title: Arthroscopic suture bridge rotator cuff repair: functional outcome, repair integrity, and preoperative factors related to postoperative outcome.
abstract: OBJECTIVE
  To assess the retear rate, retear size and location, the clinical impact of a retear, and preoperative patient factors related to postoperative outcome after arthroscopic suture bridge rotator cuff repair.
  
  
  METHODS
  Fifty six patients with an isolated, full-thickness supraspinatus tendon tear who underwent arthroscopic suture bridge rotator cuff repair were retrospectively identified. Patients were evaluated and rotator cuff integrity was assessed using ultrasonography. Visual analog score (VAS), the American Shoulder and Elbow Surgeon (ASES) score, shoulder range of motion and strength were used for clinical evaluation. Retears were assessed for size and location on ultrasonography.
  
  
  RESULTS
  Forty two patients (75%) aged a mean 59.7 ± 8.6 years (range 41-79 years) were available for follow-up at a mean 13.5 months. Postoperative evaluation indicated significant improvements in ASES score (49.76 ± 18.2 to 86.57 ± 13.4, P < 0.001), VAS pain score (4.69 ± 2.17 to 0.63 ± 1.29, P < 0.001), forward elevation range of motion (144.1° ± 29.9 to 159.69° ± 13.9, P = 0.002), and internal rotation ROM (44.13° ± 12.0 to 52.09° ± 12.0, P = 0.003). The retear rate was 14.28% (6/42). Patients with retears were not older (P = 0.526) but had a larger preoperative tear size (3.25 cm ± 0.5 vs. 2.05 cm ± 0.48, P < 0.001). Preoperative tear size was significantly associated with a postoperative retear (P < 0.001). The duration of preoperative symptoms was significantly associated with pain (P = 0.029), pain improvement (P = 0.013), internal rotation ROM (P = 0.002), and internal rotation strength (P = 0.004).
  
  
  CONCLUSIONS
  Arthroscopic suture bridge repair provides good clinical results with a low retear rate. The duration of preoperative symptoms was associated with postoperative outcome, indicating that delaying surgery may result in inferior outcomes.
  
  
  METHODS
  IV, Case Series.
authors.affiliation: a Department of Orthopaedic Surgery , Beaumont Health System , Royal Oak , MI , USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Rimmke
authors.affiliation: b Orthopaedic Research Laboratories , Beaumont Health System , Royal Oak , MI , USA.
authors.forename: Tristan
authors.initials: T
authors.lastname: Maerz
authors.affiliation: b Orthopaedic Research Laboratories , Beaumont Health System , Royal Oak , MI , USA.
authors.forename: Ross
authors.initials: R
authors.lastname: Cooper
authors.affiliation: c Department of Diagnostic Radiology , Beaumont Health System , Royal Oak , MI , USA.
authors.forename: Sailaja
authors.initials: S
authors.lastname: Yadavalli
authors.affiliation: a Department of Orthopaedic Surgery , Beaumont Health System , Royal Oak , MI , USA.
authors.forename: Kyle
authors.initials: K
authors.lastname: Anderson
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011184:Postoperative Period; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D012399:Rotation; D017006:Rotator Cuff / Q000502:physiology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013536:Suture Techniques; D016896:Treatment Outcome; D014945:Wound Healing
keywords: Arthroscopic rotator cuff repair; functional outcomes; repair integrity; retear rate; suture bridge