• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.82-89
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• 2008

Ideal rotator cuff repair is to maintain high fixation strength and minimize gap formation for optimizing the environment of biologic healing of tendon to bone. Among the current repair techniques, the suture bridge technique is superior to single- or double-row repair in ultimate load to failure, gap formation, restoring anatomical footprint and achieving pressurized contact area. The suture bridge technique also minimizes gap formation and has rotational and torsional resistances allowing early rehabilitation. However, despite superior biomechanical characteristics of the suture bridge technique, there is no evidence that these mechanical advantages result in better clinical outcomes. Furthermore, there is no difference in failure rates between the double-row repair and suture bridge techniques. An appropriate repair technique should be determined based on tear size and pattern and tendon quality.

• Journal of the Korean Arthroscopy Society
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• v.13 no.2
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• pp.179-182
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• 2009

Purpose: Point fixation at the margin of the glenoid is a limitation of conventional arthroscopic stabilization using suture anchors, and does not afford sufficient footprint healing, especially in glenoid bone deficiency. So, we introduce an arthroscopic suture bridge transosseous-equivalent technique for bony Bankart lesions to avoid the technical disadvantage of point contact with anchor fixation and to improve mechanical stability through cross compression of the labrum. Surgical approach: The technique was adapted from the transosseous-equivalent rotator cuff repair technique using suture bridges, which improved the pressurized contact area and mean pressure between the tendon and footprint. After preparation of the glenoid bed by removal, reshaping, or mobilization of the bony lesion, two anchors (3.0 mm Biofastak, $Arthrex^{(R)}$, Naples, FL) were inserted into the superior and inferior portion of the bony Bankart lesion. Using a suture hook, medial mattress sutures were applied around the capsulolabral portion of the IGHL complex to obtain sufficient depth of glenoid coverage. A 3.5 mm pushloc anchor ($Arthrex^{(R)}$, Naples, FL) hole was made in the articular edge of the anterior glenoid rim. distal, suture bridge was applied, and proximal was inserted to mobilize the labrum in the proximal direction. This avoided the technical disadvantage of point contact with anchor fixation and decreased the level of gap formation through cross-compression of the labrum.

• Clinics in Shoulder and Elbow
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• v.13 no.2
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• pp.181-187
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• 2010

Purpose: To determine clinical results for arthroscopic repair of a full-thickness rotator cuff tear using a suture bridge technique. Materials and Methods: Between November, 2007 and October, 2008, we evaluated 90 cases of arthroscopic middle, large rotator tear cuff repair. The mean follow-up period was 15 months (range, 12-23 months). Forty-three cases had medium-sized tears; 47 cases had large-sized tears. At the preoperative stage and again at last follow-up, functional results were assessed by the KSS, ASES, UCLA and the PVAS (Pain visual analogue score). Results: Pain score improved from 2.56 preoperatively to 0.96 at final follow-up; movement scores improved from 6.94 to 1.70. At. final follow-up, the average UCLA score improved from 17.08 to 31.17 with 31 excellent (34%), 49 good (54%) and 10 poor results (12%). The final UCLA score was 31.47 in the group less than 60 years of age and 30.69 in the group over 61 years of age (p=0.344). The UCLA score was 31.23 in those with medium-sized tears and 31.11 in those with large-sized tears (p=0.924). The UCLA score was 31.10 in non-trauma patients and 31.23 in trauma patients (p=0.929). Conclusion: Arthroscopic repair of a full-thickness rotator cuff tear using a suture bridge technique can produce excellent clinical results. These outcomes are not affected by age or trauma history.

