Retear Patterns after Arthroscopic Rotator Cuff Repair: Single-Row Versus Suture Bridge Technique

• Published in: The American journal of sports medicine 2010-04, Vol.38 (4), p.664-671
• Main Authors: Cho, Nam Su, Yi, Jin Woong, Lee, Bong Gun, Rhee, Yong Girl
• Format: Article
• Language: English
• Subjects: Aged; Arthroscopy; Biological and medical sciences; Cohort Studies; Diseases of the osteoarticular system; Endoscopy; Female; Humans; Investigative techniques, diagnostic techniques (general aspects); Juxtaarticular diseases. Extraarticular rhumatism; Male; Medical sciences; Middle Aged; NMR; Nuclear magnetic resonance; Postoperative Complications - epidemiology; Range of Motion, Articular; Retrospective Studies; Rotator Cuff - surgery; Rupture, Spontaneous - epidemiology; Shoulder Joint - surgery; Sports medicine; Suture Techniques; Tendon Injuries - surgery; Tendons; Tissues; Treatment Outcome
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546509350081

Background A subset of patients is often seen with an unusual pattern of tendon failure after arthroscopic rotator cuff repair using a suture bridge technique. Purpose To evaluate retear patterns in cases with structural failure after arthroscopic primary repairs of rotator cuff tears. Study Design Cohort study; Level of evidence, 3. Methods Forty-six cases revealing retear on magnetic resonance imaging performed at least 6 months after arthroscopic repair for the treatment of full-thickness rotator cuff tear were evaluated. A single-row technique had been performed in 19 cases and a suture bridge in 27 cases. According to retear patterns on postoperative magnetic resonance imaging, cases were divided into type 1 (cuff tissue repaired at the insertion site of rotator cuff was not observed remaining on the greater tuberosity) and type 2 (remnant cuff tissue remained at the insertion site in spite of retear). Results In the single-row group, 14 cases (73.7%) had type 1 and 5 cases (26.3%) type 2 retear. In the suture bridge group, 7 cases (25.9%) had type 1 and 20 cases (74.1%) type 2. There were statistically significant differences between groups (P = .049). Extent of fatty degeneration of the rotator cuff did not affect retear patterns in the single-row group (P = .160). In the suture bridge group, the percentage of type 1 retear increased with severity of fatty degeneration (P = .030). Extent of muscle atrophy did not affect retear patterns of the single-row group; in the suture bridge group, the percentage of type 1 retear increased with severity of muscle atrophy (P = .904 vs .029). Conclusion The suture bridge technique tended to better preserve the cuff tissue repaired to the insertion site of the rotator cuff than a single-row technique did; the retear in cases with a suture bridge technique was mainly in the musculotendinous junction. Direct retear at the footprint of the rotator cuff increased with severity of fatty degeneration or muscle atrophy in cases with a suture bridge technique.