Repair Integrity and Functional Outcomes After Arthroscopic Suture-Bridge Rotator Cuff Repair

Kim, Kyung Cheon; Shin, Hyun Dae; Lee, Woo Yong

doi:10.2106/jbjs.k.00158

Cited by 75 publications

(57 citation statements)

References 32 publications

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“…This review found that re-tear rates were found between 7 and 17 % in tears <1 cm and 41-69 % in tears greater than 5 cm; other studies corroborate this finding in re-tears based on the size of the tear [84]. Systematic literature reviews have not found a significant difference in percentage of re-tears based on the technique used for cuff repair, nor have more recent articles comparing newer techniques of fixation such as the suturebridge technique [85,86]. There has also been recent focus to determine whether or not clinical results are associated with the ultimate integrity of the repair; however, patients are found to do well clinically even when their repairs have failed radiographically [87][88][89][90][91].…”

Section: Osteonecrosismentioning

confidence: 81%

Management of complications after rotator cuff surgery

Parada

Dilisio

Kennedy

2014

Curr Rev Musculoskelet Med

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Rotator cuff repair (RCR) is a common procedure performed by orthopedic surgeons via arthroscopic, open, or mini-open techniques. While this surgery is considered to be of low morbidity, several potential complications can arise either intraoperatively or during the postoperative time period. Some of these complications are related to the surgical approach (arthroscopic or open), while others are patient dependent. Many of these complications can be managed through nonoperative means; however, early recognition and timely treatment is essential in limiting the long-term sequela and improving patient outcome. There are several different ways to classify complications after RCR repair: timing, severity, preventability, whether or not the pathology is intra-or extraarticular, and the type of treatment necessary. It is essential that the surgeon is cognizant of the etiology contributing to the failed RCR surgery in order to provide timely and proper management.

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Section: Osteonecrosismentioning

confidence: 81%

Management of complications after rotator cuff surgery

Parada

Dilisio

Kennedy

2014

Curr Rev Musculoskelet Med

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“…A modification of the double-row technique is the double-row suture bridge technique [36,[53][54][55][56] . Gartsman et al [54] , evaluated the repair integrity of single-row vs double-row suture bridge arthroscopic rotator cuff repairs in a prospective, randomized study.…”

Section: Muscle-tendon Unit Retractionmentioning

confidence: 99%

“…Several techniques have been described for double row suture bridge repair. Kim et al [55] compared three different methods including knotted and knotless techniques and demonstrated equivalence between techniques with regards to functional outcomes and repair integrity. An alternative to double row repairs for improving fixation and healing is to increase the number of sutures per anchor.…”

Section: Muscle-tendon Unit Retractionmentioning

confidence: 99%

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

158

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Rotator cuff repair has been shown to have good longterm results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair. Core tip: Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscletendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing after rotator cuff repair. Smoking cessation and blood glucose and cholesterol control are methods to potentially improve healing rates. Slower, less aggressive rehabilitation programs may improve healing rates with no negative effect on final range of motion and are therefore recommended after arthroscopic repair of most full thickness tears. Finally, no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates after rotator cuff repair. Routine use of these adjuvants is therefore not currently recommended.

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“…pain relief and a return of function despite a lack of healing 1,[12][13][14] . The rate and cause of successful and unsuccessful outcomes with failed rotator cuff repair is unclear.…”

mentioning

confidence: 99%