Comparison of Locking-Loop Suture Bridge Repair and Single-Row Suture Anchor Repair in Small to Medium Rotator Cuff Tears: A Prospective Cohort Study With Clinical and Ultrasound Evaluations

Yu-Chun Wang; Hung-Chou Chen; Chin-Chean Wong; Wen-Pei Chang; Chun-Hao Lin; Chen-Kun Liaw; Chih-Hwa Chen; Pei-Wei Weng

doi:10.1177/23259671221142242

Comparison of Locking-Loop Suture Bridge Repair and Single-Row Suture Anchor Repair in Small to Medium Rotator Cuff Tears: A Prospective Cohort Study With Clinical and Ultrasound Evaluations

Orthop J Sports Med. 2023 Jan 5;11(1):23259671221142242. doi: 10.1177/23259671221142242. eCollection 2023 Jan.

Authors

Yu-Chun Wang¹, Hung-Chou Chen^{2

3}, Chin-Chean Wong^{1

2

4

5

6

7}, Wen-Pei Chang^{8

9}, Chun-Hao Lin¹, Chen-Kun Liaw^{1

2

4}, Chih-Hwa Chen^{1

2

4}, Pei-Wei Weng^{1

2

4}

Affiliations

¹ Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City.
² Department of Orthopedics, College of Medicine, Taipei Medical University, Taipei.
³ Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City.
⁴ Graduate Institute of Biomedical Materials and Tissue Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei.
⁵ Research Center for Biomedical Devices and Prototyping Production, Taipei Medical University, Taipei.
⁶ College of Medicine, Taipei Medical University, Taipei.
⁷ Non-Invasive Cancer Therapy Research Institute of Taiwan, Taipei.
⁸ Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City.
⁹ College of Nursing, Taipei Medical University, Taipei.

Abstract

Background: Single-row (SR) and double-row repair techniques have been described to treat rotator cuff tears. We present a novel surgical strategy of arthroscopic-assisted mini-open repair in which a locking-loop suture bridge (LLSB) is used.

Purpose: To compare the functional outcomes and repair integrity of LLSB technique to the SR technique for arthroscopic-assisted mini-open repair of small to medium rotator cuff tears.

Study design: Cohort study; Level of evidence, 3.

Methods: Included were 39 patients who underwent LLSB repair (LLSB group) and 44 patients who underwent SR suture anchor repair (SR group) from 2015 to 2018. We evaluated all patients preoperatively and at 3, 6, 12, and 24 months postoperatively using the visual analog scale (VAS) for pain, Oxford Shoulder Score (OSS), and American Shoulder and Elbow Surgeons (ASES) score. Also, shoulder sonography was performed at 12 months postoperatively to evaluate repair integrity using the Sugaya classification system. The independent-sample t test was used to analyze functional outcomes (VAS, OSS, and ASES scores), and the Fisher exact test was used to analyze postoperative sonography results.

Results: Patients in both the LLSB and SR groups saw a significant improvement on all 3 outcome measures from preoperatively to 24 months postoperatively (P < .001 for all). However, when comparing scores between groups, only the scores at 3 months postoperatively differed significantly (VAS: P = .002; OSS: P < .001; ASES: P = .005). Shoulder sonography at 12 months postoperatively revealed no significant difference in repair integrity between the LLSB and SR groups (retear rate: 10.26% and 6.82%, respectively; P = .892).

Conclusion: Better outcome scores were seen at 3-month follow-up in the LLSB group, with no difference in retear rates compared with the SR group at 12 months postoperatively. The LLSB technique was found to be a reliable technique for rotator cuff repair of small- to medium-sized tears.

Keywords: arthroscopic-assisted mini-open; knotless suture anchor; rotator cuff tear; single-row repair; sonography; suture bridge technique.