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Arch Orthop Trauma Surg. 2017 Oct;137(10):1399-1408. doi: 10.1007/s00402-017-2750-7. Epub 2017 Jul 26.

Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years.

Author information

1
Steadman Philippon Research Institute, Center for Outcomes-Based Orthopaedic Research (COOR), 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA. drmillett@thesteadmanclinic.com.
2
The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA. drmillett@thesteadmanclinic.com.
3
Steadman Philippon Research Institute, Center for Outcomes-Based Orthopaedic Research (COOR), 181 West Meadow Drive, Suite 1000, Vail, CO, 81657, USA.
4
The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.
5
Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.

Abstract

PURPOSE:

To evaluate the outcomes of two commonly used transosseous-equivalent (TOE) arthroscopic rotator cuff repair (RCR) techniques for full-thickness supraspinatus tendon tears (FTST) using a robust multi-predictor model.

METHODS:

155 shoulders in 151 patients (109 men, 42 women; mean age 59 ± 10 years) who underwent arthroscopic RCR of FTST, using either a knotted suture bridging (KSB) or a knotless tape bridging (KTB) TOE technique were included. ASES and SF-12 PCS scores assessed at a minimum of 2 years postoperatively were modeled using propensity score weighting in a multiple linear regression model. Patients able to return to the study center underwent a follow-up MRI for evaluation of rotator cuff integrity.

RESULTS:

The outcome data were available for 137 shoulders (88%; n = 35/41 KSB; n = 102/114 KTB). Seven patients (5.1%) that underwent revision rotator cuff surgery were considered failures. The median postoperative ASES score of the remaining 130 shoulders was 98 at a mean follow-up of 2.9 years (range 2.0-5.4 years). A higher preoperative baseline outcome score and a longer follow-up had a positive effect, whereas a previous RCR and workers' compensation claims (WCC) had a negative effect on final ASES or SF 12 PCS scores. The repair technique, age, gender and the number of anchors used for the RCR had no significant influence. Fifty-two patients returned for a follow-up MRI at a mean of 4.4 years postoperatively. Patients with a KSB RCR were significantly more likely to have an MRI-diagnosed full-thickness rotator cuff re-tear (p < 0.05).

CONCLUSIONS:

Excellent outcomes can be achieved at a minimum of 2 years following arthroscopic KSB or KTB TOE RCR of FTST. The preoperative baseline outcome score, a prior RCR, WCC and the length of follow-up significantly influenced the outcome scores. The repair technique did not affect the final functional outcomes, but patients with KTB TOE RCR were less likely to have a full-thickness rotator cuff re-tear.

LEVEL OF EVIDENCE:

Level III, Retrospective Comparative Study.

KEYWORDS:

Double row; Knotless; Knotted; Rotator cuff repair; Suture bridge; Tape; Transosseous equivalent

PMID:
28748291
DOI:
10.1007/s00402-017-2750-7
[Indexed for MEDLINE]

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