Abstract / Summary
Massive rotator cuff tears (MRCTs) remain challenging to treat, with high retear rates due to compromised tendon quality and high tension at the repair site. This study aimed to evaluate whether a novel Gleno-Humeral Bridging (GHB) technique improves initial fixation and tendon-bone healing compared with conventional suture bridge (SB) repair. Seventy-five rabbits underwent unilateral supraspinatus tendon transection and were assigned to naïve (N), no repair (NR), SB, or SB + GHB groups. Initial fixation strength was assessed immediately after repair. Healing was evaluated at 4 and 12 weeks postoperatively via biomechanical testing and histologic analysis. Magnetic resonance imaging (MRI) was performed at 12 weeks. One-way ANOVA was used for statistical comparisons. The SB + GHB group showed significantly higher maximum failure load and elastic modulus than the SB group immediately after repair ( P < 0.05). At 12 weeks, the maximum failure load in the SB + GHB group was significantly higher than that in the NR group ( P < 0.05), while no significant difference was found between the SB + GHB and SB groups. MRI revealed reduced muscle atrophy and fatty infiltration in repaired groups versus NR. Histologically, both repaired groups showed organized collagen fibers and tendon maturation, whereas the NR group showed disorganized, loosely packed fibers. In this rabbit model, SB + GHB significantly improved initial fixation strength. At 12 weeks, the SB + GHB group maintained the highest values for all three biomechanical parameters among the three group. These findings suggest that SB + GHB provides superior initial fixation without compromising the mechanical properties of the healed tendon-bone complex.