Repair Integrity and Functional Outcomes After Arthroscopic Suture Bridge Subscapularis Tendon Repair

Shibayama, Kazuhiro; Sugaya, Hiroyuki; Matsuki, Keisuke; Takahashi, Norimasa; Tokai, Morihito; Onishi, Kazutomo; Tanaka, Sakae

doi:10.1016/j.arthro.2018.03.045

Cited by 21 publications

(26 citation statements)

References 33 publications

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“…Rotator cuff tendons were repaired using the medial knot-tying after suture-bridge lateral-row repair techniques. 13 , 25 , 27 One to 3 triple-loaded suture anchors were inserted at the medial border of the footprint in accordance with tear size, and two different sutures were passed through the rotator cuff at a time. Suture-bridge lateral-row fixation was initially performed using 2 of 3 sutures from an anchor.…”

Section: Methodsmentioning

confidence: 99%

Relationship between the morphology of the greater tuberosity and radiological and clinical outcomes after arthroscopic rotator cuff repair

et al. 2021

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Background Degenerative greater tuberosity (GT) changes are often associated with rotator cuff tears. However, little is known about the impact of GT morphology on surgical outcomes. The aim of this study was to examine the relationship between clinical and radiological outcomes, after rotator cuff repair, and GT morphology. Methods We retrospectively investigated shoulders that underwent arthroscopic repair of nontraumatic full-thickness supra-/infraspinatus tears. The exclusion criteria were a lack of either radiographs or magnetic resonance images, revision surgery, partial repair, complications such as infection or dislocation, and follow-up < 2 years. GT morphology on radiographs was classified into 5 groups: normal, sclerosis, bone spur, roughness, and femoralization. The acromiohumeral interval (AHI) was measured on anteroposterior radiographs. Fatty degeneration of the cuff muscles was evaluated using the global fatty degeneration index (GFDI). Postoperative cuff integrity was classified using Sugaya's classification at 2 years after surgery. Clinical outcomes were assessed preoperatively and at postoperative 2 years with the Japanese Orthopaedic Association score and the University of California, Los Angeles shoulder rating scale. Results The study included 220 shoulders in 212 patients (104 men and 108 women), with a mean age of 66 years (range 43-85). The mean follow-up period was 28 months (range, 24-60 months). Seven shoulders (3.2%) were classified as normal, 65 (29.5%) as sclerosis, 55 (25.0%) as bone spur, 78 (34.5%) as roughness, and 15 (6.8%) as femoralization. The preoperative AHI, in the roughness and femoralization groups, was significantly smaller than that in the sclerosis ( P < .01) and bone spur groups ( P < .001). The roughness and femoralization groups had a greater number of large tears ( P = .006). In the roughness and femoralization groups, mean GFDI was significantly higher than that in the sclerosis group ( P < .001 for both). Repaired cuff integrity was not different between all groups, respectively. Both Japanese Orthopaedic Association and University of California, Los Angeles scores improved postoperatively from 73.3 to 95.6 points and 18.2 to 34.0 points ( P < .001 for both), respectively, and there were no significant differences between all groups, respectively. Conclusion Roughness or femoralization of the GT was related to larger tears, with smaller AHI and higher GFDI. Repaired cuff integrity and clinical outcomes in shoulders with roughness or femoralization of the GT were not inferior to shoulders with the other types of GT morphologies in this study. Arthroscopic repair can be indicated for shoulders with advanced changes of the GT, if fatty degeneration of the cuff muscles is not severe.

