Rotator cuff repair with a tendon–fibrocartilage–bone composite bridging patch

• Novel tendon–fibrocartilage–bone composite bridging patch for rotator cuff repair
• Transforming traditional tendon–bone healing to tendon-tendon and bone–bone healing
• Higher ultimate tensile of bridging patch compared with traditional repair

BackgroundTo compare the mechanical performance of a rotator cuff repaired with a novel tendon–fibrocartilage–bone composite bridging patch vs the traditional Mason–Allen repair in an in vitro canine model.MethodsTwenty shoulders and 10 bridging patches from patellar tendon were harvested. The patches were trimmed and sliced into 2 layers. An infraspinatus tendon tear was created in each shoulder. Modified Mason–Allen sutures were used to repair the infraspinatus tendon to the greater tuberosity, with or without the bridging patch (bridging patch group and controls, respectively). Shoulders were loaded to failure under displacement control at a rate of 0.5 mm/s.FindingsThe ultimate tensile load was significantly higher in the bridging patch group than control (mean [SD], 365.46 [36.45] vs 272.79 [48.88] N; P < .001). Stiffness at the greater tuberosity repair site and the patch–infraspinatus tendon repair site was significantly higher than the control repair site (93.96 [27.72] vs 42.62 [17.48] N/mm P < .001; 65.94 [24.51] vs 42.62 [17.48] N/mm P = .02, respectively).InterpretationThe tendon–fibrocartilage–bone composite bridging patch achieved higher ultimate tensile load and stiffness at the patch–greater tuberosity repair site compared with traditional repair in a canine model. This composite tissue transforms the traditional tendon-to-bone healing interface (with dissimilar tissues) into a pair of bone-to-bone and tendon-to-tendon interfaces, which may improve healing quality and reduce retear rate.