2021 ISAKOS Biennial Congress ePoster
Arthroscopic Rotator Cuff Repair: Outcomes After Knotted Verses Knotless Double Row Transosseous Equivalent Repair Techniques
Michael Andrew Fox, MD, Pittsburgh, PA UNITED STATES
Jonathan D Hughes, MD, Allison Park, Pennsylvania UNITED STATES
Nyaluma N. Wagala, MD, Pittsburgh, PA UNITED STATES
Neel K. Patel, MD, Pittsburgh, PA UNITED STATES
Adam Popchak, DPT, PhD, Pittsburgh, PA UNITED STATES
Bryson P. Lesniak, MD, Presto, Pennsylvania UNITED STATES
Albert Lin, MD, Pittsburgh, PA UNITED STATES
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, UNITED STATES
FDA Status Cleared
Summary
A comparison of failure rates and functional outcomes after transosseous equivalent (TOE) double-row (DR) knotted suture bridge versus knotless suture tape bridge repair techniques for rotator cuff tears
ePosters will be available shortly before Congress
Abstract
Purpose
To compare failure rates and functional outcomes after transosseous equivalent (TOE) double-row (DR) knotted suture bridge versus knotless suture tape bridge repair techniques for rotator cuff tears.
Methods
A consecutive series of 133 shoulders in 124 patients (60 men, 73 women, mean age 61.7 years ± 11.9 years) underwent arthroscopic, DR TOE repairs of the supraspinatus tendon with and without involvement of the infraspinatus tendon. A total of 84 shoulders, 14 using knotted suture bridging (KSB) technique and 70 using knotless tape bridging (KTB) configuration, met inclusion criteria for the study. Patients who underwent concomitant subscapularis tendon repairs were excluded. The minimum follow-up was 12 months. Primary outcome was failure of surgical repair, defined as either confirmed retear on MRI and/or need for revision repair. Secondary clinical outcome measures were assessed including range of motion, strength, Visual Analog Scale (VAS), PROMIS mental and physical health, American Shoulder and Elbow Surgeons Shoulder Score (ASES), Brophy shoulder activity scores, and need for manipulation under anesthesia (MUA).
Results
Average follow-up after surgery was 15 (12–55) months for the KSB group and 26 (12-70) months for the KTB group (p < 0.01). Although failure rate was higher in the KSB repairs (4/14, 28.6%) compared to the KTB group (7/70, 10%), this did not reach statistical significance (p=0.09). ASES scores (p = 0.03) and range of motion in forward flexion (FF) (p < 0.01) were significantly higher in the KSB group. There was no significant difference in strength, external rotation range of motion, VAS, PROMIS, and Brophy scores between the groups, as well as no difference in stiffness requiring MUA.
Conclusion
Both knotted KSB and KTB DR TOE repair techniques demonstrate low retear rates with excellent functional outcomes when compared to preoperative baseline at a minimum of 12 months follow-up after surgery, though KSB repairs performed significantly higher on ASES reported outcomes. There are no significant differences in retear rates; however, the findings may indicate a clinically significant trend towards increased failure rate with KSB repair.