Purpose
To compare the clinical and imaging outcomes between the suture bridge technique (SB)
and the medially based single-row technique (medSR) in patients with 1- to 3-cm tear
sizes.
Methods
All patients were evaluated preoperatively and postoperatively (at 12 and 24 months)
using the modified University of California, Los Angeles scoring system; active range
of motion (flexion and external rotation); and a visual analog scale for pain. Healing
status was examined by postoperative magnetic resonance imaging.
Results
Clinical and imaging evaluations were completed by 92 patients at 1-year follow-up
and by 74 patients at 2 years. No significant differences were found between the 2
groups across all measures at final follow-up: The University of California, Los Angeles
scores were 33.4 points in SB patients and 33.0 points in medSR patients (P = .58); the visual analog scale scores were 6 mm and 7 mm, respectively (P = .38); the active flexion angles were 161° and 159°, respectively (P = .34); and the external rotation angles were 49° and 52°, respectively (P = .37). Retears were observed in 6.5% of SB patients and 2.1% of medSR patients (P = .31). Medial cuff failure was observed only in SB patients (4.3%, 2 cases), whereas
incomplete healing (deep-layer retraction pattern) was observed only in medSR patients
(8.7%, 4 cases). Neo-tendon regeneration in the medSR group was observed in 93% of
patients.
Conclusions
This study did not show any significant differences in the clinical outcomes and cuff
integrity between the 2 treatment groups at final follow-up; however, medial cuff
failure was observed only in the SB group, and incomplete healing was more frequent
in the medSR group. One should consider the risk of medial cuff failure and incomplete
healing of the repaired cuff before choosing the repair technique for medium-sized
supraspinatus tears.
Level of Evidence
Level I, therapeutic, prospective, randomized trial.
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Article info
Publication history
Accepted:
May 12,
2019
Received:
January 5,
2019
Footnotes
The author reports that he has no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
See commentary on page 2814
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Does a Medialized Repair Allow Single-Row to Outperform Double-Row Rotator Cuff Repair?ArthroscopyVol. 35Issue 10
- PreviewThe optimal surgical technique for arthroscopic rotator cuff repair remains controversial, with advantages and disadvantages to each of the most commonly used methods. The pattern as well as number of suture anchors relative to the footprint has been one of the most common sources of debate, with proponents and arguments for both single- and double-row arrangements. Although double-row techniques have been shown to be biomechanically superior and to improve footprint coverage, evidence has been mixed as to whether they are clinically superior, especially in small- and medium-sized tears.
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