Does an arthroscopic suture bridge technique maintain repair integrity?: a serial evaluation by ultrasonography.
Biomechanical studies suggest a suture bridge technique enhances rotator cuff tendon footprint contact area, holding strength, and mean contact pressure. Based on these studies, we asked whether (1) the suture bridge technique would provide a high rate of cuff integrity after surgery, (2) the status of the repaired cuff would change with time, (3) preoperative factors could predict postoperative cuff integrity, and (4) patients with retears had less favorable pain, functional scores, range of motion (ROM), and muscle strength compared with those with intact repairs. We prospectively followed 78 patients with arthroscopic repairs in whom we used the suture bridge technique. The integrity of the rotator cuff repair was determined using ultrasonographic evaluation at 4.5 and 12 months after surgery. Ultrasonography revealed intact cuffs in 91% at 4.5 months postoperatively, all of which were maintained at the 12-month followup. Failure rates were 17.6% (three of 17) for massive tears, 11.1% (two of 18) for large tears, 6.3% (two of 32) for medium tears, and no failures for small tears. Preoperative fatty degeneration of the supraspinatus muscle was a strong predictor of cuff integrity. We found no correlation between the integrity and clinical outcomes except for a temporary decrease of abduction strength at 6 months. Arthroscopic repair using suture bridge technique can achieve a low retear rate in shoulders treated for rotator cuff tears, but the occurrence of retear did not influence the outcome.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Park
Jin-Young
JY
Department of Orthopedic Surgery, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul, South Korea.
Siti
Hawa Tahir
HT
Keum
Jung-Sup
JS
Moon
Sung-Gyu
SG
Oh
Kyung-Soo
KS
D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects; D001696:Biomechanical Phenomena; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010147:Pain Measurement; D011446:Prospective Studies; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012008:Recurrence; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000517:prevention & control; D013536:Suture Techniques / Q000009:adverse effects; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography