MARGIN CONVERGENCE - A METHOD OF REDUCING STRAIN IN MASSIVE ROTATOR CUFF TEARS

Increased security of fixation in rotator cuff repair is usually achie ved by increasing the strength of fixation. Paradoxically, the problem can be approached by techniques that decrease the strain at the margi ns of the tear so that weaker fixation will still be adequate. Such te chniques provide greater safety tolerances for the strength characteri stics of suture, tendon, and bone. The principle of margin convergence can be applied to rotator cuff repair as a means to enhance the secur ity of fixation by decreasing the mechanical strain at the margins of the tear. This strain reduction should also contribute to pain reducti on by virtue of decreased stimulation of mechanoreceptors in the rotat or cuff. The cliche no pain, no strain can be converted to a paradigm by reversal of its components to no strain, no pain.