Clinical and radiologic outcome of arthroscopic rotator cuff repair: single-row versus transosseous equivalent repair

Jeong, Jeung Yeol; Park, Keun Min; Sundar, Shyam; Yoo, Jae Chul

doi:10.1016/j.jse.2017.10.040

Cited by 41 publications

(42 citation statements)

References 29 publications

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“…In their prospectively designed study, Hantes et al [38] couldn't detect any functional difference between single and double-row repairs, despite the superior tendon healing in double-row group. Jeong et al [63] also reported similar functional outcomes between single-row repair and TOE repair in a large retrospective cohort study including 415 patients.…”

Section: Introductionmentioning

confidence: 72%

Arthroscopic double-row rotator cuff repair: a comprehensive review of the literature

Aydın¹,

Karaismailoğlu²,

Gürcan³

et al. 2018

SICOT-J

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Rotator cuff repairs seek to achieve adequate tendon fixation and to secure the fixation during the process of biological healing. Currently, arthroscopic rotator cuff repair has become the gold standard. One of the earliest defined techniques is single-row repair but the inadequacy of single-row repair to precisely restore the anatomical footprint as well as the significant rates of retear especially in large tears have led surgeons to seek other techniques. Double-row repair techniques, which have been developed in response to these concerns, have various modifications like the number and placement of anchors and suture configurations.When the literature is reviewed, it is possible to say that double-row repairs demonstrate superior biomechanical properties. In regard to retear rates, both double row and transosseous equivalent (TOE) techniques have also yielded more favorable outcomes compared to single-row repair. But the clinical results are conflicting and more studies have to be conducted. However, it is more probable that superior structural integrity will yield better structural and functional results in the long run. TOE repair technique is regarded as promising in terms of better biomechanics and healing since it provides better footprint contact. Knotless TOE structures are believed to reduce impingement on the medial side of tendons and thus aid in tendon nutrition; however, there are not enough studies about its effectiveness.It is important to optimize the costs without endangering the treatment of the patients. We believe that the arthroscopic TOE repair technique will yield superior results in regard to both repair integrity and functionality, especially with tears larger than 3 cm. Although defining the pattern of the tear is one of the most important guiding steps when selecting the repair technique, the surgeon should not forget to evaluate every patient individually for tendon healing capacity and functional expectations.

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Section: Introductionmentioning

confidence: 72%

Arthroscopic double-row rotator cuff repair: a comprehensive review of the literature

Aydın¹,

Karaismailoğlu²,

Gürcan³

et al. 2018

SICOT-J

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“…After surgery, patients underwent standard rehabilitation. 8 Muscle strengthening exercises were started at 12 weeks postoperatively. Exercise training consisted of shoulder extension, internal rotation, external rotation, and scaption exercises using a resistance band.…”

Section: Surgical Procedures and Rehabilitationmentioning

confidence: 99%

Clinical Outcomes of Nonoperative Treatment for Rotator Cuff Retears and Analysis of Factors That Affect Outcomes

