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Comparative Study
. 2018 Nov 22;13(1):297.
doi: 10.1186/s13018-018-0990-z.

Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying

Hirokazu Honda  1 , Masafumi Gotoh  2 , Yasuhiro Mitsui  1 , Hidehiro Nakamura  3 , Ryo Tanesue  1 , Hisao Shimokobe  3 , Naoto Shiba  3
Affiliations
Comparative Study

Clinical and structural outcomes after arthroscopic rotator cuff repair: a comparison between suture bridge techniques with or without medial knot tying

Hirokazu Honda et al. J Orthop Surg Res. .

Abstract

Purpose: To compare arthroscopic suture bridge (SB) techniques with medial tying to those without tying, considering clinical and structural outcomes.

Methods: We included 124 patients with rotator cuff tears after arthroscopic rotator cuff repair (ARCR). Fifty-three patients with clinical and structural evaluations 3, 12, and 24 months postoperatively were included and divided into 29 patients with medial tying (WMT group) and 24 without tying (WOMT group). Clinical outcomes comprised the University of California Los Angeles (UCLA) and Japanese Orthopaedic Association (JOA) scores. Structural outcomes were evaluated with magnetic resonance images (MRI) using Sugaya classifications.

Results: JOA and UCLA scores in the WMT and WOMT groups improved significantly from before surgery to 24 months after surgery (P < 0.01, respectively). No significant difference was noted between groups. No significant postoperative retears (Sugaya types 4 and 5) between WMT and WOMT groups were noted at 3 months (5 vs 3 cases), 12 months (6 vs 5 cases), and 24 months (7 vs 6 cases) postoperatively. Complete healing (Sugaya type 1) was noted at 3 months (8 vs 11 cases), 12 months (10 vs 10 cases), and 24 months (8 vs 13 cases, P = 0.024) postoperatively. Incomplete healing (Sugaya types 2 and 3) were noted at 3 months (16 vs 10 cases), 12 months (13 vs 9 cases), and 24 months (14 vs 5 cases, P = 0.024) postoperatively.

Conclusion: Clinical outcomes for both techniques were comparable, but the number of incompletely healed tendons in SB with medial tying was significantly larger at 24 months after surgery.

Level of evidence: This study is a level III, case-control study.

Clinical relevance: This study revealed the influence of medial tying in rotator cuff repair.

Keywords: Arthroscopic rotator cuff repair; Medial tying; Suture bridge.

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Conflict of interest statement

Ethics approval and consent to participate

This study has been approved by the research ethics committee of Kurume University (#13306). Written informed consent was obtained from the patient for publication of this study and accompanying images.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a Schematic showing the surgical procedures with medial knot tying. b Schematic showing the surgical procedures without medial knot tying
See this image and copyright information in PMC

References

    1. Boyer P, Bouthors C, Delcourt T, Stewart O, Hamida F, Mylle G, et al. Arthroscopic double-row cuff repair with suture bridging: a structural and functional comparison of two techniques. Knee Surg Sports Traumatol Arthrosc. 2015;23:478–486. doi: 10.1007/s00167-013-2401-7. - DOI - PubMed
    1. Busfield BT, Glousman RE, McGarry MH, Tibone JE, Lee TQ. A biomechanical comparison of 2 technical variations of double-row rotator cuff fixation: the importance of medial row knots. Am J Sports Med. 2008;36:901–906. doi: 10.1177/0363546507312640.. - DOI - PubMed
    1. Cho NS, Yi JW, Lee BG, Rhee YG. Retear patterns after arthroscopic rotator cuff repair: single-row versus suture bridge technique. Am J Sports Med. 2010;38:664–671. doi: 10.1177/0363546509350081. - DOI - PubMed
    1. Christoforetti JJ, Krupp RJ, Singleton SB, Kissenberth MJ, Cook C, Hawkins RJ. Arthroscopic suture bridge transosseous equivalent fixation of rotator cuff tendon preserves intratendinous blood flow at the time of initial fixation. J Shoulder Elbow Surg. 2012;21(4):523–530. doi: 10.1016/j.jse.2011.02.012. - DOI - PubMed
    1. Gereber C, Schneeberger AG, Beck M, Schlegel U. Mechanical strength of repairs of the rotator cuff. J Bone Joint Surg Br. 1994;76:371–380. doi: 10.1302/0301-620X.76B3.8175836. - DOI - PubMed

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