title: Is the arthroscopic suture bridge technique suitable for full-thickness rotator cuff tears of any size?
abstract: OBJECTIVE
  The purpose of this study was to compare functional outcomes and tendon integrity between the suture bridge and modified tension band techniques for arthroscopic rotator cuff repair.
  
  
  METHODS
  A consecutive series of 128 patients who underwent the modified tension band (MTB group; 69 patients) and suture bridge (SB group; 59 patients) techniques were enrolled. The pain visual analogue scale (VAS), Constant, and American Shoulder and Elbow Surgeons (ASES) scores were determined preoperatively and at the final follow-up. Rotator cuff hypotrophy was quantified by calculating the occupation ratio (OR). Rotator cuff integrity and the global fatty degeneration index were determined by using magnetic resonance imaging at 6 months postoperatively.
  
  
  RESULTS
  The average VAS, Constant, and ASES scores improved significantly at the final follow-up in both groups (p < 0.05 for all scores). The retear rate of small-to-medium tears was similar in the modified tension band and suture bridge groups (7.0 vs. 6.8%, respectively; p = n.s.). The retear rate of large-to-massive tears was significantly lower in the suture bridge group than in the modified tension band group (33.3 vs. 70%; p = 0.035). Fatty infiltration (postoperative global fatty degeneration index, p = 0.022) and muscle hypotrophy (postoperative OR, p = 0.038) outcomes were significantly better with the suture bridge technique.
  
  
  CONCLUSIONS
  The retear rate was lower with the suture bridge technique in the case of large-to-massive rotator cuff tears. Additionally, significant improvements in hypotrophy and fatty infiltration of the rotator cuff were obtained with the suture bridge technique, possibly resulting in better anatomical outcomes. The suture bridge technique was a more effective method for the repair of rotator cuff tears of all sizes as compared to the modified tension band technique.
  
  
  METHODS
  Retrospective Cohort Design, Treatment Study, level III.
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.
authors.forename: Sung Hyun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea. serina@wonkwang.ac.kr.
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.
authors.forename: Tae Kyun
authors.initials: TK
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.
authors.forename: Seok Hyun
authors.initials: SH
authors.lastname: Kweon
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.
authors.forename: Hong Je
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.
authors.forename: Se Jin
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Wonkwang University Hospital, 344-2 Shinyong-dong, Iksan, Jeollabuk-do, Korea.
authors.forename: Jin Sung
authors.initials: JS
authors.lastname: Park
mesh_terms: D001178:Arthroplasty; D001182:Arthroscopy / Q000379:methods; D004551:Elbow Joint / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009133:Muscular Atrophy; D019635:Neurosurgical Procedures; D010147:Pain Measurement; D011184:Postoperative Period; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D012785:Shoulder Joint / Q000601:surgery*; D013537:Sutures; D013708:Tendon Injuries / Q000601:surgery*
keywords: Modified tension band; Retear rate; Rotator cuff tear; Suture bridge; Tear size