The purpose of this study was to evaluate whether or not the rotator cuff footprint is restored after single row, triple loaded suture anchor repair. The hypothesis was that the rotator cuff footprint is restored when the tendon heals, even with a single row of suture anchors placed medially in the footprint. A secondary purpose was to evaluate when the rotator cuff footprint is restored after surgery.
This was a prospective study of 100 consecutive arthroscopic rotator cuff repairs done by a single surgeon. The rotator cuff tears were of varying sizes. All tears were repaired arthroscopically with the same triple loaded suture anchor. Tears were repaired with 1 to 3 anchors and margin convergence sutures as deemed necessary by the surgeon. Patients were evaluated by shoulder ultrasound at 6 weeks, 3 months, and 6 months after surgery. UCLA scores were obtained preoperatively and at the same postoperative intervals as the shoulder ultrasound examinations. For statistical analysis, patients were separated into 3 groups based on the anterior to posterior size of the cuff tear determined arthroscopically (<2cm, 2-4 cm, >4cm).
There were 48 rotator cuff tears measuring less than 2 cm and the healing rate, as determined by restoration of the footprint on ultrasound evaluation, was 92%. Footprint restoration was visible at the 3 month ultrasound examination in 80% of the patients. There were 41 rotator cuff tears measuring 2cm to 4cm and 88% of them had footprint restoration by 6 months postoperatively. Of the patients with footprint restoration, only 51% had footprint restoration at 3 months. There were 11 rotator cuff tears greater than 4cm and 70% of them had footprint restoration by 6 months postoperatively. Of the patients with footprint restoration, only 18% had footprint restoration at 3 months.
Arthroscopic single row rotator cuff repair with triple loaded suture anchors can lead to a high rate of tendon healing. The lateral aspect of the rotator cuff footprint does appear to be restored by the end of the healing process, as visualized dynamically by shoulder ultrasound.
© 2010 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.