scholarly journals Recurrent tears of the rotator cuff: Effect of repair technique and management options

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
Yehia H. Bedeir ◽  
Andrew E. Jimenez ◽  
Brian M. Grawe
Keyword(s):  
Rotator Cuff ◽  
Surgical Techniques ◽  
Potential Complication ◽  
Management Options ◽  
Double Row ◽  
Suture Bridge ◽  
Operative Repair ◽  
Repair Technique ◽  
Medial Cuff Failure

Retears of the rotator cuff, following operative repair, is not an uncommon event. Various factors have been shown to influence recurrence including the technique of repair. Multiple techniques have been performed with varying results and complications. The repair technique significantly affects the rate and pattern of retears. Although risk of retears with double row and suture bridge techniques is relatively low, medial cuff failure is a potential complication which poses significant challenges when revision repair is undertaken. Modifications in surgical techniques in, both, double row and suture bridge repairs can help decrease the risk of medial cuff failure. Thorough analysis of retear rates and patterns reported, and their relation with the repair technique, provides new insights about the pathogenesis of rotator cuff retears, their future prevention and appropriate management.

Intratendinous Strain Variations of the Supraspinatus Tendon Depending on Repair Technique: A Biomechanical Analysis Regarding the Cause of Medial Cuff Failure

2021 ◽  
pp. 036354652110061
Author(s):  
Michael Hackl ◽  
Julia Nacov ◽  
Sandra Kammerlohr ◽  
Manfred Staat ◽  
Eduard Buess ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Tendon Repair ◽  
Supraspinatus Tendon ◽  
Biomechanical Analysis ◽  
Double Row ◽  
Camera System ◽  
Musculotendinous Junction ◽  
Repair Technique ◽  
Medial Cuff Failure ◽  
Tendon Strain

Background: Double-row (DR) and transosseous-equivalent (TOE) techniques for rotator cuff repair offer more stability and promote better tendon healing compared with single-row (SR) repairs and are preferred by many surgeons. However, they can lead to more disastrous retear patterns with failure at the medial anchor row or the musculotendinous junction. The biomechanics of medial cuff failure have not been thoroughly investigated thus far. Purpose: To investigate the intratendinous strain distribution within the supraspinatus tendon depending on repair technique. Study Design: Controlled laboratory study. Methods: Twelve fresh-frozen cadaveric shoulders were used. The intratendinous strain within the supraspinatus tendon was analyzed in 2 regions—(1) at the footprint at the greater tuberosity and (2) medial to the footprint up to the musculotendinous junction—using a high-resolution 3-dimensional camera system. Testing was performed at submaximal loads of 40 N, 60 N, and 80 N for intact tendons, after SR repair, after DR repair, and after TOE repair. Results: The tendon strain of the SR group differed significantly in both regions from that of the intact tendons and the TOE group at 40 N ( P≤ .043) and from the intact tendons, the DR group, and the TOE group at 60 N and 80 N ( P≤ .048). SR repairs showed more tendon elongation at the footprint and less elongation medial to the footprint. DR and TOE repairs did not provide significant differences in tendon strain when compared with the intact tendons. However, the increase in tendon strain medial to the footprint from 40 N to 80 N was significantly more pronounced in the DR and TOE group ( P≤ .029). Conclusion: While DR and TOE repair techniques more closely reproduced the strains of the supraspinatus tendon than did SR repair in a cadaveric model, they showed a significantly increased tendon strain at the musculotendinous junction with higher loads in comparison with the intact tendon. Clinical Relevance: DR and TOE rotator cuff reconstructions lead to a more anatomic tendon repair. However, their use has to be carefully evaluated whenever tendon quality is diminished, as they lead to a more drastic increase in tendon strain medial to the footprint, putting these repairs at risk of medial cuff failure.

scholarly journals Comparison of arthroscopic suture-bridge technique and double-row technique for treating rotator cuff tears

