Abstract
Purpose: To compare the effect of 2 common rotator cuff repair techniques, for smaller tears limited to the use of a single anchor, on tendon morphology in relation to the footprint. Methods: Six matched pairs of human shoulders were dissected, and a standardized 10-mm supraspinatus tendon tear was created. Two single-anchor repairs were performed: simple repair with the anchor on the footprint or inverted-mattress repair with the anchor 1 cm distal-lateral to the footprint. The repaired specimens were frozen in situ with liquid nitrogen. Coronal cross sections through the intact and repaired tendon were made. A digitizer was used to measure variables including tendon area and radius of tendon curvature. Results: Comparing between repairs, we found significantly more gap formation for the simple repair at the repair cross section (3.67±0.32 mm v 0.68±0.10 mm, P = .00050). The simple repair had less tendon area (38.28±2.50 mm2 v 58.65±4.06 mm2, P = .0036) and a smaller radius of curvature (8.47±1.39 mm v 32.51±3.94 mm, P = .0046). For the simple repair, there was significantly more gap formation, less tendon area, and a smaller radius of tendon curvature for all repair cross sections compared with the intact cross sections (P < .05). For the inverted-mattress repair, there was more gap formation compared with the intact condition (P < .05), although it was less than 1 mm on average; for tendon area, radius of curvature, and tendon height, the cross section centered on the repair showed no differences compared with the intact control. Conclusions: For rotator cuff tears that are 10 mm or smaller and limited to the use of a single anchor, using a distal-lateral anchor position with tape-type suture can provide better maintenance of native tendon morphology and footprint dimensions when compared with repair that uses standard sutures and places the anchor on the footprint. Clinical Relevance: For smaller tears, the inverted-mattress repair described in this article may provide a relatively improved healing environment compared with a simple repair on the footprint, potentially optimizing the prevention of early tear progression.