The effect of suture materials and techniques on the outcome of repair of the rotator cuff

Abstract

In a prospective, randomised study on the repair of tears of the rotator cuff we compared the clinical results of two suture techniques for which different suture materials were used. We prospectively randomised 100 patients with tears of the rotator cuff into two groups. Group 1 had transosseous repair with No. 3 Ethibond using modified Mason-Allen sutures and group 2 had transosseous repair with 1.0 mm polydioxanone cord using modified Kessler sutures. After 24 to 30 months the patients were evaluated clinically using the Constant score and by ultrasonography. Of the 100 patients, 92 completed the study. No significant statistical difference was seen between the two groups: Constant score, 91% vs 92%; rate of further tear, 18% vs 22%; and revision, 4% vs 4%. In cases of further tear the outcome in group 2 did not differ from that for the intact repairs (91% vs 91%), but in group 1 it was significantly worse (94% vs 77%, p = 0.005). Overall, seven patients had complications which required revision surgery, in four for pain (two in each group) and in three for infection (two in group 1 and one in group 2).

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

“…Because clinical diagnosis of rerupture is difficult [13,22], an imaging modality is commonly required to evaluate tendon healing. Although ultrasound is accurate for diagnosing rerupture [6][7][8][9][10][11][12][13][14][15], the comprehensive assessment provided by MR imaging is preferred by many authors [3,17,21,34,36]. However, postoperative MR imaging has a number of drawbacks, including susceptibility artefacts [19], tendency to overcall full-thickness tears [24], risk of misinterpreting scar tissue as partial tear [19,25], and lack of accuracy in determining rerupture size [28].…”

“…Tendon rerupture has attracted preferential attention and has been extensively assessed by means of arthrography [2][3][4][5], ultrasound [6][7][8][9][10][11][12][13][14][15], arthrography combined with computed tomography (CT) [16][17][18], magnetic resonance (MR) imaging [13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], and MR arthrography [34].…”

A Prospective Randomized Clinical Trial Comparing Arthroscopic Single-and Double-Row Rotator Cuff Repair

“…Exclusion criteria included the following: (1) an active history of smoking, 45 (2) an autoimmune or rheumatological disease, (3) the active use of steroids, (4) previous rotator cuff surgery on the affected shoulder, (5) a tear at the time of surgery that was not deemed to be repairable using the double-row technique as employed in this study, (6) workers' compensation patients, 50 (7) a significant subscapularis tear, and (8) a tear pattern that required a significant side-to-side repair of the tendon. 9 These large "U"-shaped tears were excluded, as failures may have been more indicative of in situ tendon failure than a failure of tendon-to-bone healing.…”

Structural Integrity After Rotator Cuff Repair Does Not Correlate with Patient Function and Pain

“…This result has sparked interest in evaluating whether structural integrity of the repair correlates with patients' clinical outcome. Despite the evolution of repair techniques, the rate of unhealed or retorn cuffs after repair remains relatively high 2,[8][9][10][11][12][13][14][15][16][17][18][19][20] . Regardless of the repair technique, recurrent rotator cuff tears or repair failures are seen in 20% to 94% of patients [21][22][23][24] .…”