Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Arthroscopic Rotator Cuff Repair: Single Row Technique

관절경적 회전근 개 봉합술: 일열 봉합 수기

  • Park, Hyung-Bin (Department of Orthopaedic Surgery, School of Medicine, Gyeongsang National University)
  • 박형빈 (경상대학교 의학전문대학원 정형외과학교실)
  • Published : 2007.12.15
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Abstract

Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.

관절경적 일열 봉합법은 잘 정립된 회전근 개 봉합술로 우수한 임상성적을 보여왔다. 하지만, 수술 후 재파열의 빈도가 높은 것으로 알려져 있어 다양한 방법들이 술 후 재파열을 줄이기 위하여 시도되어왔다. 일부 연구들에서는 해부학적 회전근 개 부착부를 재건하면 봉합한 회전근 개의 치유 및 초기 역학적 강도를 증가시킬 수 있을 것이라고 보고하였고, 이열 봉합법이 해부학적 회전근 개 부착부 재건과 봉합부의 강도를 증가 시키고, 간격형성을 감소 시킬 목적으로 소개되었다. 하지만, 재부착된 회전근 개 건의 장력, 봉합된 건의 혈관 형성 등의 생물학적 치유환경이 일렬 봉합법에 비하여 우수함이 아직 입증되지 않았고 수술 후 기능적 개선도 측면에서도 두 봉합술간 차이가 없으므로, 수술 수기가 상대적으로 쉽고, 요구되는 기구 및 내고정물의 추가적 비용이 적어 경제적인 측면에 장점이 있는 일렬 봉합법은 여전히 추천되는 수술수기이다.

Keywords

References

  1. Abrams JS, Savoie FH III: Arthroscopic rotator cuff repair: Is it the new gold standard? AAOS. Rosememont, IL; 71, 2005.
  2. Bardana DD, Burks RT, West JR, Greis PE: The effect of suture anchor design and orientation on suture abrasion: An in vitro study. Arthroscopy, 19: 274-281, 2003. https://doi.org/10.1053/jars.2003.50032
  3. Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL: Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg, 15: 290-299, 2006. https://doi.org/10.1016/j.jse.2005.09.017
  4. Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG: Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am, 87: 1229-1240, 2005. https://doi.org/10.2106/JBJS.D.02035
  5. Brady PC, Arrigoni P, Burkhart SS: Evaluation of residual rotator cuff defects after in vivo single- versus double-row rotator cuff repairs. Arthroscopy, 22: 1070-1075, 2006. https://doi.org/10.1016/j.arthro.2006.05.007
  6. Burkhart SS: The deadman theory of suture anchors: observations along a south Texas fence line. Arthroscopy, 11: 119-123, 1995. https://doi.org/10.1016/0749-8063(95)90100-0
  7. Burkhart SS, Wirth MA, Simonich M, Salem D, Lanctot D, Athanasiou K: Knot security in simple sliding knots and its relationship to rotator cuff repair: how secure must the knot be? Arthroscopy, 16: 202-207, 2000. https://doi.org/10.1016/S0749-8063(00)90037-9
  8. Caldwell GL, Warner JP, Miller MD, Boardman D, Towers J, Debski R: Strength of fixation with transosseous sutures in rotator cuff repair. J Bone Joint Surg Am, 79: 1064-1068, 1997. https://doi.org/10.2106/00004623-199707000-00013
  9. Deakin M, Stubbs D, Bruce W, Goldberg J, Gillies RM, Walsh WR: Suture strength and angle of load application in a suture anchor eyelet. Arthroscopy, 21: 1447-1451, 2005. https://doi.org/10.1016/j.arthro.2005.09.003
  10. Deutsch A. Arthroscopic rotator cuff repair: The effect of depth of suture passage on three-dimensional repair site surface area and load to failure using single-row anchor fixation. AAOS. Chicago IL; 2006.
  11. Franceschi F, Ruzzini L, Longo UG, et al: Equivalent clinical results of arthroscopic single- row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. Am J Sports Med, 35: 1254-1260, 2007. https://doi.org/10.1177/0363546507302218
  12. Gartsman GM, Khan M, Hammerman SM: Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am, 80: 832-840, 1998. https://doi.org/10.2106/00004623-199806000-00007
  13. Kim DH, Elattrache NS, Tibone JE, et al: Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med, 34: 407-414, 2006. https://doi.org/10.1177/0363546505281238
  14. Liporace FA, Bono CM, Caruso SA, et al: The mechanical effects of suture anchor insertion angle for rotator cuff repair. Orthopedics, 25: 399-402, 2002.
  15. Lo IK, Burkhart SS: Double-row arthroscopic rotator cuff repair: re-establishing the footprint of the rotator cuff. Arthroscopy, 19: 1035-1042, 2003. https://doi.org/10.1016/j.arthro.2003.09.036
  16. Lo IK, Burkhart SS, Athanasiou K: Abrasion resistance of two types of nonabsorbable braided suture. Arthroscopy, 20: 407-413, 2004. https://doi.org/10.1016/j.arthro.2004.01.022
  17. Ma CB, Comerford L, Wilson J, Puttlitz CM: Biomechanical evaluation of arthroscopic rotator cuff repairs: double-row compared with single-row fixation. J Bone Joint Surg Am, 88: 403-410, 2006. https://doi.org/10.2106/JBJS.D.02887
  18. MacGillivray JD, Ma CB: An arthroscopic stitch for massive rotator cuff tears: the Mac stitch. Arthroscopy, 20: 669-671, 2004. https://doi.org/10.1016/j.arthro.2004.04.065
  19. Massoud SN, Levy O, Copeland SA: Subacromial decompression. Treatment for small- and medium-sized tears of the rotator cuff. J Bone Joint Surg Br, 84: 955-960, 2002. https://doi.org/10.1302/0301-620X.84B7.12378
  20. Mazzocca AD, Millett PJ, Guanche CA, Santangelo SA, Arciero RA: Arthroscopic single-row versus double-row suture anchor rotator cuff repair. Am J Sports Med, 33: 1861-1868, 2005. https://doi.org/10.1177/0363546505279575
  21. Millstein ES, Snyder SJ: Arthroscopic evaluation and management of rotator cuff tears. Orthop Clin North Am, 34: 507-520, 2003. https://doi.org/10.1016/S0030-5898(03)00095-6
  22. Murray TF, Jr., Lajtai G, Mileski RM, Snyder SJ: Arthroscopic repair of medium to large full-thickness rotator cuff tears: outcome at 2- to 6-year follow-up. J Shoulder Elbow Surg, 11: 19-24, 2002. https://doi.org/10.1067/mse.2002.120142
  23. Smith CD, Alexander S, Hill AM, et al: A biomechanical comparison of single and double-row fixation in arthroscopic rotator cuff repair. J Bone Joint Surg Am, 88: 2425-2431, 2006. https://doi.org/10.2106/JBJS.E.00697
  24. Snyder SJ: Technique of arthroscopic rotator cuff repair using implantable 4-mm Revo suture anchors, suture Shuttle Relays, and no. 2 nonabsorbable mattress sutures. Orthop Clin North Am, 28: 267-275, 1997. https://doi.org/10.1016/S0030-5898(05)70285-6
  25. Sugaya H, Maeda K, Matsuki K, Moriishi J: Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy, 21: 1307-1316, 2005. https://doi.org/10.1016/j.arthro.2005.08.011
  26. Tingart MJ, Apreleva M, Zurakowski D, Warner JJ: Pullout strength of suture anchors used in rotator cuff repair. J Bone Joint Surg Am, 85: 2190-2198, 2003. https://doi.org/10.2106/00004623-200311000-00021