title: Surface-holding repair: an original arthroscopic rotator cuff repair technique.
abstract: BACKGROUND
  Arthroscopic rotator cuff repair provides satisfactory results; however, there is still a high rate of re-tear. The objective of this study was to present a surface-holding technique that we recently developed for arthroscopic rotator cuff repair in detail and to evaluate the clinical outcome as well as cuff repair integrity with this new method.
  
  
  METHODS
  A consecutive series of 116 patients with full-thickness rotator cuff tears underwent arthroscopic surface-holding repair and were monitored with the Japanese Orthopaedic Association, Constant-Murley, and University of California-Los Angeles scores to assess the clinical outcome. The mean follow-up period was 17.9 months (range, 12-40 months). Cuff repair integrity was evaluated by magnetic resonance imaging.
  
  
  RESULTS
  All 3 rating systems at the time of final follow-up reflected a significant improvement in functional recovery of the shoulder compared with the preoperative scores. The overall rate of rotator cuff retear was 19.0% (22 of 116 shoulders), and the rates were 13.6% (9 of 66 shoulders) for small and medium-sized tears and 26% (13 of 50 shoulders) for large and massive tears. The rate for large and massive tears was much higher in patients older than 70 years (58.3%) compared with those younger than 70 years (36.3%), whereas the retear rates were similar in these 2 groups (22.2% and 17.5%, respectively).
  
  
  CONCLUSIONS
  Arthroscopic surface-holding repair technique with medial suture and transosseous fixation improved rotator cuff healing. This method may be useful both for young patients and for elderly patients, who frequently have chronic large and massive tears, including osteoporotic bones.
authors.affiliation: Department of Orthopaedic Surgery, University of Miyazaki, Miyazaki, Japan; Institute of Medical Science, Tokyo Medical University, Tokyo, Japan. Electronic address: nobutanigu@gmail.com.
authors.forename: Noboru
authors.initials: N
authors.lastname: Taniguchi
authors.affiliation: Upper Extremity Center of Joint Replacement and Endoscopic Surgery, Hokushin Orthopaedic Hospital, Sapporo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Suenaga
authors.affiliation: Upper Extremity Center of Joint Replacement and Endoscopic Surgery, Hokushin Orthopaedic Hospital, Sapporo, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Oizumi
authors.affiliation: Department of Orthopaedic Surgery, Asahikawa Medical University, Asahikawa, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Miyoshi
authors.affiliation: Department of Rehabilitation, Hakuaikai Kaisei Hospital, Obihiro, Japan.
authors.forename: Noriya
authors.initials: N
authors.lastname: Araki
authors.affiliation: Department of Orthopaedic Surgery, University of Miyazaki, Miyazaki, Japan.
authors.forename: Etsuo
authors.initials: E
authors.lastname: Chosa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013536:Suture Techniques; D013708:Tendon Injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroscopic rotator cuff repair; arthroscopic medial advanced footprint fixation; elderly; retear; stress dispersion; surface-holding technique; wide contact area