Medicine ◽  
2019 ◽  
Vol 98 (20) ◽  
pp. e15640 ◽  
Author(s):  
Yi-Ming Ren ◽  
Hong-Bin Zhang ◽  
Yuan-Hui Duan ◽  
Yun-Bo Sun ◽  
Tao Yang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Suture Bridge ◽  
Suture Bridge Technique

scholarly journals Double-Row Repair Technique for Bursal-Sided Partial-Thickness Rotator Cuff Tears

2018 ◽  
Vol 7 (3) ◽  
pp. e199-e203 ◽  
Author(s):  
Hytham Salem ◽  
Aaron Carter ◽  
Fotios Tjoumakaris ◽  
Kevin B. Freedman
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Repair Technique ◽  
Partial Thickness ◽  
Double Row Repair

Functional and Structural Outcomes of Single-Row Versus Double-Row Versus Combined Double-Row and Suture-Bridge Repair for Rotator Cuff Tears

2011 ◽  
Vol 39 (10) ◽  
pp. 2091-2098 ◽  
Author(s):  
Teruhisa Mihata ◽  
Chisato Watanabe ◽  
Kunimoto Fukunishi ◽  
Mutsumi Ohue ◽  
Tomoyuki Tsujimura ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Single Row ◽  
Suture Bridge

Arthroscopic Single-Row Versus Double-Row Suture Bridge Technique for Rotator Cuff Tears in Patients Younger Than 55 Years: A Prospective Comparative Study

2017 ◽  
Vol 46 (1) ◽  
pp. 116-121 ◽  
Author(s):  
Michael E. Hantes ◽  
Yohei Ono ◽  
Vasilios A. Raoulis ◽  
Nikolaos Doxariotis ◽  
Aaron Venouziou ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Constant Score ◽  
Tendon Healing ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Single Row ◽  
Suture Bridge ◽  
Ucla Score ◽  
Arthroscopic Rotator Cuff

Background: When arthroscopic rotator cuff repair is performed on a young patient, long-lasting structural and functional tendon integrity is desired. A fixation technique that potentially provides superior tendon healing should be considered for the younger population to achieve long-term clinical success. Hypothesis/Purpose: The purpose was to compare the radiological and clinical midterm results between single-row and double-row (ie, suture bridge) fixation techniques for arthroscopic rotator cuff repair in patients younger than 55 years. We hypothesized that a double-row technique would lead to improved tendon healing, resulting in superior mid- to long-term clinical outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: A consecutive series of 66 patients younger than 55 years with a medium to large full-thickness tear of supraspinatus and infraspinatus tendons who underwent arthroscopic single-row or double-row (ie, suture bridge) repair were enrolled and prospectively observed. Thirty-four and 32 patients were assigned to single-row and double-row groups, respectively. Postoperatively, tendon integrity was assessed by MRI following Sugaya’s classification at a minimum of 12 months, and clinical outcomes were assessed with the Constant score and the University of California, Los Angeles (UCLA) score at a minimum of 2 years. Results: Mean follow-up time was 46 months (range, 28-50 months). A higher tendon healing rate was obtained in the double-row group compared with the single-row group (84% and 61%, respectively [ P < .05]). Although no difference in outcome scores was observed between the 2 techniques, patients with healed tendon demonstrated superior clinical outcomes compared with patients who had retorn tendon (UCLA score, 34.2 and 27.6, respectively [ P < .05]; Constant score, 94 and 76, respectively [ P < .05]). Conclusion: The double-row repair technique potentially provides superior tendon healing compared with the single-row technique. Double-row repair should be considered for patients younger than 55 years with medium to large rotator cuff tears.

Biomechanical characteristics of the horizontal mattress stitch: implication for double-row and suture-bridge rotator cuff repair

2014 ◽  
Vol 19 (2) ◽  
pp. 235-241 ◽  
Author(s):  
Mallika Tamboli ◽  
James Hwang ◽  
Michelle H. McGarry ◽  
Yangmi Kang ◽  
Thay Q. Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Double Row ◽  
Suture Bridge ◽  
Cuff Repair
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