Clin Should Elbow.  2015 Dec;18(4):197-205. 10.5397/cise.2015.18.4.197.

Minimal Medial-row Tie with Suture-bridge Technique for Medium to Large Rotator Cuff Tears

• Lee HI
• Ryu HY
• Shim SJ
• Yoo JC

• KMID: 2171434
• DOI: http://doi.org/10.5397/cise.2015.18.4.197

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 (2x2 anchor with 4x4 suture stands).
METHODS
From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2x2 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 medialrow 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.

Keyword

Rotator cuff; Tendon; Suture anchor; Shoulder; Arthroscopy

MeSH Terms

Arthroscopy
Atrophy
Classification
Humans
Magnetic Resonance Imaging
Muscular Atrophy
Rotator Cuff*
Shoulder
Suture Anchors
Sutures
Tears*
Tendons