Naohide Takeuchi1, Naoya Kozono2, Akihiro Nishii3, Koumei Matsuura4, Eiichi Ishitani5, Toshihiro Onizuka6, Yoshihisa Zaitsu7, Takamitsu Okada8, Yasuhiro Mizuki9, Takehiro Kimura10, Hidehiko Yuge7, Taiki Uchimura9, Kunio Iura11, Tatsuya Mori6, Koki Ueda9, Go Miake6, Takahiro Senju9, Kenji Takagishi12, Yasuharu Nakashima2. 1. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan. naohide@ortho.med.kyushu-u.ac.jp. 2. Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City, Fukuoka, 812-8582, Japan. 3. Department of Orthopaedic Surgery, Kitakyushu Municipal Medical Center, Kitakyushu City, Fukuoka, 802-0077, Japan. 4. Department of Orthopaedic Surgery, Saiseikai Yahata General Hospital, Kitakyushu City, Fukuoka, 805-0050, Japan. 5. Department of Orthopaedic Surgery, Fukuoka Shion Hospital, Ogori City, Fukuoka, 838-0101, Japan. 6. Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Kitakyushu City, Fukuoka, 800-0296, Japan. 7. Department of Orthopaedic Surgery, Mizoguchi Orthopaedic Hospital, Fukuoka City, Fukuoka, 810-0001, Japan. 8. Department of Orthopaedic Surgery, Nakabaru Hospital, Kasuya District, Fukuoka, 811-2233, Japan. 9. Department of Orthopaedic Surgery, Sasebo Kyosai Hospital, Sasebo City, Fukuoka, 857-0879, Japan. 10. Department of Orthopaedic Surgery, Moro-oka Orthopaedic Hospital, Chikushi District, Fukuoka, 811-1201, Japan. 11. Department of Orthopaedic Surgery, Fukuoka Orthopaedic Hospital, Fukuoka City, Fukuoka, 815-0063, Japan. 12. Department of Orthopaedic Surgery, Sada Hospital, Fukuoka City, Fukuoka, 810-0004, Japan.
Abstract
PURPOSE: The Stump classification is significantly correlated with a retear after arthroscopic rotator cuff repair. However, no study has evaluated whether or not the stump classification is correlated with retear in the suture-bridge or double-row repair techniques. The aim of this study was to evaluate the relationship between a retear and the stump classification in the suture-bridge and double-row repair techniques. METHODS: Among 389 patients who underwent arthroscopic repairs of full-thickness rotator cuff tears using suture-bridge or double-row repair techniques, 326 patients (median age 67.0 years; range 25-85) were included. There were 51 small, 172 medium, 83 large, and 20 massive tears. Two hundred forty patients were treated with the suture-bridge technique, and 86 patients were treated with the double-row technique. The following variables were analyzed: age, sex, the Cofield classification, anteroposterior and mediolateral tear size on preoperative MRI, global fatty degeneration index, and the stump classification. Cuff integrity was evaluated on magnetic resonance imaging at 6 months after surgery. The patients were divided into the intact and retear groups and the relationship between the variables and retear was evaluated by multivariate logistic regression analysis. RESULTS: The overall retear rate was 10.1%. In the multivariate logistic regression analysis, the independent predictors of a retear were the stump classification type 3 (Odds ratio: 4.71, p = 0.0246), global fatty degeneration index (Odds ratio: 3.87, p = 0.0030), and anteroposterior tear size (Odds ratio: 1.07, p = 0.0077) in the suture bridge technique. In the double-row technique, the independent predictors of retear were stump classification type 3 (Odds ratio: 7.82, p = 0.0348), and age (Odds ratio: 1.22, p = 0.0163). CONCLUSION: The stump classification was significantly correlated with retear in the suture-bridge and double-row repair technique. Stump classification type 3 was indicated to be an important risk factor for predicting retear. LEVEL OF EVIDENCE: III.
PURPOSE: The Stump classification is significantly correlated with a retear after arthroscopic rotator cuff repair. However, no study has evaluated whether or not the stump classification is correlated with retear in the suture-bridge or double-row repair techniques. The aim of this study was to evaluate the relationship between a retear and the stump classification in the suture-bridge and double-row repair techniques. METHODS: Among 389 patients who underwent arthroscopic repairs of full-thickness rotator cuff tears using suture-bridge or double-row repair techniques, 326 patients (median age 67.0 years; range 25-85) were included. There were 51 small, 172 medium, 83 large, and 20 massive tears. Two hundred forty patients were treated with the suture-bridge technique, and 86 patients were treated with the double-row technique. The following variables were analyzed: age, sex, the Cofield classification, anteroposterior and mediolateral tear size on preoperative MRI, global fatty degeneration index, and the stump classification. Cuff integrity was evaluated on magnetic resonance imaging at 6 months after surgery. The patients were divided into the intact and retear groups and the relationship between the variables and retear was evaluated by multivariate logistic regression analysis. RESULTS: The overall retear rate was 10.1%. In the multivariate logistic regression analysis, the independent predictors of a retear were the stump classification type 3 (Odds ratio: 4.71, p = 0.0246), global fatty degeneration index (Odds ratio: 3.87, p = 0.0030), and anteroposterior tear size (Odds ratio: 1.07, p = 0.0077) in the suture bridge technique. In the double-row technique, the independent predictors of retear were stump classification type 3 (Odds ratio: 7.82, p = 0.0348), and age (Odds ratio: 1.22, p = 0.0163). CONCLUSION: The stump classification was significantly correlated with retear in the suture-bridge and double-row repair technique. Stump classification type 3 was indicated to be an important risk factor for predicting retear. LEVEL OF EVIDENCE: III.