10.1007/s00167-014-3008-3en
dc.identifier.urihttp://hdl.handle.net/11287/593951en
dc.description.abstractPURPOSE: Pectoralis major tendon avulsion injury benefits from surgical repair. The technique used and speed of rehabilitation in this demanding population remains subject to debate. We performed a biomechanical study comparing suture button (Pec Button, Arthrex, Naples, FL) with a transosseous suture technique (FibreWire, Arthrex, Naples, FL). METHODS: Freshly slaughtered porcine humeri were prepared to model a single transosseous suture or suture button repair. A static, tensile load to failure experiment and a cyclic, tensile load experiment to model standard (10,000 cycles) and accelerated rehabilitation (20,000 cycles) philosophies were tested. The mode of failure, yield and ultimate failure load, extension (clinical failure >10 mm) and the resistance to cyclic loading was measured. RESULTS: The mode of failure was suture fracture in all the static load experiments with 10/11 occurring as the suture passed through the button and 7/11 as the suture passed through the bone tunnels. There was a significant difference in yield load, favouring transosseous suture [p = 0.009, suture button (SB) 673.0 N (647.2-691.7 N), transosseous suture (TOS) 855.0 N (750.0-891.4 N)] and median extension, favouring suture button [p = 0.009, SB 8.8 mm (5.0-12.4 mm), TOS 15.2 mm (13.2-17.1 mm)]. 2/3 transosseous suture and 0/3 suture buttons failed before completing 20,000 cycles. The difference in mean number of cycles completed was non-significant. The difference in mean extension was 5.1 mm (SB 6.7 mm, TOS 11.7 mm). CONCLUSIONS: Both techniques show advantages. The difference in extension is likely to be more clinically relevant than load tolerated at failure, which is well above physiological levels. The findings do not support an accelerated rehabilitation model.en
dc.language.isoengen
dc.publisherSpringeren
dc.relation.urlhttp://dx.doi.org/10.1007/s00167-014-3008-3en
dc.titlePectoralis major tendon repair: a biomechanical study of suture button versus transosseous suture techniquesen
dc.typeJournal Articleen
dc.identifier.journalKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKAen

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