title: Difference in vascular patterns between transosseous-equivalent and transosseous rotator cuff repair.
abstract: BACKGROUND
  Vascularity is the important factor of biologic healing of the repaired tissue. The purpose of this study was to clarify sequential vascular patterns of repaired rotator cuff by suture techniques.
  
  
  METHODS
  We randomized 21 shoulders in 20 patients undergoing arthroscopic rotator cuff repair into 2 groups: transosseous-equivalent repair (TOE group, n = 10) and transosseous repair (TO group, n = 11). Blood flow in 4 regions inside the cuff (lateral articular, lateral bursal, medial articular, and medial bursal), in the knotless suture anchor in the TOE group, and in the bone tunnel in the TO group was measured using contrast-enhanced ultrasound at 1 month, 2 months, 3 months, and 6 months postoperatively.
  
  
  RESULTS
  The sequential vascular pattern inside the repaired rotator cuff was different between groups. The blood flow in the lateral articular area at 1 month, 2 months, and 3 months (P = .002, .005, and .025) and that in the lateral bursal area at 2 months (P = .031) in the TO group were significantly greater than those in the TOE group postoperatively. Blood flow was significantly greater for the bone tunnels in the TO group than for the knotless suture anchor in the TOE group at 1 month and 2 months postoperatively (P = .041 and .009).
  
  
  CONCLUSIONS
  This study clarified that the sequential vascular pattern inside the repaired rotator cuff depends on the suture technique used. Bone tunnels through the footprint may contribute to biologic healing by increasing blood flow in the repaired rotator cuff.
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Urita
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan. Electronic address: tfunakoshi@gmail.com.
authors.forename: Tadanao
authors.initials: T
authors.lastname: Funakoshi
authors.affiliation: Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan; Department of Radiological Technology, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Horie
authors.affiliation: Diagnostic Center for Sonography, Hokkaido University Hospital, Sapporo, Japan; Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Mutsumi
authors.initials: M
authors.lastname: Nishida
authors.affiliation: Department of Orthopaedic Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Norimasa
authors.initials: N
authors.lastname: Iwasaki
mesh_terms: D000368:Aged; D001182:Arthroscopy; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000098:blood supply*; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D053441:Suture Anchors; D013536:Suture Techniques; D014463:Ultrasonography; D014945:Wound Healing
chemical_list: D003287:Contrast Media
keywords: Rotator cuff tear; biologic healing; contrast-enhanced ultrasound; transosseous repair; transosseous-equivalent repair; vascularity