Shim

Lee

Yoo

2020

Orthopaedic Journal of Sports Medicine

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Background: Patients who sustain a rotator cuff retear after arthroscopic rotator cuff repair are generally considered to have worse clinical outcomes compared with patients with an intact rotator cuff. However, some patients have good clinical outcomes, even with a retorn rotator cuff. Purpose: To report the clinical outcomes of nonoperative treatment for rotator cuff retears and analyze the factors affecting clinical outcomes after a retear. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent arthroscopic rotator cuff repair between 2011 and 2017 were reviewed, and those with a full-thickness retear on postoperative magnetic resonance imaging (MRI) were included in this study. According to their pre- and postoperative scores on the pain visual analog scale (pVAS) and functional visual analog scale (fVAS), the patients were divided into 3 groups: (1) mild group (pVAS ≤ 1 and fVAS ≥ 8), (2) moderate group (pVAS ≤ 1 and fVAS ≤ 7 or pVAS 2-3 and fVAS ≥ 8), and (3) severe group (pVAS ≥ 3 and fVAS ≤ 7). Preoperative data (dominant hand involvement, heavy labor) and tear size on 6-month postoperative MRI were analyzed as factors affecting clinical outcomes. Results: A total of 712 patients were reviewed, and a retear was observed in 62 patients (8.7%). Of the patients with retears, 52 were included in this study: 25 men and 27 women with a mean age of 62.6 years (range, 49-80 years) and mean follow-up period of 40 months (range, 24-88 months). According to the pVAS and fVAS scores, 25 patients (48.1%) were classified into the mild group, 9 (17.3%) into the moderate group, and 18 (34.6%) into the severe group. There were no significant differences in preoperative data among the 3 groups. The tear size in the coronal and sagittal planes decreased by 5.1 and 6.6 mm, respectively, in the mild group but increased by 2.8 and 1.4 mm, respectively, in the severe group. Conclusion: In patients with retears, 48.1% had only mild symptoms at a mean of 40 months postoperatively. Patients with severe symptoms tended to have an increased tear size on postoperative MRI.

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“…Nicholas et al [19] 2016 II 49 SR = DR -All size Transosseous equivalent SR: single row repair; DR, double row repair; MRA: Magnetic Resonance arthrography; PRP: platelet-rich plasma fibrin membrane. [20] 2012 108 1980-2012 -Roth et al [21] 2014 10(7 level I studies and 3 level 2 studies) 2007-2013 SR = DR Ying et al [22] 2015 11(7 level I studies and 4 level 2 studies) 2007-2012 SR < DR; in large tears Sobhy et al [23] [7][8][9] reported better clinical outcomes of DR compared to SR, whereas some [10][11][12][13] described no difference of clinical outcomes between SR and DR. The purpose of this article was to review the current evidence regarding outcomes of DR.…”

Section: Radiological Assessment Tear Size Dr Techniques Othersmentioning

confidence: 99%

Arthroscopic Rotator Cuff Repair: Single or Double Row?

Titchener

D’sa

Gaden

et al. 2019

International Journal of Orthopaedics

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BACKGROUND: Surgical techniques for rotator cuff tears have improved from single row repair (SR) to double row repair (DR) including transosseous equivalent repair as new surgical devices or suture anchors were developed. Many biomechanical evidence favors DR with respect to footprint contact area and pressure and compression for cuff tendons. Some surgeons reported better clinical outcomes of DR compared to SR, whereas some described no difference of clinical outcomes between SR and DR. The purpose of this article was to review the current evidence regarding outcomes of DR comparing to SR and clarify whether better clinical or radiological outcomes can be obtained by performing DR. METHODS: We conducted a systematic review of clinical studies published for last 5 years which compared SR to DR. A systematic review of the literature was performed to identify all publications in the English literature. The databases MEDLINE and Google Scholar were searched. Also, we reviewed the latest systematic review and meta-analysis published between 2012 and 2018. RESULTS: Four clinical articles with evidence Levels I or II published in last 5 years were identified. Two of them documented superiority of DR over SR. Four systematic review and meta-analysis published between 2012 and 2018 were identified. Among them, two showed that DR provides better clinical outcomes and a lower retear rate compared with SR but its superiority is seen in the limited situation (only large tears or UCLA score). CONCLUSION: Although some reports with higher evidence Levels showed DR provides better clinical outcomes, it may be too early to conclude which repair technique is better because of lack of enough evidence.

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Clinical and radiologic outcome of arthroscopic rotator cuff repair: single-row versus transosseous equivalent repair

Cited by 41 publications

References 29 publications

Arthroscopic double-row rotator cuff repair: a comprehensive review of the literature

Arthroscopic double-row rotator cuff repair: a comprehensive review of the literature

Clinical Outcomes of Nonoperative Treatment for Rotator Cuff Retears and Analysis of Factors That Affect Outcomes

Arthroscopic Rotator Cuff Repair: Single or Double Row?

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