Clinical research of arthroscopic separate double-layer suture bridge technique for delaminated rotator cuff tear_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

REN Jiangtao ,  XU Cong , LIU Xianglin , WANG Jiansong , LI Zhihuai , LÜ Yongming

Department of Joint Surgery, Affiliated Hospital of Chengde Medical University, Chengde Hebei, 067000, P.R.China;

Corresponding author：

XU Cong, Email: arthroscopy2012@163.com

Keywords：

Delaminated rotator cuff tear; suture bridge; separate double-layer repair; whole-layer repair

DOI：

10.7507/1002-1892.201703005

Video：

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Objective To explore the effectiveness of the arthroscopic separate double-layer suture bridge technique in treatment of the delaminated rotator cuff tear. Methods Between May 2013 and May 2015, 54 patients with the delaminated rotator cuff tears were recruited in the study. They were randomly allocated into 2 groups to receive repair either using arthroscopic separate double-layer suture bridge technique (trial group, n=28) or using arthroscopic whole-layer suture bridge technique (control group, n=26). There was no significant difference in gender, age, injured side, tear type, and preoperative visual analogue scale (VAS) score, Constants score, American Shoulder and Elbow Surgeons (ASES) score, University of California Los Angeles (UCLA) score, and the range of motion of shoulder joint between 2 groups (P>0.05). Postoperative functional scores, range of motion, and recurrence rate of tear in 2 groups were observed and compared. Results The operation time was significant longer in trial group than in control group (t=8.383, P=0.000). All incisions healed at stage Ⅰ without postoperative complication. All the patients were followed up 12 months. At 12 months postoperatively, the UCLA score, ASES score, VAS score, Constant score, and the range of motion were significantly improved when compared with the preoperative values in 2 groups (P<0.05). However there was no significant difference in above indexes between 2 groups (P>0.05). Four cases (14.3%) of rotator cuff tear recurred in trial group while 5 cases (19.2%) in control group, showing no significant difference (χ²=0.237, P=0.626). Conclusion Compared with the arthroscopic whole-layer suture bridge technique, arthroscopic separate double-layer suture bridge technique presents no significant difference in the shoulder function score, the range of motion, and recurrence of rotator cuff tear, while having a longer operation time.

Citation： REN Jiangtao, XU Cong, LIU Xianglin, WANG Jiansong, LI Zhihuai, LÜ Yongming. Clinical research of arthroscopic separate double-layer suture bridge technique for delaminated rotator cuff tear. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(10): 1168-1172. doi: 10.7507/1002-1892.201703005 Copy

1.	Kim SJ, Choi YR, Lee HH, et al. Surgical Results of Delaminated Rotator Cuff Repair Using Suture-Bridge Technique With All-Layers or Bursal Layer-Only Repair. Am J Sports Med, 2016, 44(2): 468-473.
2.	Boileau P, Brassart N, Watkinson DJ, et al. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg (Am), 2005, 87(6): 1229-1240.
3.	Choo HJ, Lee SJ, Kim JH, et al. Delaminated tears of the rotator cuff: prevalence, characteristics, and diagnostic accuracy using indirect MR arthrography. AJR Am J Roentgenol, 2015, 204(2): 360-366.
4.	MacDougal GA, Todhunter CR. Delamination tearing of the rotator cuff: prospective analysis of the influence of delamination tearing on the outcome of arthroscopically assisted mini open rotator cuff repair. J Shoulder Elbow Surg, 2010, 19(7): 1063-1069.
5.	Gwak HC, Kim CW, Kim JH, et al. Delaminated rotator cuff tear: extension of delamination and cuff integrity after arthroscopic rotator cuff repair. J Shoulder Elbow Surg, 2015, 24(5): 719-726.
6.	Kim IB, Kim MW. Risk Factors for Retear After Arthroscopic Repair of Full-Thickness Rotator Cuff Tears Using the Suture Bridge Technique: Classification System. Arthroscopy, 2016, 32(11): 2191-2200.
7.	Park JS, Park HJ, Kim SH, et al. Prognostic Factors Affecting Rotator Cuff Healing After Arthroscopic Repair in Small to Medium-sized Tears. Am J Sports Med, 2015, 43(10): 2386-2392.
8.	Chung SW, Kim JY, Yoon JP, et al. Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med, 2015, 43(3): 588-596.
9.	Nakamura H, Gotoh M, Mitsui Y, et al. Factors Affecting Clinical Outcome in Patients With Structural Failure After Arthroscopic Rotator Cuff Repair. Arthroscopy, 2016, 32(5): 732-739.
10.	Hepp P, Engel T, Osterhoff G, et al. Knotless anatomic double-layer double-row rotator cuff repair: a novel technique re-establishing footprint and shape of full-thickness tears. Arch Orthop Trauma Surg, 2009, 129(8): 1031-1036.
11.	Mori D, Funakoshi N, Yamashita F. Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears. Arthrosc Tech, 2014, 3(6): e667-e671.
12.	Cofield RH. Rotator cuff disease of the shoulder. J Bone Joint Surg (Am), 1985, 67(6): 974-979.
13.	Cha SW, Lee CK, Sugaya H, et al. Retraction pattern of delaminated rotator cuff tears: dual-layer rotator cuff repair. J Orthop Surg Res, 2016, 11: 75.
14.	Cheon SJ, Kim JH, Gwak HC, et al. Comparison of histologic healing and biomechanical characteristics between repair techniques for a delaminated rotator cuff tear in rabbits. J Shoulder Elbow Surg, 2017, 26(5): 838-845.
15.	Kim YS, Lee HJ, Jin HK, et al. Conventional En Masse Repair Versus Separate Double-Layer Double-Row Repair for the Treatment of Delaminated Rotator Cuff Tears. Am J Sports Med, 2016, 44(5): 1146-1152.
16.	Lee SH, Kim JW, Kim TK, et al. Is the arthroscopic suture bridge technique suitable for full-thickness rotator cuff tears of any size? Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2138-2146.
17.	Rimmke N, Maerz T, Cooper R, et al. Arthroscopic suture bridge rotator cuff repair: functional outcome, repair integrity, and preoperative factors related to postoperative outcome. Phys Sportsmed, 2016, 44(2): 126-132.
18.	Han Y, Shin JH, Seok CW, et al. Is posterior delamination in arthroscopic rotator cuff repair hidden to the posterior viewing portal? Arthroscopy, 2013, 29(11): 1740-1747.

1. Kim SJ, Choi YR, Lee HH, et al. Surgical Results of Delaminated Rotator Cuff Repair Using Suture-Bridge Technique With All-Layers or Bursal Layer-Only Repair. Am J Sports Med, 2016, 44(2): 468-473.
2. Boileau P, Brassart N, Watkinson DJ, et al. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg (Am), 2005, 87(6): 1229-1240.
3. Choo HJ, Lee SJ, Kim JH, et al. Delaminated tears of the rotator cuff: prevalence, characteristics, and diagnostic accuracy using indirect MR arthrography. AJR Am J Roentgenol, 2015, 204(2): 360-366.
4. MacDougal GA, Todhunter CR. Delamination tearing of the rotator cuff: prospective analysis of the influence of delamination tearing on the outcome of arthroscopically assisted mini open rotator cuff repair. J Shoulder Elbow Surg, 2010, 19(7): 1063-1069.
5. Gwak HC, Kim CW, Kim JH, et al. Delaminated rotator cuff tear: extension of delamination and cuff integrity after arthroscopic rotator cuff repair. J Shoulder Elbow Surg, 2015, 24(5): 719-726.
6. Kim IB, Kim MW. Risk Factors for Retear After Arthroscopic Repair of Full-Thickness Rotator Cuff Tears Using the Suture Bridge Technique: Classification System. Arthroscopy, 2016, 32(11): 2191-2200.
7. Park JS, Park HJ, Kim SH, et al. Prognostic Factors Affecting Rotator Cuff Healing After Arthroscopic Repair in Small to Medium-sized Tears. Am J Sports Med, 2015, 43(10): 2386-2392.
8. Chung SW, Kim JY, Yoon JP, et al. Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med, 2015, 43(3): 588-596.
9. Nakamura H, Gotoh M, Mitsui Y, et al. Factors Affecting Clinical Outcome in Patients With Structural Failure After Arthroscopic Rotator Cuff Repair. Arthroscopy, 2016, 32(5): 732-739.
10. Hepp P, Engel T, Osterhoff G, et al. Knotless anatomic double-layer double-row rotator cuff repair: a novel technique re-establishing footprint and shape of full-thickness tears. Arch Orthop Trauma Surg, 2009, 129(8): 1031-1036.
11. Mori D, Funakoshi N, Yamashita F. Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears. Arthrosc Tech, 2014, 3(6): e667-e671.
12. Cofield RH. Rotator cuff disease of the shoulder. J Bone Joint Surg (Am), 1985, 67(6): 974-979.
13. Cha SW, Lee CK, Sugaya H, et al. Retraction pattern of delaminated rotator cuff tears: dual-layer rotator cuff repair. J Orthop Surg Res, 2016, 11: 75.
14. Cheon SJ, Kim JH, Gwak HC, et al. Comparison of histologic healing and biomechanical characteristics between repair techniques for a delaminated rotator cuff tear in rabbits. J Shoulder Elbow Surg, 2017, 26(5): 838-845.
15. Kim YS, Lee HJ, Jin HK, et al. Conventional En Masse Repair Versus Separate Double-Layer Double-Row Repair for the Treatment of Delaminated Rotator Cuff Tears. Am J Sports Med, 2016, 44(5): 1146-1152.
16. Lee SH, Kim JW, Kim TK, et al. Is the arthroscopic suture bridge technique suitable for full-thickness rotator cuff tears of any size? Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2138-2146.
17. Rimmke N, Maerz T, Cooper R, et al. Arthroscopic suture bridge rotator cuff repair: functional outcome, repair integrity, and preoperative factors related to postoperative outcome. Phys Sportsmed, 2016, 44(2): 126-132.
18. Han Y, Shin JH, Seok CW, et al. Is posterior delamination in arthroscopic rotator cuff repair hidden to the posterior viewing portal? Arthroscopy, 2013, 29(11): 1740-1747.

Chinese Journal of Reparative and Reconstructive Surgery

Clinical research of arthroscopic separate double-layer suture bridge technique for delaminated rotator cuff tear

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