Purpose
The purpose of this study was to compare morphologic features of the acromion after
2 different repair methods (single-row [SR] repair with a minimum of 4 knots and suture-bridge
[SB] repair with minimal knots) in medium to large rotator cuff tears.
Methods
From May 2005 to July 2012, 1,693 rotator cuff repairs were performed, among them
medium to large tears requiring more than 2 anchors for repair; those who had 6-month
postoperative magnetic resonance imaging (MRI) scans were included (221 shoulders).
They were divided into 2 groups; group A (SR repair) and group B (SB repair). Acromial
morphologic characteristics were evaluated using MRI 6 months postoperatively. An
acromial defect was defined as an irregular defect or erosion on the flat acromion.
Clinical measurements were performed using the American Shoulder and Elbow Surgeons
(ASES) score, Constant score, visual analogue scale (VAS) pain score, and range of
motion (ROM).
Results
Erosion in the acromion was observed in 2 of 118 patients (1.7%) in group A and in
1 of 103 (1%) patients in group B. There was no statistically significant difference
between the 2 groups (P = .796). A statistically significant improvement was observed in the clinical scores
measured (P = .0043). ROM was not fully recovered to the preoperative level at 6 months postoperatively.
Acromioplasty was performed in 2 of 3 patients with acromial erosion. There was acromial
erosion in one patient in group A without performing subacromial decompression.
Conclusions
Our study showed that there was no difference in acromial erosion in high-profile
knots made by an SR compared with double-row (DR) SB low-profile repairs.
Level of Evidence
Level III, retrospective comparative study.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Long-term follow-up of arthroscopic rotator cuff repair.Arthroscopy. 2011; 27: 885-888
- Quality of life after arthroscopic rotator cuff repair: Evaluation using SF-36 and an analysis of affecting clinical factors.Am J Sports Med. 2012; 40: 631-639
- Rotator cuff integrity after arthroscopic repair for large tears with less-than-optimal footprint coverage.Arthroscopy. 2009; 25: 1093-1100
- Small supraspinatus tears repaired by arthroscopy: Are clinical results influenced by the integrity of the cuff after two years? Functional and anatomic results of forty-six consecutive cases.J Shoulder Elbow Surg. 2012; 21: 699-706
- Repair results of 2-tendon rotator cuff tears utilizing the transosseous equivalent technique.J Shoulder Elbow Surg. 2010; 19: 1210-1217
- Arthroscopic suture-bridge repair for small to medium size supraspinatus tear: healing rate and retear pattern.Arthroscopy. 2013; 29: 10-17
- Arthroscopic rotator cuff repair using a suture bridge technique: Is the repair integrity actually maintained?.Am J Sports Med. 2011; 39: 2108-2116
- Comparison of mechanical stability in double-row rotator cuff repairs between a knotless transtendon construct versus the addition of medial knots.Arthroscopy. 2010; 26: S127-S133
- American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness.J Shoulder Elbow Surg. 2002; 11: 587-594
- Osteolysis of the inferior surface of the acromion caused by knots of the suture thread after rotator cuff repair surgery: Knot impingement after rotator cuff repair.J Shoulder Elbow Surg. 2010; 19: e17-e23
- Prospective randomized clinical trial of single- versus double-row suture anchor repair in 2- to 4-cm rotator cuff tears: Clinical and magnetic resonance imaging results.Arthroscopy. 2011; 27: 453-462
- Single-row versus double-row arthroscopic rotator cuff repair: A prospective randomized clinical study.Arthroscopy. 2009; 25: 4-12
- Mechanical performance of square knots and sliding knots in surgery: Comparative study.Am J Obstet Gynecol. 1990; 162: 93-97
- Factors relating to the volume of surgical knots.Int J Gynaecol Obstet. 1989; 30: 355-359
Article info
Publication history
Published online: June 05, 2014
Accepted:
April 11,
2014
Received:
September 16,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
