Arthroscopic Supraspinatus Tendon Repair with Suture-Bridging Technique: Functional Outcome and Magnetic Resonance Imaging

• Published in: The American journal of sports medicine 2010-05, Vol.38 (5), p.983-991
• Main Authors: Voigt, Christine, Bosse, Christin, Vosshenrich, Rolf, Schulz, Arndt P., Lill, Helmut
• Format: Article
• Language: English
• Subjects: Adult; Aged; Arthroscopy; Arthroscopy - methods; Biological and medical sciences; Clinical outcomes; Diseases of the osteoarticular system; Endoscopy; Female; Humans; Hypotheses; Investigative techniques, diagnostic techniques (general aspects); Juxtaarticular diseases. Extraarticular rhumatism; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Muscular system; NMR; Nuclear magnetic resonance; Orthopedic Procedures - methods; Prospective Studies; Range of Motion, Articular; Reconstructive Surgical Procedures - methods; Rotator Cuff - surgery; Rotator Cuff Injuries; Rupture - diagnosis; Rupture - surgery; Shoulder; Sports medicine; Suture Techniques; Tendon Injuries - surgery; Tendons; Treatment Outcome
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546509359063

Background The suture-bridging technique is a new arthroscopic technique to repair rotator cuff tears. Biomechanical advantages compared with double-row fixations have been described. Hypothesis The authors hypothesized that arthroscopic suture-bridging repair of the supraspinatus tendon would result in a superior clinical outcome and lower retear rates compared with previously published results after double-row fixation. Study Design Case series; Level of evidence, 4. Methods Fifty-one consecutive patients, with a median age of 62 years (range, 37-76 years), who had undergone an arthroscopic suture-bridging repair of an isolated supraspinatus tendon tear were evaluated in this prospective study 4, 12, and a median of 24 months postoperatively. Subjective and functional outcome was assessed using the simple shoulder test and Constant score. With magnetic resonance imaging 12 months postoperatively, the tendon integrity and potential predictors of failures were evaluated. Results The simple shoulder test scores improved significantly from 9 points (range, 1-12 points) at 4 months, to 12 points (range, 1-12 points) at 12 months, and 12 points (range, 5-12 points) at 24 months postoperatively. The Constant score increased significantly from preoperative 64% (range, 37%-92%) to 82% (range, 36%-100%) at 4 months, 96% (range, 49%-100%) at 12 months, and 96% (range, 64%-100%) at 24 months postoperatively. Magnetic resonance imaging 12 months after surgery showed retears in 28.9%. Two different types of retears could be observed: insufficiently healed and medially retorn supraspinatus tendons. The Constant score did not differ significantly between the groups with retears and intact repairs. A patient age of more than 60 years was found to influence tendon healing significantly. Conclusion The hypothesis, that arthroscopic suture-bridging repair of the supraspinatus tendon would result in a superior clinical outcome and lower retear rates compared with previously published results after double-row fixation, could not be confirmed. The functional outcome after the new suture-bridging technique was good and comparable with the reported results after double-row repair from the literature. A structural failure of tendon repair was not identical to clinical failure.