Philipp R Heuberer1,2,3, Leo Pauzenberger4, Michael S Gruber5, Bernhard Kriegleder4, Roman C Ostermann4, Brenda Laky4,6, Werner Anderl4,6. 1. , Health Pi, Wollzeile 1-3, 1010, Vienna, Austria. philipp@heuberer.at. 2. Vienna Shoulder and Sports Clinic, Vienna, Austria. philipp@heuberer.at. 3. Austrian Research Group for Regenerative and Orthopedic Medicine (AURROM), Vienna, Austria. philipp@heuberer.at. 4. Vienna Shoulder and Sports Clinic, Vienna, Austria. 5. The Medical University Vienna, Vienna, Austria. 6. Austrian Research Group for Regenerative and Orthopedic Medicine (AURROM), Vienna, Austria.
Abstract
PURPOSE: To compare functional outcomes and magnetic resonance image (MRI) tendon integrity following either the suture bridge or the knotless cinch-bridge technique used for arthroscopic double-layer rotator cuff repair. METHODS: 37 prospectively enrolled patients (46-76 years), who were treated with arthroscopic double-layer rotator cuff repair (group 1: suture bridge n = 20, group 2: cinch bridge n = 17) were clinically and radiographically assessed before and at an average of 24.0 ± 4.7 months after the procedure. Shoulder function was evaluated by the constant score (CS), range of motion, and various patient-related scores. Repaired tendon integrity was evaluated by MRI. Peri- and postoperative complications were recorded. RESULTS: All functional and patient-related scores significantly improved from pre- to postoperative. Significantly better postoperative CS (P = 0.037), flexion (P < 0.001), and abduction (P = 0.009) were detected after arthroscopic cinch compared to suture-bridge repair. The mean CS improvements from baseline to follow-up were not significantly different between the groups (n.s.). Patient-related scores did not show any statistical significant differences. The MRI healing rate following arthroscopic double-layer repair with the suture- and cinch-bridge technique was 95% and 94%, respectively. Fatty infiltration regarding the supraspinatus and infraspinatus increased in 55% and 35% (group 1) and in 53% and 48% (group 2), respectively. Muscle hypotrophy remained stable in all patients. Overall, 92% of the patients were very satisfied or satisfied with the procedure. No complications were detected. CONCLUSIONS: Arthroscopic knotless double-layer rotator cuff repair with the cinch-bridge technique showed higher CS, forward flexion, and abduction values, as well as similar patient-related short-term outcome and MRI integrity compared to the suture-bridge technique. These results highlight the potential importance of less tendon strangulation for better clinical short-term outcome. LEVEL OF EVIDENCE: Level II, prospective comparative study.
PURPOSE: To compare functional outcomes and magnetic resonance image (MRI) tendon integrity following either the suture bridge or the knotless cinch-bridge technique used for arthroscopic double-layer rotator cuff repair. METHODS: 37 prospectively enrolled patients (46-76 years), who were treated with arthroscopic double-layer rotator cuff repair (group 1: suture bridge n = 20, group 2: cinch bridge n = 17) were clinically and radiographically assessed before and at an average of 24.0 ± 4.7 months after the procedure. Shoulder function was evaluated by the constant score (CS), range of motion, and various patient-related scores. Repaired tendon integrity was evaluated by MRI. Peri- and postoperative complications were recorded. RESULTS: All functional and patient-related scores significantly improved from pre- to postoperative. Significantly better postoperative CS (P = 0.037), flexion (P < 0.001), and abduction (P = 0.009) were detected after arthroscopic cinch compared to suture-bridge repair. The mean CS improvements from baseline to follow-up were not significantly different between the groups (n.s.). Patient-related scores did not show any statistical significant differences. The MRI healing rate following arthroscopic double-layer repair with the suture- and cinch-bridge technique was 95% and 94%, respectively. Fatty infiltration regarding the supraspinatus and infraspinatus increased in 55% and 35% (group 1) and in 53% and 48% (group 2), respectively. Muscle hypotrophy remained stable in all patients. Overall, 92% of the patients were very satisfied or satisfied with the procedure. No complications were detected. CONCLUSIONS: Arthroscopic knotless double-layer rotator cuff repair with the cinch-bridge technique showed higher CS, forward flexion, and abduction values, as well as similar patient-related short-term outcome and MRI integrity compared to the suture-bridge technique. These results highlight the potential importance of less tendon strangulation for better clinical short-term outcome. LEVEL OF EVIDENCE: Level II, prospective comparative study.
Authors: Philipp R Heuberer; Daniel Smolen; Leo Pauzenberger; Fabian Plachel; Sylvia Salem; Brenda Laky; Bernhard Kriegleder; Werner Anderl Journal: Am J Sports Med Date: 2017-03-08 Impact factor: 6.202
Authors: Pascal Boileau; Nicolas Brassart; Duncan J Watkinson; Michel Carles; Armodios M Hatzidakis; Sumant G Krishnan Journal: J Bone Joint Surg Am Date: 2005-06 Impact factor: 5.284
Authors: Philipp R Heuberer; Roman Kölblinger; Stefan Buchleitner; Leo Pauzenberger; Brenda Laky; Alexander Auffarth; Philipp Moroder; Sylvia Salem; Bernhard Kriegleder; Werner Anderl Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-08-08 Impact factor: 4.342