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Section: Methodsmentioning

confidence: 99%

Relationship between the morphology of the greater tuberosity and radiological and clinical outcomes after arthroscopic rotator cuff repair

et al. 2021

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“…Re-tear rates after arthroscopic repair of subscapularis tendon tears range from 5% to 30% in the current literature. 10 However, it is still unclear whether singleor double-row repair is superior and whether concomitant treatment of the long head of the biceps tendon with a biceps tenotomy or tenodesis should be performed in every case.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Knotless Repair of Complete Full-Thickness Tears of the Subscapularis Tendon Through a Single Portal

Perret²,

Borbas³

2020

Arthroscopy Techniques

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Arthroscopic repair of subscapularis tendon tears has shown to be a reliable and reproducible technique and is now considered the gold standard method over open repair. However, most arthroscopic techniques use several working portals and the procedure can be technically challenging and time-consuming, especially when knot-tying is required and when multiple anchors are used. Recently, single-portal knotless techniques have been popularized for upper-third lesions (e.g. Lafosse type 1 or 2 tears). Here, we describe a technique of repairing complete tears of the subscapularis tendon (Lafosse type 3 and 4) using knotless suture anchors through a single portal. This technique is quick and allows a safe anatomic footprint repair to the lesser tuberosity.

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“…We also performed arthroscopic suture-bridge rotator cuff repair for full-thickness subscapularis tendon tears using the same techniques. 24…”

Section: Surgical Proceduresmentioning

confidence: 99%

Repair Integrity and Retear Pattern After Arthroscopic Medial Knot-Tying After Suture-Bridge Lateral Row Rotator Cuff Repair

et al. 2020

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Background: Type 2 failure is a big issue after suture-bridge rotator cuff repair, which may be because of stress concentration at the medial row stitches. We have been performing medial knot-tying after suture-bridge lateral row repair to avoid the stress concentration. This study aimed to evaluate clinical and radiological outcomes after arthroscopic rotator cuff repair using this technique. Hypothesis: This technique would yield better radiological outcomes with a reduced type 2 failure rate compared with reported outcomes after conventional suture-bridge repair. Study Design: Case series; Level of evidence, 4. Methods: The inclusion criteria of this study were (1) full-thickness tears, (2) primary surgery, and (3) minimum 2-year follow-up with pre- and postoperative magnetic resonance imaging (MRI). We investigated active ranges of motion (forward elevation and external rotation), as well as the Japanese Orthopaedic Association (JOA) and University of California, Los Angeles (UCLA), scores preoperatively and at the final follow-up. Results: This study included 384 shoulders in 373 patients (205 men and 168 women) with a mean age of 65 years (range, 24-89 years) at the time of surgery. The mean follow-up was 29 months (range, 24-60 months). There were 91 small, 137 medium, 121 large, and 35 massive tears. Postoperative MRI scans demonstrated successful repair in 324 shoulders (84.4%, group S) and retear in 60 shoulders (15.6%). Among 60 retears, 40 shoulders (67%) had type 1 failure (group F1) and 20 shoulders (33%) had type 2 failure (group F2). Forward elevation and external rotation significantly improved after surgery ( P < .001 for both). Postoperative JOA and UCLA scores in group F2 were significantly lower than those in the other groups. Conclusion: The medial knot-tying after suture-bridge lateral row repair demonstrated excellent functional and radiological outcomes after surgery, with a retear rate of 15.6%. The type 2 failure showed significantly inferior functional outcomes; however, the rate of type 2 failure was less relative to previous studies using conventional suture-bridge techniques. Our technique could be a good alternative to conventional suture-bridging rotator cuff repair because it may reduce the rate of postoperative type 2 failure.

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Repair Integrity and Functional Outcomes After Arthroscopic Suture Bridge Subscapularis Tendon Repair

Cited by 21 publications

References 33 publications

Relationship between the morphology of the greater tuberosity and radiological and clinical outcomes after arthroscopic rotator cuff repair

Relationship between the morphology of the greater tuberosity and radiological and clinical outcomes after arthroscopic rotator cuff repair

Arthroscopic Knotless Repair of Complete Full-Thickness Tears of the Subscapularis Tendon Through a Single Portal

Repair Integrity and Retear Pattern After Arthroscopic Medial Knot-Tying After Suture-Bridge Lateral Row Rotator Cuff Repair

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