Clinical outcomes of arthroscopic rotator cuff repair: a retrospective comparison of double-layer, double-row and suture bridge methods

Kakoi, Hironori; Izumi, Toshihiko; Fujii, Yasuhiro; Nagano, Satoshi; Setoguchi, Takao; Ishidou, Yasuhiro; Komiya, Setsuro

doi:10.1186/s12891-018-2244-y

Cited by 12 publications

(17 citation statements)

References 25 publications

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“…In general, rotator cuff repair techniques are divided into singlerow and double-row repair techniques. It has been reported that there was no statistical difference in retear rate between the two techniques [14]; however, long-term follow-ups and systematic review studies have shown that the retear rate after single-row repair was signi cantly higher than that after double-row repair [8,17].…”

Section: Discussionmentioning

confidence: 97%

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Five Years Follow-up After Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique: Evaluation of the Retear Rate and the Impairment of the Shoulder Function

Zhang¹,

Shi²,

Liu³

et al. 2020

Preprint

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Purpose: To evaluate the retear rate after arthroscopic rotator cuff repair using a suture bridge (SB) technique for patients with full thickness rotator cuff tears and whether the non- healing cuff impaired the shoulder function.Methods: From January 2013 to January 2014, 92 patients in our institution underwent arthroscopic double-row suture bridge repair for the treatment of full-thickness rotator cuff tear 55 patients who have completed the 5 years follow-up were enrolled in this study. There were 36 female and 19 male patients, and the average age was 58.6 years (range, 41- 70 years). The tears were classified into small (<1 cm), medium (1-3 cm), large (3-5 cm), and massive (> 5 cm) according to the classification of DeOrio and Cofield. According to the intraoperative measurement, small tears were found in 5 shoulders (9%), medium tears in 19 shoulders (34.5%), large tears in 23 shoulders (41.8%), and massive tears in 8 shoulders (14.5%). The mean follow-up was 71.2 months (range, 66-78 months). Post-operative cuff integrity was evaluated with ultrasound (US) according to the published literature which was comparable to Sugaya MRI classification. Types I-III indicated cuff healing and types IV or V indicated retear. The retear patterns were divided into type 1 (failure at the original repair site) or 2 (failure around the medial row). At baseline and final follow-up, shoulder functional outcomes were measured using validated, shoulder-specific outcome scores, including the Constant-Murley score (CS) and the American Shoulder and Elbow Score (ASES). The difference in abduction muscle strength was also evaluated between the integrity and the retear group.Results: At final follow-up, the rotator cuff was completely healed in 45 of the 55 shoulders. There were recurrent tears in 10 shoulders, and the retear rate was 18.2%. The type 1 re- tear pattern was found in 4 shoulders (40%), and type 2 in 6 shoulders (60%). The Constant and ASES scores improved from 41.00 to 92.00, and from 41.33 to 88.00, respectively. The mean differences in shoulder scaption strength between the healing and the retear group were 1.1±0.82Kg and 3.0±0.88Kg respectively. The difference in muscle strength between the retear and the healing group was statistically significant (p<0.001).Conclusion: Arthroscopic suture bridge repair of full-thickness rotator cuff tears led to excellent improvement in shoulder function, but maintained a high retear rate. Although the retear group had inferior muscle strength, the patients were still satisfied, and shoulder function was improved due to pain relief. Whether such changes in muscle strength impair patients' long-term quality of life and shoulder function remains to be discussed.Level of evidence IV

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Section: Discussionmentioning

confidence: 97%

“…In general, rotator cuff repair techniques are divided into single-row and double-row repair techniques. It has been reported that there was no statistical difference in retear rate between the two techniques [14];…”

Section: Introductionmentioning

confidence: 90%

Five Years Follow-up After Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique: Evaluation of the Retear Rate and the Impairment of the Shoulder Function

Zhang¹,

Shi²,

Liu³

et al. 2020

Preprint

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“…In the study in which Burks et al [41] evaluated the results of medium-sized rotator cuff tears, they detected a retear rate of 10% in both groups at the end of 1 year after single- or double-row repairs. In another recent retrospective study, Kakoi et al [42] couldn't detect any difference between the retear rates of single- and double-row constructs at average 16 months follow-up.…”

Section: Introductionmentioning

confidence: 96%

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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“…The standard treatment for RC tears is surgical reattachment of the torn tendon on to its anatomical insertion. This treatment is reported to result in approximately 50% improvement in shoulder function in 1.5 years [ 5 ]. Although recovery of shoulder function after conservative treatment has been reported to be comparable with surgical repair [ 6 ], healing of the injured tendons was less favourable.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of animal models and methods for assessing shoulder function after rotator cuff tear: A systematic review

Liu

Leong

et al. 2021

Journal of Orthopaedic Translation

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Clinical outcomes of arthroscopic rotator cuff repair: a retrospective comparison of double-layer, double-row and suture bridge methods

Cited by 12 publications

References 25 publications

Five Years Follow-up After Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique: Evaluation of the Retear Rate and the Impairment of the Shoulder Function

Five Years Follow-up After Arthroscopic Rotator Cuff Repair Using Suture Bridge Technique: Evaluation of the Retear Rate and the Impairment of the Shoulder Function

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

Evaluation of animal models and methods for assessing shoulder function after rotator cuff tear: A systematic review

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