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

Chen, Hung-Chou; Wong, Chin-Chean; Chang, Wen‐Pei; Lin, Chia-Chin; Liaw, Chen Kun; Chen, Chih-Hwa; Weng, Pei-Wei

doi:10.1177/23259671221142242

Cited by 2 publications

(1 citation statement)

References 48 publications

(72 reference statements)

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“…Rotator cuff tears are one of the most common surgical conditions affecting the shoulder, with greater than 460,000 surgeries performed annually. While many patients do well, there is still a significant portion of patients who experience either failure of repair or re-tearing of their rotator cuff, with rates ranging from 3.9-26.8% in those with small or medium sized tears, up to as high as 94% in patients with large or massive tears (Longo et al 2021;Flurin et al 2013; H. M. Kim et al 2014;Galatz et al 2004;Inagaki et al 2023;Wang et al 2023). One solution to address this problem has been the development of scaffolds.…”

Section: Introductionmentioning

confidence: 99%

Short-term radiographic and clinical outcomes of arthroscopic rotator cuff repair with and without augmentation with an interpositional nanofiber scaffold

Beleckas

Minetos

Badman³

2023

Journal of Orthopaedic Experience &Amp; Innovation

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Background The rate of retear after primary rotator cuff failure remains unacceptably high (up to 36% for small- to medium-sized tears). Augmentation of the repair with an interpositional scaffold has been reported to improve healing. Purpose To compare the short-term radiographic and clinical outcomes of arthroscopic rotator cuff repair with and without augmentation with an interpositional nanofiber scaffold. Methods We prospectively enrolled patients with full thickness rotator cuff tears into a multicenter study with institutional review board approval. All patients had a minimum of one year clinical and radiographic follow-up. A single fellowship trained shoulder surgeon performed all procedures. Patients were blinded and randomized at the time of surgery into either a treatment group consisting of double row rotator cuff repair augmented with an interpositional nanofiber scaffold or a control group in which a standard double-row repair without augmentation was performed. Range of motion, muscle dynamometer strength testing (Lafayette Instruments), and clinical outcomes according to visual analog scale pain, American Shoulder and Elbow Surgeons (ASES), and Simple Shoulder Test (SST) scores were assessed preoperatively and at routine follow-up intervals. Magnetic resonance imaging (MRI) was obtained at a minimum of 4 months (range 4.5-14) on all patients and assessed according to the Sugaya classification with failure noted as grade 4 or higher. Patients without initial failure were then assessed at a minimum of one year (range 12-24 months) by ultrasound examination or MRI to assess for late failure of the repair and clinical outcomes. Results Thirty patients with a mean age of 64.6 years were statistically analyzed. Fourteen patients were treated with the nanofiber scaffold and 16 patients were non-augmented and made up the control. At an average of 6.8 months, all patients underwent MRI and early failure occurred in 7.1% of the nanofiber scaffold patients compared to 18.8% in the control group (p=.602). At an average time of 17 months postoperatively, all remaining patients with intact repairs underwent MRI (2) or ultrasound (28) and 9 more patients demonstrated Sugaya tear progression with five progressing to failure. All late failures and Sugaya tear progressions occurred in the control group. Cumulative treatment failure occurred significantly less often in patients who received the nanofiber scaffold (7.1%) compared to those who did not receive the bioresorbable scaffold (50%) (p=.017). Conclusion The present prospective study demonstrates a statistically significant difference in rotator cuff healing with use of an interpositional nanofiber scaffold. While future studies and larger series are warranted, the current data is promising in further advancing the outcomes of rotator cuff repairs.

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