Lim WSR, Yew AKS, Lie H, Chou SM, Lie DTT. Rotator cuff repair with an interposition polypropylene mesh: A biomechanical ovine study. World J Orthop 2023; 14(5): 319-327 [PMID: 37304195 DOI: 10.5312/wjo.v14.i5.319]
Corresponding Author of This Article
Winston Shang Rong Lim, MBBS, Doctor, Department of Orthopaedic Surgery, Singapore General Hospital, Academia Level 4, Outram Road, Singapore 169856, Singapore. limshangrong@msn.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. May 18, 2023; 14(5): 319-327 Published online May 18, 2023. doi: 10.5312/wjo.v14.i5.319
Rotator cuff repair with an interposition polypropylene mesh: A biomechanical ovine study
Winston Shang Rong Lim, Andy Khye Soon Yew, Hannah Lie, Siaw Meng Chou, Denny Tijauw Tjoen Lie
Winston Shang Rong Lim, Andy Khye Soon Yew, Hannah Lie, Denny Tijauw Tjoen Lie, Department of Orthopaedic Surgery, Singapore General Hospital, Singapore 169856, Singapore
Siaw Meng Chou, College of Engineering, Nanyang Technical University, Singapore 797101, Singapore
Author contributions: Lim WSR contributed to the data analysis and manuscript preparation; Lie H contributed to study conception, protocol development, specimen testing and manuscript preparation; Yew AKS contributed to study conception, protocol development, specimen testing and critical review of manuscript; Chou SM contributed to study conception, protocol development and critical review of manuscript; Lie DTT contributed to study conception, protocol development and manuscript preparation; and all authors have reviewed the final manuscript.
Institutional review board statement: This study involved the use of animal joints procured from a local abattoir and approval from our Institutional Animal Care and Use Committee was not required.
Institutional animal care and use committee statement: This study involved the use of animal joints procured from a local abattoir and approval from our Institutional Animal Care and Use Committee was not required.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No other data is available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Winston Shang Rong Lim, MBBS, Doctor, Department of Orthopaedic Surgery, Singapore General Hospital, Academia Level 4, Outram Road, Singapore 169856, Singapore. limshangrong@msn.com
Received: December 15, 2022 Peer-review started: December 15, 2022 First decision: March 14, 2023 Revised: March 31, 2023 Accepted: April 20, 2023 Article in press: April 20, 2023 Published online: May 18, 2023 Processing time: 154 Days and 9 Hours
ARTICLE HIGHLIGHTS
Research background
Augments and scaffolds are increasing in importance in patients with large to massive cuff tears. There is limited data on the mechanical properties of such materials.
Research motivation
The polypropylene mesh is a time tested, bio-compatible material with strong mechanical properties that may be used in rotator cuff repairs to improve the strength of the repair.
Research objectives
To investigate the mechanical properties of rotator cuff tears repaired with a polypropylene interposition graft in an ovine ex-vivo model.
Research methods
We used a polypropylene mesh as an interposition graft between the ends of the tendon to repair a tear in the infraspinatus of fresh sheep shoulders. The mesh was secured to remnant tendon by continuous stitching in seven specimens while mattress stitches were used for eight specimens. Five specimens with an intact tendon were tested. The specimens underwent testing to determine the ultimate failure load and gap formation.
Research results
The mean gap formation after 3000 cycles was significantly lower in the continuous group than the mattress group. The mean ultimate failure load was also significantly higher in the continuous group when compared to mattress stitching or intact tendon.
Research conclusions
The use of a polypropylene mesh is biomechanically suitable as an interposition graft for large rotator cuff tears.
Research perspectives
Further studies such as comparing the biomechanical properties of the polypropylene mesh to other types of commercially available grafts, and an in-vivo ovine study should be undertaken before adopting its use in human patients.
