title: Arthroscopic rotator cuff repair using modified Mason-Allen medial row stitch: knotless versus knot-tying suture bridge technique.
abstract: BACKGROUND
  When using a method of suture bridge technique, there may be a possibility of strangulation of the rotator cuff tendon at the medial row. The style of knots chosen to secure the medial row might conceivably be a factor to reduce this possibility.
  
  
  OBJECTIVE
  To compare the clinical results and repair integrity of arthroscopic rotator cuff repair between a knotless and a conventional knot-tying suture bridge technique for patients with full-thickness rotator cuff tears and to evaluate retear patterns in the cases with structural failure after arthroscopic repair by magnetic resonance imaging (MRI).
  
  
  METHODS
  Cohort study; Level of evidence, 2.
  
  
  METHODS
  After arthroscopic repair for medium-sized rotator cuff tears, 110 patients available for postoperative MRI evaluation at least 6 months were enrolled in this study. According to the repair technique, 51 shoulders were enrolled in a knotless suture bridge technique group (group A) and 59 shoulders in a conventional knot-tying suture bridge technique group (group B). The mean age at the time of the operation was 61.0 years (range, 44-68 years) in group A and 57.6 years (range, 45-70 years) in group B. The mean follow-up period was 21.2 months (range, 12-34 months) and 22.1 months (range, 13-32 months), respectively.
  
  
  RESULTS
  The Constant score of group A increased from the preoperative mean of 65.2 points to 79.1 points at the last follow-up (P < .001). The corresponding figures for group B improved from 66.6 points to 76.3 points (P < .001). The preoperative Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score was 21.1 points in group A and 18.3 points in group B. The UCLA score at the last follow-up was 31.0 points in group A and 27.9 points in group B (P < .001, P < .001). Retear rate was significantly lower in group A (5.9%) than group B (18.6%) (P < .001). In group B, retear occurred at the musculotendinous junction in 72.7%, but group A had no medial cuff failure.
  
  
  CONCLUSIONS
  In arthroscopic suture bridge repair of full-thickness rotator cuff tears, clinical results of both a knotless and a conventional knot-tying group showed improvement without significant difference between the 2 groups. However, the knotless group had a significantly lower retear rate compared with the conventional knot-tying group. A knotless suture bridge technique could be a new supplementary repair technique to conventional technique.
authors.affiliation: Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Korea. shoulderrhee@hanmail.net
authors.forename: Yong Girl
authors.initials: YG
authors.lastname: Rhee
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Cho
authors.forename: Chong Suck
authors.initials: CS
authors.lastname: Parke
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013536:Suture Techniques; D013708:Tendon Injuries / Q000175:diagnosis / Q000601:surgery*