A Biomechanical Comparison of Transosseous–Suture Anchor and Suture Bridge Rotator Cuff Repairs in Cadavers

Background Several biomechanical studies comparing open and arthroscopic rotator cuff repair methods have shown inferior performance of arthroscopic repairs. Suture anchor–augmented transosseous repairs and suture bridge repairs have shown superior biomechanical performance when compared with other methods, but these 2 repair methods have not been directly compared. Hypothesis There will be no difference in the biomechanical performance of the transosseous–suture anchor and suture bridge techniques. Study Design Controlled laboratory study. Methods Eight paired cadaveric shoulder specimens (16 specimens) had creation followed by repair of a complete tear of the supraspinatus, with the first member of each pair undergoing repair by a transosseous–suture anchor technique and the second member undergoing repair by the suture bridge technique. Specimens were then cycled from 10 to 180 N for 200 cycles, followed by testing to failure at 33 mm/s. Elongation was measured during cyclic testing, and failure load and stiffness were obtained during load-to-failure testing. Failure method was recorded. Results There was no significant difference between transosseous–suture anchor repairs and suture bridge repairs for elongation (4.0 ± 1.60 mm vs 3.5 ± 1.1 mm, P = .31), failure load (408 ± 93 N vs 419 ± 62 N, P = .70), or stiffness (58 ± 10 N/mm vs 58 ± 14 N/mm, P = .94). The most common mode of failure with each method was suture cutting through tendon. Conclusion The suture bridge repair exhibited similar biomechanical performance during cyclic and load-to-failure testing as a transosseous–suture anchor repair, which historically has been performed in open or mini-open fashion. Clinical Relevance Arthroscopic rotator cuff repairs can be performed that are as strong as open or mini-open repairs.