How to Maximize Suture Tension in Double-Row Suture-Bridge Rotator Cuff Repair?

Abstract

Double-row suture-bridge technique for rotator cuff repair has been used for rotator cuff tears. In large tears that require 2 or more lateral row anchors, loosening of the suture bridges could occur because of tightening sequence. By retightening suture limbs before deploying the first lateral row anchor, premature loosening could be prevented and enhance the tension of the construct.

Three Medial All Suture Anchors Improves Contact Force Compared to Two Hard Body Anchors in a Biomechanical Two-Tendon Rotator Cuff Tear Model

“…Contact area in particular is felt to be important for achieving tendon healing. 24 , 25 , 26 While DR repairs have decreased the incidence of retear, overall retears rates remain at approximately 25%, and are notably increased with larger tears. 27 Thus, it appears worthwhile to continue to attempt to maximize contact force in large and massive rotator cuff tears, given its direct relationship with area.…”

Changes in the Lateral Acromion Angle in Rotator Cuff Tear Patients with Acromioplasty

“…Additionally, the fixation of anchors at the distal end of the rotator cuff leads to a concentrated stress distribution, contributing to the occurrence of retears. 29,[36][37][38] However, the investigation conducted by Ying et al failed to yield a definitive conclusion concerning the overall outcomes associated with double-row and single-row techniques used for repairing small to medium (<3 cm) or large to massive (>3 cm) RCTs. 39 Generally, double-row techniques exhibit lower retear rates compared to single-row techniques across most tear-size categories.…”

“…In terms of the anatomy, the contact area between the rotator cuff and the bone surface is relatively limited, which predisposes the formation of a gap at the suture site, thereby impacting the healing process of the bone‐tendon unit. Additionally, the fixation of anchors at the distal end of the rotator cuff leads to a concentrated stress distribution, contributing to the occurrence of retears 29,36–38 . However, the investigation conducted by Ying et al .…”

A Simple Technique to Restore Tension of a Loose Suture Bridge During Rotator Cuff Repair: Save the Repair

“…This may be due to overtightening of the second group of sutures after fixation of the first group, which becomes loose. 8 Recovery of the suture’s tension is important for the strength and healing property of this technique. The technique that will be presented helps to restore tension in a simple way and with no need for extra material.…”