Key result
A minimal medial-row tying technique with a four-by-four strand double-row suture-bridge configuration yielded a 6.3% retear rate at 6.2 months in patients with medium to large rotator cuff tears.
Why the study?
Does minimal-tying technique with double-row suture-bridge configuration improve repair integrity in patients with medium to large rotator cuff tears?
Observational (n=79)
No
Does minimal-tying technique with double-row suture-bridge configuration improve repair integrity in patients with medium to large rotator cuff tears?
A minimal tying technique with a four-by-four strand double-row suture-bridge configuration yielded a low retear rate of 6.3% in medium to large rotator cuff tears.
May support low retear rates with minimal medial-row tying; leaves open confirmation versus standard techniques in randomized trials.
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 (2×2 anchor with 4×4 suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using 2×2 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.
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Lee et al. (2015) conducted an observational in Medium to large full-thickness rotator cuff tears (n=79). Minimal medial-row tie with suture-bridge technique was evaluated on Retear rate (Sugaya classification type IV or V) evaluated by MRI. A minimal medial-row tying technique with a four-by-four strand double-row suture-bridge configuration yielded a 6.3% retear rate at 6.2 months in patients with medium to large rotator cuff tears.
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