• Clinics in Shoulder and Elbow
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• v.12 no.2
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• pp.180-188
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• 2009

Purpose: We evaluate the short-term clinical outcome of arthroscopic rotator cuff tendon repair with suture-bridge technique in patients with full thickness rotator cuff tear. Materials and Methods: 29 (male:17, female:12) consecutive shoulders treated with this index procedure and early rehabilitation were enrolled. Mean age was 56.4 years (range, 34~73 years) and mean follow-up period was 13 months (range, 12-15 months). Clinical outcomes were evaluated by using the University of California Los Angeles (UCLA) score, the Korean Shoulder Scoring System (KSS) and Visual Analogue Scale (VAS). Postoperative cuff integrity was evaluated through magnetic resonance imaging (MRI) and categorized by Sugaya classification. Results: Postoperative UCLA scores improved from 16.4 to 31.6 (p< 0.05) and KSS scores showed 88 at 6 months and 92 at last follow up. Preoperative VAS score was 8.6, which was decreased to 2.1 at 3 months and 1.4 at 6 months postoperatively. 28 patients (96.5%) had increase in range of motion. The follow up MRI was taken in 15 shoulders and the cuff integrity was type I in 6 cases, type II in 7, type III in 1 and type V in 1 by Sugaya classification. Conclusion: Arthroscopic suture-bridge technique resulted in good or excellent clinical outcome in 96.5% of the cases, so we think this technique is one of the reliable procedure for full-thicknes rotator cuff tear.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.73-77
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• 2016

Purpose: The purpose of this study was to evaluate the clinical outcome of a modified Kidner procedure using a suture bridge technique in symptomatic type II accessory navicular. Materials and Methods: Between January 2013 and December 2014, a total of 35 cases with symptomatic type II accessory navicular were treated with a modified Kidner procedure using the suture bridge technique. The patients were evaluated preoperatively, 3 months after surgery, and at the latest follow-up (at least six months postoperatively) clinically via the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot score, visual analogue scale (VAS), and the self-subjective satisfaction score. Results: The mean AOFAS midfoot score demonstrated significant improvement from a mean of 45.3 preoperatively to a mean of 89.2 at 3 months after surgery. At the latest follow-up, the mean AOFAS midfoot score was 92.6 (p<0.001). The mean VAS also improved significantly, decreasing from 6.7 out of 10 preoperatively to 1.8 at 3 months after surgery. At the latest follow-up, the VAS was 1.2 (p<0.001). The mean time of a single-limb heel raise was 4.6 months postoperatively and the self-subjective satisfaction score was 1.4 out of 4 at the latest follow-up. Conclusion: The short-term surgical results of the modified Kidner procedure with a suture bridge technique for symptomatic type II accessory navicular were good to excellent in terms of pain, functional and clinical assessments. In conclusion, the modified Kidner procedure with the suture bridge technique is a reasonable treatment option for symptomatic type II accessory navicular.

• Journal of Korean Foot and Ankle Society
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• v.18 no.3
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• pp.108-114
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• 2014

Purpose: Ligament reattachment technique using a suture anchor appears to show satisfactory functional outcomes and mechanical stability compared with conventional bone tunnel technique. This study was prospectively conducted in order to evaluate functional outcomes of modified Brostrom procedures using the suture bridge technique for chronic ankle instability in athletes. Materials and Methods: Twenty eight athletes under 30 years of age were followed for more than two years after undergoing the modified Brostrom procedure using the suture bridge technique. Functional evaluation consisted of the foot and ankle outcome score (FAOS), foot and ankle ability measure (FAAM) score. Range of motion and time to return to exercise were evaluated using a periodic questionnaire. Talar tilt angle and anterior talar translation were measured through stress radiographs for evaluation of mechanical stability. Results: FAOS improved significantly from preoperative mean 59.4 points to 91.4 points (p<0.001). Daily living and sport activity scores of FAAM improved significantly from preoperative mean 50.5, 32.5 points to 94.8, 87.3 points, respectively (p<0.001). Talar tilt angle and anterior talar translation improved significantly from preoperative mean $16.8^{\circ}$, 13.5 mm to $4.2^{\circ}$, 4.1 mm at final follow-up (p<0.001). Times to return to exercise were as follows: mean 10.2 weeks in jogging, 15.4 weeks in spurt running, 13.1 weeks in jumping, 11.5 weeks in walking on uneven ground, 9.1 weeks in standing on one leg, 7.2 weeks in tip-toeing gait, 8.4 weeks in squatting, and 10.6 weeks in descending stairs. Conclusion: Modified Brostrom procedure using the suture bridge technique showed satisfactory functional outcomes for chronic ankle instability in athletes. Optimal indication and cost-effectiveness of the suture bridge technique will be studied in the future.