Jeung Yeol Jeong1, Keun Min Park1, Shyam Sundar2, Jae Chul Yoo3. 1. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 2. Department of Orthopedic Surgery, Ortho One Orthopaedic Speciality Centre, Coimbatore, Tamil Nadu, India. 3. Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: shoulderyoo@gmail.com.
Abstract
BACKGROUND: There is ongoing controversy regarding the ideal repair modality for rotator cuff tear, with single-row (SR) repair and double-row transosseous equivalent (TOE) repair as the main contenders. METHODS: This study included 415 patients who underwent arthroscopic rotator cuff type I (complete coverage of the greater tuberosity footprint) or II (incomplete coverage) repair between January 2006 and December 2012. SR repair followed the conventional protocol. For double-row TOE repairs, 4 medial sutures were inserted with 2 lateral row anchors. The patients were evaluated for cuff integrity (on magnetic resonance imaging at 6 months postoperatively) and for clinical outcome (pain on the visual analog scale and various scores assessing shoulder function; all logged preoperatively and postoperatively at 3 months, 6 months, and at the last follow-up). RESULTS: SR and TOE repairs were performed in 46% and 54% of patients, respectively. Type I and type II repairs were performed in 87% and 13% of patients, respectively. The overall incidence of retear assessed on postoperative magnetic resonance imaging was 6.74%. The incidence of retear in the SR group was statistically significantly higher only in large-sized tears (28.57% vs. 4.5%; P = .028). Among the postoperative scores at the final follow-up, only the function on the visual analog scale differed significantly between the groups (P < .01), with patients treated by TOE repair showing higher scores (8.47 ± 1.70 vs. 7.91 ± 1.66). CONCLUSION: In this large cohort study, SR and TOE repair provided similar clinical and radiologic outcomes. Nevertheless, TOE repair was associated with significantly improved healing rate for large-sized tears.
BACKGROUND: There is ongoing controversy regarding the ideal repair modality for rotator cuff tear, with single-row (SR) repair and double-row transosseous equivalent (TOE) repair as the main contenders. METHODS: This study included 415 patients who underwent arthroscopic rotator cuff type I (complete coverage of the greater tuberosity footprint) or II (incomplete coverage) repair between January 2006 and December 2012. SR repair followed the conventional protocol. For double-row TOE repairs, 4 medial sutures were inserted with 2 lateral row anchors. The patients were evaluated for cuff integrity (on magnetic resonance imaging at 6 months postoperatively) and for clinical outcome (pain on the visual analog scale and various scores assessing shoulder function; all logged preoperatively and postoperatively at 3 months, 6 months, and at the last follow-up). RESULTS:SR and TOE repairs were performed in 46% and 54% of patients, respectively. Type I and type II repairs were performed in 87% and 13% of patients, respectively. The overall incidence of retear assessed on postoperative magnetic resonance imaging was 6.74%. The incidence of retear in the SR group was statistically significantly higher only in large-sized tears (28.57% vs. 4.5%; P = .028). Among the postoperative scores at the final follow-up, only the function on the visual analog scale differed significantly between the groups (P < .01), with patients treated by TOE repair showing higher scores (8.47 ± 1.70 vs. 7.91 ± 1.66). CONCLUSION: In this large cohort study, SR and TOE repair provided similar clinical and radiologic outcomes. Nevertheless, TOE repair was associated with significantly improved healing rate for large-sized tears.
Authors: Ahmet Fırat; Mustafa Aydın; Osman Tecimel; Ali Öçgüder; Yavuz Sanisoğlu; Mahmut Uğurlu Journal: Acta Orthop Traumatol Turc Date: 2020-03 Impact factor: 1.511
Authors: Nathan P Fackler; Cooper B Ehlers; Kylie T Callan; Arya Amirhekmat; Eric J Smith; Robert L Parisien; Dean Wang Journal: Orthop J Sports Med Date: 2022-05-10