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Purpose . To compare the biomechanical properties of 3 suture-bridge techniques for rotator cuff repair.  Methods . Twelve pair-matched fresh-frozen shoulder specimens were randomized to 3 groups of different repair types: the medially Knotted Suture Bridge (KSB), the medially Untied Suture Bridge (USB), and the Modified Suture Bridge (MSB). Cyclic loading and load-to-failure test were performed. Parameters of elongation, stiffness, load at failure, and mode of failure were recorded.  Results . The MSB technique had the significantly greatest load to failure (515.6 ± 78.0 N,  P  = 0.04 for KSB group;  P  < 0.001 for USB group), stiffness (58.0 ± 10.7 N/mm,  P  = 0.005 for KSB group;  P  < 0.001 for USB group), and lowest elongation (1.49 ± 0.39 mm,  P  = 0.009 for KSB group;  P  = 0.001 for USB group) among 3 groups. The KSB repair had significantly higher ultimate load (443.5 ± 65.0 N) than USB repair (363.5 ± 52.3 N,  P  = 0.024). However, there was no statistical difference in stiffness and elongation between KSB and USB technique ( P  = 0.396 for stiffness and  P  = 0.242 for elongation, resp.). The failure mode for all specimens was suture pulling through the cuff tendon.  Conclusions . Our modified suture bridge technique (MSB) may provide enhanced biomechanical properties when compared with medially knotted or knotless repair.  Clinical Relevance . Our modified technique may represent a promising alternative in arthroscopic rotator cuff repair.

Biomechanical Comparison of Modified Suture Bridge Using Rip-Stop versus Traditional Suture Bridge for Rotator Cuff Repair