Document Detail


Treatment Outcomes of Single- Versus Double-Row Repair for Larger Than Medium-Sized Rotator Cuff Tears: The Effect of Preoperative Remnant Tendon Length.
MedLine Citation:
PMID:  23942285     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:In rotator cuff repair, no practical guidelines exist for deciding which technique is the most beneficial to outcomes. PURPOSE:To determine which of 2 repair techniques, the single-row (SR) and double-row suture bridge (DR-SB) methods, leads to better therapeutic outcomes in terms of remnant tendon length in patients with larger than medium-sized cuff tears. STUDY DESIGN:Cohort study; Level of evidence, 3. METHODS:Remnant tendon length, muscle atrophy, and fatty degeneration were measured on preoperative magnetic resonance imaging (MRI) in 78 patients with larger than medium-sized rotator cuff tears who were available for follow-up MRI. There were 30 patients with remnant tendons <10 mm in length (group 1) and 48 with remnant tendons ≥10 mm in length (group 2). In group 1, the SR technique was performed on 17 patients and the DR-SB technique on 13 patients. In group 2, the SR technique was performed on 16 patients and the DR-SB technique on 32 patients. The mean follow-up period for all patients was 26.6 months (range, 24-42 months). Clinical outcomes were evaluated using the University of California, Los Angeles (UCLA), Constant, and American Shoulder and Elbow Surgeons (ASES) scores. RESULTS:In group 1, there was 1 retear (6%) with the SR repair and 6 (46%) with the DR-SB repair. In group 2, there were 3 retears (19%) with the SR repair and 2 (6%) with the DR-SB repair. The retear rate was significantly higher in patients with the DR-SB repair in group 1 (P = .025), while there was no significant difference between the 2 techniques in group 2 (P = .316). The UCLA and Constant scores were significantly higher in patients with the SR repair in group 1 (P = .02 and P = .029, respectively), and the UCLA and ASES scores were significantly higher in patients with the DR-SB repair in group 2 (P < .001 and P = .001, respectively). CONCLUSION:Remnant tendon length should be considered to improve repair integrity. The SR technique may provide superior rotator cuff integrity when remnant tendons are <10 mm in length.
Authors:
Young Kyu Kim; Sung Hoon Moon; Seung Hyun Cho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-13
Journal Detail:
Title:  The American journal of sports medicine     Volume:  -     ISSN:  1552-3365     ISO Abbreviation:  Am J Sports Med     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-8-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7609541     Medline TA:  Am J Sports Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Orthopaedic Surgery, Gil Hospital, Gacheon University, Incheon, South Korea.
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