Low incidence of adverse events or construct failure of a novel high-strength No.2 round suture in rotator cuff repair: An IDEAL Stage 2a assessment retrospective cohort analysis

Abstract

Background: Despite technical and material improvements in rotator cuff repair (RCR) clinical and radiological failure remains common. Following suture fixation, tension and footprint compression decrease from time zero. A novel suture (Dynacord, Depuy Synthes) has been designed to shorten when submerged in liquid to maintain tension and increase repair construct security. Methods: A retrospective cohort analysis was performed on the PRULO (Patient Reported Outcomes in Upper Limb Surgery) registry for 12 months follow up after RCR using this suture regarding all cause failure, rates of common complications, Quick Disability of the Arm, Shoulder and Hand (QuickDASH), and Western Ontario Rotator Cuff Index (WORC). Summary statistics were generated for patient characteristics and patient-reported outcome measures (PROMs) analysed using multiple imputation and a linear model to assess changes over 12 months follow up. Results: A cohort of 236 cases was included for analysis. Complication rates and functional improvements were comparable to literature on similar sutures. At 12 months follow up, all-cause failure occurred in 12% of cases, and mean scores for QuickDASH decreased by 37 and WORC increased by 44, both of which surpass the minimum clinically important difference. Our observed rates of complications are as follows: Infection 2.1%, stiffness/capsulitis 11% and retear 12%. Conclusion: The novel suture demonstrated favourable safety and efficacy profiles, with outcomes comparable to those published for commonly used sutures. This study through an IDEAL 2a framework for surgical innovation highlights this suture as safe, effective in mitigating common failure mechanisms and having satisfactory outcomes in RCR.

Competing Interest Statement

The investigators disclose a funding arrangement with Johnson & Johnson Medical Pty Ltd for EBM Analytics to manage data custodianship of a clinical outcomes registry, and for assistance with running and documentation of this study. Johnson & Johnson Medical Pty Ltd did not provide staff, materials or facilities under this arrangement, and do not have access to the registry database or any identifying information from it. Industry sponsors had no role in the design, collection, management, analysis or interpretation of the data or writing of the manuscript. A copy of the manuscript was provided to Johnson & Johnson Medical Pty Ltd prior to submission for peer-review, but the sponsor had no role in the decision to submit.

Clinical Protocols

https://academic.oup.com/jsprm/article/2023/4/snad014/7317733

Funding Statement

The investigators disclose a funding arrangement with DePuy Mitek (Johnson & Johnson Medical Pty Ltd) for EBM Analytics to manage data custodianship of a clinical outcomes registry, and for assistance with running and documentation of this study. Johnson & Johnson Medical Pty Ltd did not provide staff, materials or facilities under this arrangement, do not have access to the registry database or any identifying information from it. Industry sponsors had no role in the design, collection, management, analysis or interpretation of the data or writing of the manuscript. A copy of the manuscript was provided to Johnson & Johnson Medical Pty Ltd prior to submission for peer-review, but the sponsor had no role in the decision to submit.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for the study was obtained from the Barwon Health Research Ethics Committee

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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