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The Effect of Arthroscopic Suture Passing Instruments on Rotator Cuff Repair Integrity

Authors: Laith M Jazrawi (New York)

References: Poster Presentation at AAOS 2005

Abstract
Suture passing instruments with smaller and smoother tips may create more symmetric holes in the tendon and ultimately decrease suture cut-out.

For arthroscopic rotator cuff repair, numerous studies have examined the methods of suture anchor insertion and arthroscopic knot tying, with little emphasis on the devices used for suture passage through the tendon. The purpose of our study was to compare the effect of suture passage device on the durability of rotator cuff repair.

Eight shoulders were randomly assigned to 4 treatment groups. Rotator cuff repair was performed with two suture anchors preloaded with #2 Ethibond. Suture passage was performed by a Lasso suture passerTM , straight BirdBeak suture passerTM , Viper suture passerTM , and #7 Mayo tapered needle. Each specimen was cyclically loaded to 150 N at a rate of 33 mm/s until failure. Histological analysis of the defect in the tendon created by all instruments was also performed.

The Lasso suture passerTM and Mayo tapered needle specimens were the strongest constructs averaging the highest number of cycles to failure (5000 cycles for all but one specimen in each group). The BirdBeak suture passerTM and Viper suture passerTM specimens failed at a lower number of cycles (48 cycles and 459.5 cycles, respectively). Cross-sectional area of the hole created by the devices was smallest for the tapered needle and largest for the BirdBeakTM.

Integrity of rotator cuff repair may be dependent upon the method used for suture passage through the tendon. Suture passing instruments with smaller and smoother tips may create more symmetric holes in the tendon and ultimately decrease suture cut-out.

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