Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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Minimal Medial-row Tie with Suture-bridge Technique for Medium to Large Rotator Cuff Tears

  • Lee, Hyun Il (Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan Collage of Medicine) ;
  • Ryu, Ho Young (Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Shim, Sang-Jun (Department of Orthopedic Surgery, Gangneung Asan Hospital, University of Ulsan Collage of Medicine) ;
  • Yoo, Jae Chul (Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2014.09.26
  • Accepted : 2014.12.13
  • Published : 2015.12.31
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Abstract

Background: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration ($2{\times}2$ anchor with $4{\times}4$ suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using $2{\times}2$ anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medial-row stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. Results: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. Conclusions: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.

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References

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