Biomechanical Comparison of the Modified ML (Mattress Locking) Suture and the Modified MA (Mason-Allen) Suture in Rotator Cuff Repairs

Sang-Hun Ko; Young-Jin Yum; Hyung-Min Jeon; Ki-Bong Park; Tae-Won Kim; Sung-Woo Park; Hyun-Woo Im; Byung-Ki Choi; Jong-Kook Kim

doi:10.4055/jkoa.2010.45.2.120

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Ko, Yum, Jeon, Park, Kim, Park, Im, Choi, and Kim: Biomechanical Comparison of the Modified ML (Mattress Locking) Suture and the Modified MA (Mason-Allen) Suture in Rotator Cuff Repairs

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2010; 45(2): 120-126.

Published online: 19 April 2010

DOI: https://doi.org/10.4055/jkoa.2010.45.2.120

Biomechanical Comparison of the Modified ML (Mattress Locking) Suture and the Modified MA (Mason-Allen) Suture in Rotator Cuff Repairs

Sang-Hun Ko, M.D., Young-Jin Yum, Ph.D.^*, Hyung-Min Jeon, M.D., Ki-Bong Park, M.D., Tae-Won Kim, M.D., Sung-Woo Park^*, Hyun-Woo Im^*, Byung-Ki Choi^*, Jong-Kook Kim^*

Department of Orthopedic Surgery, Arthro-center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

^*School of Mechanical and Automotive Engineering University of Ulsan, Ulsan, Korea.

Correspondence to: Sang-Hun Ko, M.D. Department of Orthopedic Surgery, Ulsan University Hospital, 290-3, Jeonha-dong, Dong-gu, Ulsan 682-714, Korea. TEL: +82-52-250-7129, FAX: +82-52-235-2823, shkoshko@yahoo.co.kr

Received 1 June 2009 Accepted 6 February 2010

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

In arthroscopic rotator cuff repairs, there is generally a weak link in the tendon suture interface, and arthroscopic rotator cuff repairs can have higher retear rates than open repairs. The purpose of this study was to compare the strength of modified ML (Mattress Locking) suture vs. the modified MA (Mason-Allen) suture when the suture is anchored into bone.

Materials and Methods

Paired human supraspinatus tendons were harvested and split in half, producing four tendons per one cadaver, for a total of 24 specimens. Two suture configurations (ML, MA) were randomized and checked for each set of tendons. Specimens were cyclically loaded under force control between 5 and 30 N at 0.25 Hz for fifty cycles. Each specimen was loaded to failure under displacement control at 1 mm/sec. Cyclic elongation, peak to peak displacement, stiffness, ultimate tensile load, and mode of failure were checked.

Results

No significant difference was found between the two suture configuration with respect to peak to peak displacement, cyclic elongation, and stiffness. With regard to ultimate failure load, there were no statistically significant differences between the modified ML suture and the modified MA suture (223.18N, 220.82N). The most common mode of failure between both sutures was suture pullout.

Conclusion

The modified ML suture and the modified MA suture have similar biomechanical properties. The modified ML suture may be a simple and clever method and similar biomechanical alternative to the modified Mason-Allen suture in arthroscopic rotator cuff repair.

Keywords: modified ml (mattress locking) suture, modified ma (mason-allen) suture

Figures and Tables

Figure 1

Modified Mason-Allen suture diagram.

Figure 2

Modified mattress locking suture diagram.

Figure 3

(A) Each specimen was loaded to failure under displacement control at the speed of 1 mm/sec. (B) The gray color tape is a laser marker and the bright red line is laser beam.

Table 1

Conditioning Elongation and Peak-to-Peak Elongation on Modified Mattress Locking Suture

Table 2

Conditioning Elongation and Peak-to-Peak Elongation on Modified Mason-Allen Suture

Table 3

Ultimate Tensile Load and Stiffness on Modified Mattress Locking Suture

Table 4

Ultimate Tensile Load and Stiffness on Modified Mason-Allen Suture

References

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