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. 2016 Jan-Mar;10(1):3-9.
doi: 10.4103/0973-6042.174511.

Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair

Brody A Flanagin  1 , Raffaele Garofalo  2 , Eddie Y Lo  3 , LeeAnne Feher  1 , Alessandro Castagna  4 , Huanying Qin  1 , Sumant G Krishnan  1
Affiliations

Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair

Brody A Flanagin et al. Int J Shoulder Surg. 2016 Jan-Mar.

Abstract

Purpose: Arthroscopic transosseous (TO) rotator cuff repair has recently emerged as a new option for surgical treatment of symptomatic rotator cuff tears. Limited data is available regarding outcomes using this technique. This study evaluated midterm clinical outcomes following a novel arthroscopic TO (anchorless) rotator cuff repair technique.

Materials and methods: A consecutive series of 107 patients and 109 shoulders underwent arthroscopic TO (anchorless) rotator cuff repair for a symptomatic full-thickness tear. Pre and postoperative range of motion (ROM) was compared at an average of 11.8 months. Postoperative outcome scores were obtained at an average of 38.0 months. Statistical analysis was performed to compare pre and postoperative ROM data. Univariate analysis was performed using Student's t-test to compare the effect of other clinical characteristics on final outcome.

Results: Statistically significant improvements were noted in forward flexion, external rotation and internal rotation (P < 0.0001). Average postoperative subjective shoulder value was 93.7, simple shoulder test 11.6, and American Shoulder and Elbow Surgeons (ASES) score 94.6. According to ASES scores, results for the 109 shoulders available for final follow-up were excellent in 95 (87.1%), good in 8 (7.3%), fair in 3 (2.8%), and poor in 3 (2.8%). There was no difference in ROM or outcome scores in patients who underwent a concomitant biceps procedure (tenodesis or tenotomy) compared with those who did not. Furthermore, there was no significant difference in outcome between patients who underwent either biceps tenodesis or tenotomy. Age, history of injury preceding the onset of pain, tear size, number of TO tunnels required to perform the repair, and presence of fatty infiltration did not correlate with postoperative ROM or subjective outcome measures at final follow-up. Two complications and four failures were noted.

Conclusions: Arthroscopic TO rotator cuff repair technique leads to statistically significant midterm improvement in ROM and satisfactory midterm subjective outcome scores with low complication/failure rates in patients with average medium-sized rotator cuff tears with minimal fatty infiltration. Further work is required to evaluate radiographic healing rates with this technique and to compare outcomes following suture anchor repair.

Level of evidence: Level IV.

Keywords: Arthroscopic transosseous rotator cuff repair; rotator cuff tear; shoulder arthroscopy; suture anchors.

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Figures

Figure 1
Figure 1
Arthroscopic pictures of one tunnel simple (left), two tunnel mattress (middle), and two tunnel XBOX (right) repair configurations
Figure 2
Figure 2
Schematic drawings of one tunnel simple (left), two tunnel mattress (middle), and two tunnel XBOX (right) repair configurations
See this image and copyright information in PMC

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