Clinical and ultrasonographic outcomes of arthroscopic suture bridge repair for massive rotator cuff tear.
OBJECTIVE
The purpose of this study was to analyze the outcomes of arthroscopic suture bridge repairs of massive rotator cuff tears.


METHODS
Thirty-six patients with massive rotator cuff tears that had been repaired by arthroscopic suture bridge repair were enrolled in this study. The mean follow-up period after surgery was 37.6 ± 8.9 months (range, 25 to 56). Arthroscopic en masse suture bridge repair was used in delaminated tears. The integrity of the repaired rotator cuff was examined by ultrasonography 4.5 months, 1 year, and 2 years after surgery. Functional outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) shoulder score, Constant score, range of motion, and muscle power.


RESULTS
Twenty-seven cases (75%) showed complete healing on serial ultrasonography, whereas recurrent tears were detected in the remaining 9 cases (25%). Five retears were smaller than, and the other 4 were the same as or larger than, the initial tear. Overall mean functional scores and values improved after surgery. Although the 4 larger retears had a poorer outcome with respect to ASES score than the healed group (P = .005), the Constant score for these 4 retears did not significantly differ at the last follow-up (P = .175). Mean ASES and Constant scores for the larger tear group were also relatively satisfactory (64.2 and 63.0, respectively). Fatty degeneration of the supraspinatus on preoperative magnetic resonance images was associated with a high retear rate (P = .003, odds ratio = 13.664).


CONCLUSIONS
Massive rotator cuff tears can be treated successfully by arthroscopic en masse suture bridge repair with satisfactory results. Larger retears had some adverse effects on functional outcome, whereas patients with smaller retears did not significantly differ in functional outcome from the healed group. Fatty degeneration of the supraspinatus on preoperative magnetic resonance images is a poor prognostic indicator.


METHODS
Level IV, therapeutic case series.
Glocal Center for Shoulder & Elbow, Department of Orthopedic Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Republic of Korea.
Jin-Young
JY
Park
Sang-Hoon
SH
Lhee
Kyung-Soo
KS
Oh
Sung Gyu
SG
Moon
Jung-Taek
JT
Hwang
D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging* / Q000601:surgery; D013536:Suture Techniques; D013708:Tendon Injuries / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography