Modified Double-Row Suture Bridge Technique With Double-Row Biceps Tenodesis for Massive Rotator Cuff Tear

Abstract

This article aims to describe a modification of the arthroscopic suture bridge technique for repair of a massive (>3 cm) rotator cuff tear. The method uses 2 medial anchors and 2 lateral anchors for rotator cuff repair, as well as doublerow biceps tenodesis. This operative modification may impart better tendon healing and fewer rupture complications than the traditional double-row repair techniques. R otator cuff repair using arthroscopic techniques was developed initially to reduce the high morbidity associated with open surgery. The recent literature has indicated that it is possible to obtain effective treatment for rotator cuff tears smaller than 1 cm using single-row (SR) repair. 1 In contrast, for defects between 1 and 3 cm, there is no clear agreement on what double-row (DR) modification is superior to the other, and any SR, DR, knotted transosseous-equivalent (TOE), or knotless TOE technique can be chosen depending on the preference of the surgeon and expectations of the patient. 1 For tears larger than 3 cm, the literature agrees that the modified DR TOE technique can yield better outcomes both functionally and in terms of repair integrity. 1 This study aims to describe a technique that uses medial-row anchors and knotless lateral-row anchors, with an evaluation of its clinical outcomes.

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 .…”