Five Year Follow up of Retrospective Cohort Comparing Structural and Functional Outcome of Arthroscopic Single-row versus Double-row Suture Bridge Repair of Large Posterosuperior Rotator Cuff Tear in Patients Less than or Equal to 70 Years
نویسندگان
1 Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, India
2 Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, India
3 Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, India
4 Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, India
5 Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, India
6 Shoulder unit, Lairesse Kliniek, Valeriusplein, BG Amsterdam, The Netherlands
doi
10.22038/abjs.2020.47883.2369چکیده
Background: High re-tear rates after repairing large-sized posterosuperior rotator cuff tears remain a significantconcern which may affect the clinical outcome. The most optimal type of repair (single versus double-row suturebridge) suited for large size tear remains debatable.Methods: In a retrospective cohort study with a minimum of five years follow up, the structural and functional outcome of103 patients with large size cuff tear repaired with single row (SR) or double row suture bridge (DRSB) were evaluated.The structural outcome was assessed with ultrasonography whereas functional outcome was evaluated with ConstantMurley (CM) and American shoulder elbow score (ASES).Results: There were 55 patients in the SR group and 48 patients in the DRSB group with a mean follow-up of 74.2months (range, 60-96 months). While comparing the structural integrity in two groups, we found significantly lower retearrates in the DRSB group as compared to the SR group (10.4% vs. 32.7%; P=0.006). Also, there were more focaldefects in the SR group (25.4%) than the DRSB group (8.3%). Overall, there was no significant difference in CM andASES scores when the SR group was compared to DRSB. However, subgroup analysis between those with intact andretorn tendon revealed significant difference (P=0.0001) in the clinical scores.Conclusion: At a minimum of five years follow-up, the DRSB repair of large posterosuperior cuff tear resulted insuperior structural healing over SR repair. Nevertheless, overall there was no significant functional difference betweenboth the techniques. However, the functional outcome of the healed tendon subgroup was superior to retear tendonsubgroup.Level of evidence: III
