Retear patterns after arthroscopic rotator cuff repair: single-row versus suture bridge technique.
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.


OBJECTIVE
To evaluate retear patterns in cases with structural failure after arthroscopic primary repairs of rotator cuff tears.


METHODS
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).


CONCLUSIONS
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.
Cho
Nam Su
NS
Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Dongdaemun-gu, Seoul 130-702, Korea. shoulderrhee@hanmail.net
Yi
Jin Woong
JW
Lee
Bong Gun
BG
Rhee
Yong Girl
YG
D000368:Aged; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D012422:Rupture, Spontaneous / Q000453:epidemiology; D012785:Shoulder Joint / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery; D016896:Treatment Outcome