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J Shoulder Elbow Surg. 2018 Jun;27(6):1021-1029. doi: 10.1016/j.jse.2017.10.040. Epub 2017 Dec 27.

Clinical and radiologic outcome of arthroscopic rotator cuff repair: single-row versus transosseous equivalent repair.

Author information

1
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Department of Orthopedic Surgery, Ortho One Orthopaedic Speciality Centre, Coimbatore, Tamil Nadu, India.
3
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: shoulderyoo@gmail.com.

Abstract

BACKGROUND:

There is ongoing controversy regarding the ideal repair modality for rotator cuff tear, with single-row (SR) repair and double-row transosseous equivalent (TOE) repair as the main contenders.

METHODS:

This study included 415 patients who underwent arthroscopic rotator cuff type I (complete coverage of the greater tuberosity footprint) or II (incomplete coverage) repair between January 2006 and December 2012. SR repair followed the conventional protocol. For double-row TOE repairs, 4 medial sutures were inserted with 2 lateral row anchors. The patients were evaluated for cuff integrity (on magnetic resonance imaging at 6 months postoperatively) and for clinical outcome (pain on the visual analog scale and various scores assessing shoulder function; all logged preoperatively and postoperatively at 3 months, 6 months, and at the last follow-up).

RESULTS:

SR and TOE repairs were performed in 46% and 54% of patients, respectively. Type I and type II repairs were performed in 87% and 13% of patients, respectively. The overall incidence of retear assessed on postoperative magnetic resonance imaging was 6.74%. The incidence of retear in the SR group was statistically significantly higher only in large-sized tears (28.57% vs. 4.5%; P = .028). Among the postoperative scores at the final follow-up, only the function on the visual analog scale differed significantly between the groups (P < .01), with patients treated by TOE repair showing higher scores (8.47 ± 1.70 vs. 7.91 ± 1.66).

CONCLUSION:

In this large cohort study, SR and TOE repair provided similar clinical and radiologic outcomes. Nevertheless, TOE repair was associated with significantly improved healing rate for large-sized tears.

KEYWORDS:

Rotator cuff repair; clinical outcomes; double-row transosseous equivalent repair; healing rate; retear; single-row repair

PMID:
29289493
DOI:
10.1016/j.jse.2017.10.040
[Indexed for MEDLINE]

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