Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears

Choi, Sung Wook; Kim, Myung Ku; Kim, Gyeong Min; Roh, Young Ho; Hwang, Im Kyung; Kang, Hyunseong

doi:10.1016/j.jse.2014.02.021

Cited by 106 publications

(77 citation statements)

References 21 publications

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“…These findings are similar to other reported clinical improvements following rotator cuff repair 4,5,23 . While a recent study has suggested that some functional clinical scores are not different between patient with intact repairs and those with retears 5 , other studies have demonstrated a correlation between repair integrity and clinical improvement 4,23 . Additional studies are needed to confirm the importance of cuff integrity on long-term cuff function.…”

supporting

confidence: 92%

“…There was no control (no implant) group, the study only examined 9 patients, and the size of the rotator cuff lesions repaired in the current study ranged from 1-3 cm. Although it is well-established that tear size has a direct correlation to re-tear rate 3 , several studies have reported significant re-tear rates of 11% to 28.6% in mediumsized (1-3 cm) tears 3,6,23,24 . Therefore, using peerreviewed data as historic controls, it could be expected that at least one re-tear would have occurred in a similar number of patients with medium-sized (1-3 cm) tears.…”

mentioning

confidence: 99%

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Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Bokor

Sonnabend

Deady³

et al. 2015

MLTJ

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tissue matured over time and became indistinguishable from the underlying tendon. At 24 months all repairs remained intact and normal footprint anatomy of the tendon was restored in all patients. All clinical scores improved significantly over time. Conclusion: the ability of a collagen implant to induce new host tissue formation and restore the normal footprint anatomy may represent a significant advancement in the biological augmentation and ultimate durability of rotator cuff repairs. KEY WORDS: collagen implant, cuff repair, footprint, tendon. IntroductionRotator cuff repair is one of the most common orthopaedic procedures performed, with between 200,000 and 300,000 rotator cuffs being surgically repaired annually 1, 2 . Although surgical techniques for rotator cuff repair have advanced over the last decade, one of the most important postoperative complications of rotator cuff repair is re-tear of the repaired tendon 3 . Recent estimates suggest that retear rates in rotator cuff repair are in the order of 11 to 57% 3 . While studies have suggested that re-torn repairs can still provide clinical benefit to patients, subjective and objective outcome metrics in these patients are inferior to those patients with intact repairs [3][4][5] . Re-tear of a rotator cuff repair has been associated with a multitude of factors including patient age, tear dimensions, and tendon tissue quality 3 . However, a recent report of 1000 consecutive rotator cuff repairs found that no single preoperative or intra-operative factor was overwhelmingly predictive of re-tearing 3 . Several studies have suggested that the biomechanical environment of the healing tendon may also play a significant role in the ability to achieve a durable rotator cuff repair [6][7][8][9][10] . These studies have advocated restoring the normal footprint dimensions of the rotator cuff tendon attachment to bone and decreasing tissue strain in the healing tendon as techniques to improve the long-term integrity of rotator cuff repairs [6][7][8][9][10] . Biomechanical analysis of surgical techniques such as the 'double-row' fixation, which utilizes two rows of tendon fixation to bone to increase the contact area of the tendon attachment to bone, has shown improved initial tendon contact and strength 10 and also decreased tendon strain 8 . How- SummaryBackground: the inability to restore the normal tendon footprint and limit strains on the repair site are thought to contribute to re-tearing following rotator cuff repair. The purpose of this study was to use a collagen implant to augment rotator cuff repairs through the restoration of the native tendon footprint and the induction of new tissue to decrease overall tendon strain. Methods: repairs of full-thickness rotator cuff lesions in 9 adult patients were augmented with a novel collagen implant placed over the bursal surface of the repair. Tendon thickness and footprint anatomy were evaluated using MRI at 3, 6, 12, and 24 months. Clinical results were assessed using standard outcome metrics. Mean follow-up for ...

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supporting

confidence: 92%

mentioning

confidence: 99%

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Bokor

Sonnabend

Deady³

et al. 2015

MLTJ

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“…Systematic literature reviews have not found a significant difference in percentage of re-tears based on the technique used for cuff repair, nor have more recent articles comparing newer techniques of fixation such as the suturebridge technique [85,86]. There has also been recent focus to determine whether or not clinical results are associated with the ultimate integrity of the repair; however, patients are found to do well clinically even when their repairs have failed radiographically [87][88][89][90][91]. Further stratification of these findings has been difficult to interpret as many studies have utilized different outcome scores and different imaging modalities when providing their results.…”

Section: Osteonecrosismentioning

confidence: 99%

“…Tear size, muscle atrophy, fatty infiltration, age, and level of work have all been recognized as potential reasons that some RCRs end in re-tear [88,93]. Many of these available studies are retrospective reviews that were conducted to determine if the rate of re-tear was acceptable in determining whether or not to perform a RCR based on the size of the original tear.…”

Section: Osteonecrosismentioning

confidence: 99%

Management of complications after rotator cuff surgery

Parada

Dilisio

Kennedy

2014

Curr Rev Musculoskelet Med

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Rotator cuff repair (RCR) is a common procedure performed by orthopedic surgeons via arthroscopic, open, or mini-open techniques. While this surgery is considered to be of low morbidity, several potential complications can arise either intraoperatively or during the postoperative time period. Some of these complications are related to the surgical approach (arthroscopic or open), while others are patient dependent. Many of these complications can be managed through nonoperative means; however, early recognition and timely treatment is essential in limiting the long-term sequela and improving patient outcome. There are several different ways to classify complications after RCR repair: timing, severity, preventability, whether or not the pathology is intra-or extraarticular, and the type of treatment necessary. It is essential that the surgeon is cognizant of the etiology contributing to the failed RCR surgery in order to provide timely and proper management.

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“…8,9 It is an added advantage over knotless sutures in that traction is realized through the impact of the suture on the lateral implant. 10 Conventional suture bridges reduce cuff tears from traction forces exerted on the medial row, which makes for cases of retearing being located on the myotendinous junction. These are tragic circumstances for the future of the sleeve, especially if we try to make a new repair.…”

Section: Discussionmentioning

confidence: 99%

All-Suture Repair for Compressive Rotator Cuff Tears: Reducing the Traction of the Tissue

Uroz¹,

Abat²,

Díaz³

2017

Arthroscopy Techniques

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Tears of the rotator cuff are a frequent pathology, but the best surgical procedure remains unclear. The arthroscopic approach has become the gold standard, but there are many different suture configurations that can be used. We describe an all-suture repair system with which the anatomical reduction of the rotator cuff is achieved performing traction from the anchor of the lateral row to subsequently performing a suture bridge suture from the medial row. The major advantage of this technique is that it creates compression forces and minimizing tensioning of the tissue.

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Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears

Cited by 106 publications

References 21 publications

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Management of complications after rotator cuff surgery

All-Suture Repair for Compressive Rotator Cuff Tears: Reducing the Traction of the Tissue

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