Knotted and knotless double row transosseous equivalent repair techniques for arthroscopic rotator cuff repair demonstrate comparable post-operative outcomes

Knotted and knotless double row transosseous equivalent repair techniques for arthroscopic rotator cuff repair demonstrate comparable post-operative outcomes

Purpose To compare failure rates and outcomes after transosseous equivalent (TOE) double row (DR) knotted suture bridge versus knotless suture tape bridge repair techniques for rotator cuff tears. Methods A consecutive series of 272 shoulders in 256 patients who underwent arthroscopic, double row, T...

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Bibliographic Details
Published in:Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 31; no. 5; pp. 1919 - 1924
Main Authors: Fox, Michael A., Hughes, Jonathan D., Drain, Nicholas P., Wagala, Nyaluma, Patel, Neel, Nazzal, Ehab, Popchak, Adam, Sabsevari, Soheil, Lesniak, Bryson P., Lin, Albert
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-05-2023
Springer Nature B.V
Subjects:
Anesthesia
Arthroscopy - methods
Demographic variables
Elbow
Elbow (anatomy)
Equivalence
Failure analysis
Failure rates
Humans
Injuries
Medicine
Medicine & Public Health
Motion detection
Orthopedics
Patients
Range of motion
Revisions
Rotator cuff
Rotator Cuff - surgery
Rotator Cuff Injuries - surgery
Shoulder
Sports Medicine
Stiffness
Sutures
Tendons
Treatment Outcome
Rotator cuff tear
Post-surgical outcomes
Transosseous equivalent
Knotless tape bridge
Double row
Rotator cuff repair
Knotted suture bridge
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Summary:Purpose To compare failure rates and outcomes after transosseous equivalent (TOE) double row (DR) knotted suture bridge versus knotless suture tape bridge repair techniques for rotator cuff tears. Methods A consecutive series of 272 shoulders in 256 patients who underwent arthroscopic, double row, TOE repair for full-thickness tears of the supraspinatus tendon were reviewed. Eighty-four shoulders were repaired using knotted suture bridge (KSB) technique, and 188 shoulders were repaired using all knotless suture tape bridge (KTB) technique. Revision procedures and concomitant subscapularis tendon repairs were excluded from analysis. The minimum follow-up was 12 months. Primary outcome was failure of surgical repair, defined as either confirmed retear on MRI and/or need for revision surgery. Secondary clinical outcome measures were assessed including range of motion, strength, visual analog scale (VAS), operative time, subjective shoulder value (SSV), Patient-Reported Outcomes Measurement Information System (PROMIS) mental and physical health, American Shoulder and Elbow Surgeons Shoulder Score (ASES), Brophy shoulder activity scores, and need for manipulation under anesthesia (MUA). Results A total of 127 shoulders (38 KSB and 89 KTB) met inclusion criteria for the study. No significant difference in demographic variables were present between the groups at baseline. Supraspinatus tear size and average follow-up time did not differ significantly between groups. Failure rates were similar between the KSB and KTB repairs (13.1 vs 7.9%, n.s.). There was no significant difference in functional outcomes including strength, range of motion in forward flexion and external rotation, as well as patient reported outcomes including VAS, SSV, PROMIS, ASES, and Brophy scores between the groups. There was also no difference in post-operative stiffness requiring MUA. Conclusion Both KSB and KTB repair techniques demonstrate low retear rates with excellent functional outcomes when compared to pre-operative examination. Both KSB and KTB techniques are viable options for achieving a successful rotator cuff repair. Level of evidence Level III
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ISSN:0942-2056
1433-7347
DOI:10.1007/s00167-022-07121-0