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Scientific Articles   |    
Repair Integrity and Functional Outcomes After Arthroscopic Suture-Bridge Rotator Cuff Repair
Kyung Cheon Kim, MD, PhD1; Hyun Dae Shin, MD, PhD1; Woo Yong Lee, MD1
1 Department of Orthopaedic Surgery, Chungnam National University Hospital, 640 Daesa-Dong, Jung-Gu, Daejeon 301-721, South Korea. E-mail address for K.C. Kim: kckim@cnu.ac.kr
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Investigation performed at the Department of Orthopaedic Surgery, Chungnam National University School of Medicine, Daejeon, South Korea



Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Apr 18;94(8):e48 1-6. doi: 10.2106/JBJS.K.00158
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Abstract

Background: 

We evaluated the clinical and imaging outcomes of arthroscopic suture-bridge repair of full-thickness rotator cuff tears.

Methods: 

From May 2007 to April 2008, seventy-nine patients with a full-thickness rotator cuff tear consecutively underwent arthroscopic suture-bridge repair. The mean age of the patients was 58.3 years (range, thirty-eight to seventy-eight years), and the mean duration of follow-up was 30.6 months (range, twenty-four to forty-four months). Seventy-three patients underwent postoperative ultrasonography or magnetic resonance imaging; seventy-one underwent the imaging at a minimum of two years postoperatively, and the remaining two did so after the operation because of persistent symptoms. The clinical results of seventy-seven patients (all except two who had undergone revision) were evaluated at a minimum of two years postoperatively. University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), and Constant-Murley scores were used for clinical and functional evaluations before surgery and at the time of final follow-up.

Results: 

The imaging follow-up rate was 92%, and the follow-up rate for clinical evaluation was 100%. The re-tear rate after suture-bridge repair was 15%. The re-tear rate of the medium, large, and massive tears (as classified according to the anterior-to-posterior diameter of the tear) was 12%, 21%, and 22%, respectively. Massive and large tears tended to show a higher re-tear rate than did medium tears, but the difference was not significant (p = 0.417 and p = 0.964, respectively). The mean UCLA, ASES, and Constant-Murley scores improved from 21.6, 50.4, and 52.7 preoperatively to 30.9, 86.2, and 74.7 at the time of final follow-up (p < 0.001). However, the clinical outcomes after the operation did not differ significantly between the patients who had healing of the tear and those who did not (p = 0.438, p = 0.625, and p = 0.898 for the UCLA, ASES, and Constant-Murley scores, respectively).

Conclusions: 

Arthroscopic suture-bridge repair of full-thickness rotator cuff tears was followed by a re-tear rate of 15% as seen with imaging and resulted in significant improvement of functional outcomes and clinical results compared with the preoperative findings.

Level of Evidence: 

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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