caa a22 4500 605456968 CHVBK 20210128100220.0 cr unu---uuuuu 210128e20150901xx s 000 0 eng 10.1007/s00167-014-3008-3 doi (NATIONALLICENCE)springer-10.1007/s00167-014-3008-3 Pectoralis major tendon repair: a biomechanical study of suture button versus transosseous suture techniques [Elektronische Daten] [William Thomas, Sabina Gheduzzi, Iain Packham] Purpose: Pectoralis major tendon avulsion injury benefits from surgical repair. The technique used and speed of rehabilitation in this demanding population remains subject to debate. We performed a biomechanical study comparing suture button (Pec Button™, Arthrex, Naples, FL) with a transosseous suture technique (FibreWire, Arthrex, Naples, FL). Methods: Freshly slaughtered porcine humeri were prepared to model a single transosseous suture or suture button repair. A static, tensile load to failure experiment and a cyclic, tensile load experiment to model standard (10,000 cycles) and accelerated rehabilitation (20,000 cycles) philosophies were tested. The mode of failure, yield and ultimate failure load, extension (clinical failure >10mm) and the resistance to cyclic loading was measured. Results: The mode of failure was suture fracture in all the static load experiments with 10/11 occurring as the suture passed through the button and 7/11 as the suture passed through the bone tunnels. There was a significant difference in yield load, favouring transosseous suture [p=0.009, suture button (SB) 673.0N (647.2-691.7N), transosseous suture (TOS) 855.0N (750.0-891.4N)] and median extension, favouring suture button [p=0.009, SB 8.8mm (5.0-12.4mm), TOS 15.2mm (13.2-17.1mm)]. 2/3 transosseous suture and 0/3 suture buttons failed before completing 20,000 cycles. The difference in mean number of cycles completed was non-significant. The difference in mean extension was 5.1mm (SB 6.7mm, TOS 11.7mm). Conclusions: Both techniques show advantages. The difference in extension is likely to be more clinically relevant than load tolerated at failure, which is well above physiological levels. The findings do not support an accelerated rehabilitation model. Springer-Verlag Berlin Heidelberg, 2014 Pectoralis major repair nationallicence Transosseous suture nationallicence Pec button nationallicence Rehabilitation nationallicence Thomas William Exeter Shoulder and Elbow Team, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK aut Gheduzzi Sabina Orthopaedic Department, Avon Orthopaedic Center, Bristol, UK aut Packham Iain Department of Mechanical Engineering, Centre for Orthopaedic Biomechanics, University of Bath, Bath, UK aut Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/9(2015-09-01), 2617-2623 0942-2056 23:9<2617 2015 23 167 https://doi.org/10.1007/s00167-014-3008-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00167-014-3008-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Thomas William Exeter Shoulder and Elbow Team, Princess Elizabeth Orthopaedic Centre, Royal Devon and Exeter Hospital, Exeter, UK aut NATIONALLICENCE 700 1- Gheduzzi Sabina Orthopaedic Department, Avon Orthopaedic Center, Bristol, UK aut NATIONALLICENCE 700 1- Packham Iain Department of Mechanical Engineering, Centre for Orthopaedic Biomechanics, University of Bath, Bath, UK aut NATIONALLICENCE 773 0- Knee Surgery, Sports Traumatology, Arthroscopy Springer Berlin Heidelberg 23/9(2015-09-01), 2617-2623 0942-2056 23:9<2617 2015 23 167