Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up

Abstract

Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 ± 9.19 (38–77) years were included. The mean surgery time was 35.33 ± 5.34 (28–55) min. The mean follow-up time was 28.31 ± 3.03 (24–36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 ± 7.46 (13–41) to 81.25 ± 3.77 (74–87; p = 0.0001) and the Q-DASH score had decreased from 82.34 ± 10.37 (65.91–100) to 10.28 ± 6.88 (0–23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline–final follow-up between the small, medium, large, and massive tear groups ( p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.

Rotator manşet onarımında İki farklı tekniğinin fonksiyonel ve klinik sonuçlarının karşılaştırmalı olarak incelenmesi: sütür ankor ve transosseöz Sharc-FT.

“…In 2016, Flanagin et al published the successful mid-term results of transosseous repair in 109 patients (24). In our present study and another recent study, we achieved good functional and clinical results using the new transosseous device Sharc-FT in mini-open rotator cuff repair (16). In 2018, Dyrna et al (26) compared this new device (Sharc-FT) biomechanically with suture anchor as a revision option following failed rotator cuff surgeries.…”

“…They found that even in revision surgeries, Sharc-FT was a viable option for commonly used suture anchors that provide equivalent fixation properties. Unlike other transosseous methods, this transosseous device has a perforated body that is intended to handle one to four (or more) internal sutures, and it is specially shaped to maximize resistance to tensile strain and to prevent suture-bone interaction (16). Transosseous cortical fixation sutures form a lateral suture with tensile compression within the footprint, greatly increasing weak bone resistance problems, reducing movement at the tendon-footprint interface, increasing fatigue resistance, and homogenizing the load distribution on the footprint, thus optimizing biological recovery (26).…”

“…Sharc-FT® (NCS Lab Srl, Modena, Italy), a novel implantable transosseous device, was designed for rotator cuff surgery using a special instrument, Taylor Stitcher. Recently, we have published satisfactory clinical and functional outcomes of our patients undergoing deltoid-splitting rotator cuff repair using this new transosseous device (16). The aim of the present study was to compare the clinical and functional outcomes of transosseous repair and single-row suture anchor repair in mini-open rotator cuff repairs.…”

Functional outcomes of arthroscopic transosseous rotator cuff repair using a 2-mm tape suture in a 137-patient cohort

“… 3 , 10 More recently, Sandow and Schutz 27 described satisfactory functional and anatomical results with a TO repair in an osteoporotic cohort of 15. Similarly, Arican et al 2 described satisfactory clinical outcomes at >2 years in 70 patients treated with TO repair. In a larger randomized controlled trial of 69 patients, Randelli et al 24 described comparable radiologic and functional results at >3 years between arthroscopic anchor-based and TO repair, while the latter was associated with significantly less postoperative pain.…”