Arthroscopic suture-bridge repair for small to medium size supraspinatus tear: healing rate and retear pattern

Abstract

Purpose: The purpose of the study was to assess the repair site integrity after transosseous equivalent/suture-bridge (TOE/SB) repair with the use of magnetic resonance imaging (MRI).

Methods: One hundred seven consecutive shoulders with a small to medium-size full-thickness supraspinatus tear were repaired arthroscopically with use of the TOE/SB technique. There were 64 men and 41 women, and mean age at the time of surgery was 54.8 years (range, 21 to 74 years). All patients underwent postoperative MRI and clinical examination. Mean follow-up was 16.1 months (range, 12 to 28 months).

Results: The mean Constant score improved from 54.5 ± 12.5 points preoperatively to 80 ± 12.1 points postoperatively (P < .0001). The mean pain score improved from 7 ± 2 points preoperatively to 13 ± 2.5 postoperatively (P < .0001). The mean active forward flexion improved from 151° ± 37° preoperatively to 169° ± 14° postoperatively (P < .0001). The mean Constant score was 81 points when repaired tendon had healed and it was 72.6 points when repaired tendon was unhealed (P = .02). Smoking status was found to have detrimental influence on the tendon healing (P = .04). Postoperative MRI showed a healed repair in 96 (89.7%) of 107 shoulders. Among 11 retears, 10 occurred at the greater tuberosity and 1 occurred at the musculotendinous junction.

Conclusions: Arthroscopic TOE/SB repair of full-thickness supraspinatus tendon led to a healing rate of 89.7%. Patients with healed tendons according to MRI had significant better functional and subjective outcome. Smoking habit was found to be detrimental on healing. Retears occurred mainly at tendon-bone interface at the greater tuberosity, whereas medial cuff failure was observed in only one case in the mean time of follow-up.

Level of evidence: Level IV, therapeutic case series.