Summary

The single-row repair technique that preserved the articular-sided fibers provided satisfactory clinical outcomes in patients with symptomatic, bursal-sided partial-thickness rotator cuff tears compared with conversion the tear to full thickness and fixed with suture-bridge techinique

Abstract

Purpose

For bursal-side partial supraspinatus tendon tear, the standard surgical treatment is to repair the tendon after conversion the tear to full thickness. Another technique is using single row suture to preserve intact articular fibers. The purpose of this study is to compare the clinical results of reservation articular fibers using single-row repair with double-row suture-bridge technique.

Methods

A retrospective study was conducted on 183 consecutive patients with symptomatic, bursal-sided partial-thickness rotator cuff tears from January 2008 to December 2011. There were 86 patients who received double-row suture bridge technique after conversion to full-thickness tears. At the same time, there were 97 patients who received reservation articular fibers and single row suture. To assess the outcome, pain visual analog scale (VAS), American Shoulder and Elbow Surgeon (ASES) score, and Constant score were evaluated at final follow-up. Postoperative MRI at least 6 months after surgery was evaluated for repair integrity.

Results

Together 136 patients were available for final follow-up. The mean follow-up time was 18.4 months (range, 14-36 months). There were 69 patients in the single-row group. In the patients treated with the single-row repair, the VAS score decreased from a preoperative 6.1±0.6 to 1.1±0.5 at the time of final follow-up. The mean ASES score (from 46.2±5.1 to 83.6±4.8) and mean Constant score (from 67.8± 4.2 to 86.4 ±3.2) were significant increased(P< .001). There were 67 patients in the double-row suture-bridge group and the VAS improved from 5.7 ±3.1 to 1.6±1.5), and mean ASES and Constant scores improved from 48.4±4.6 and 64.6±5.8 to 85.1±3.9 and 85.2 ±4.8. There were no significant difference between these two groups before and after the operation. Postoperative MRI was available at a mean 8.2 months after surgery. The union rate is 78.6% and 63.4 % (P<0.05).

Conclusions

The single-row repair technique that preserved the articular-sided fibers provided satisfactory clinical outcomes in patients with symptomatic, bursal-sided partial-thickness rotator cuff tears compared with conversion the tear to full thickness and fixed with suture-bridge techinique. Even at the early time, the union rate in patients who received singe-row repair was higher than double-row suture-bridge repair. Therefore, the single-row repair technique can be considered as an effective treatment in patients with bursal-sided partial-thickness rotator cuff tears.