The modified massive cuff stitch: functional and structural outcome in massive cuff tears.
BACKGROUND
The massive cuff stitch (MCS) is known to be a strong suture, suitable for rotator cuff repair. We modified this technique for massive cuff tears by employing a horizontal medial mattress suture from an anchor as well as a vertically crossing transosseous suture.


METHODS
We included 42 patients with massive cuff tears suitable for repair: 22 were treated with the modified MCS (MCS group), and 20 with a simple transosseous suture (STS group). The range of motion (ROM), muscle strength, visual analog scale, and the Japanese Orthopaedic Association (JOA) scores were evaluated pre-operatively and 12 and 24 months post-operatively. The incidence of post-operative re-tears was examined at least 1 year post-operatively using Sugaya's classification.


RESULTS
The ROM, muscle strength, degree of pain, and the JOA scores were much improved after surgery in both groups, and there was no significant intergroup difference throughout the pre- and post-operative periods. In contrast, post-operative MRI revealed a significantly lower re-tear rate in the MCS group than in the STS group (9.1% vs. 40%, P = 0.0296).


CONCLUSIONS
The techniques tested were comparable in terms of functional outcome after surgical repair of massive cuff tears; however, the modified MCS repair technique produced superior structural outcomes with a significantly lower re-tear rate.
Department of Orthopaedic Surgery, Kurume University Medical Center Kurume, Kurume, Fukuoka, Japan. gomasa@med.kurume-u.ac.jp
Masafumi
M
Gotoh
Yasuhiro
Y
Mitsui
Kazuhiro
K
Yoshimitsu
Kenjiro
K
Nakama
Takahiro
T
Okawa
Fujio
F
Higuchi
Kensei
K
Nagata
D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010146:Pain / Q000209:etiology; D010147:Pain Measurement / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology; D012008:Recurrence; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D012785:Shoulder Joint / Q000503:physiopathology; D013536:Suture Techniques; D013708:Tendon Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome