Arthroscopic repair of partial-thickness articular surface rotator cuff tears: single-row transtendon technique versus double-row suture bridge (transosseous equivalent) fixation: results from a prospective randomized study

Arch Orthop Trauma Surg. 2020 Aug;140(8):1065-1071. doi: 10.1007/s00402-020-03387-6. Epub 2020 Mar 13.

Abstract

Background: The purpose of this prospective study was to compare the clinical and structural findings following the arthroscopic repair of partial-thickness (exceeding 50%) articular-sided rotator cuff tears using either a single-row or a double-row suture bridge fixation.

Materials and methods: Fifty patients were included in this study. The patients were randomly placed into two groups: 25 underwent the single-row (Group I) and 25 a double-row suture bridge fixation (Group II). The clinical outcomes were assessed using ASES and Constant shoulder scores, both preoperatively and at the end of follow-up. The pain level was evaluated using the visual analogue scale (VAS), preoperatively, at 6 months and at the end of follow-up. All patients underwent preoperative MRI to identify the rotator cuff tear, and postoperatively at 12 months to evaluate tendon integrity.

Results: The average follow-up was 32.5 months. The mean ASES scores increased from 35.9 to 96.7 in Group I and from 35.3 to 93.4 in Group II; the mean Constant shoulder scores increased from 55.6 to 97.8 in Group I and from 57.5 to 97.3 in Group II. There were no significant differences between the two groups. The average preoperative pain level decreased from 7.4 to 3 at 6 months and to 0.4 at the end of the Group I; and from 7.6 to 3 at 6 months and 0.8 in Group II. There was no significant difference between the two groups. At 12 months, the MRI assessments showed two retears in Group I (8%) and one retear in Group II (4%).

Conclusion: Arthroscopic repair of partial-thickness articular rotator cuff tears that exceed 50% of tendon thickness with a single-row transtendon repair or double-row suture bridge provides functional improvement and pain relief regardless of the repair technique used. There were no differences in clinical results between both techniques.

Level of evidence: Level II; prospective comparative study.

Keywords: Arthroscopic magnetic resonance imaging; Double row; Partial rotator cuff tears; Single row.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Arthroscopy* / adverse effects
  • Arthroscopy* / methods
  • Arthroscopy* / statistics & numerical data
  • Humans
  • Pain, Postoperative
  • Prospective Studies
  • Rotator Cuff
  • Rotator Cuff Injuries / surgery*
  • Suture Techniques* / adverse effects
  • Suture Techniques* / statistics & numerical data
  • Sutures
  • Tendons / surgery