Comparison of early clinical results and re-tear rates of transosseous-equivalent rotator cuff repairs with or without medial knots
Tahsin Gürpınar1, Barış Polat2, Saltuk Buğra Tekin1, Ayşe Esin Polat3, Engin Çarkçı1, Yusuf Öztürkmen1
1Department of Orthopedics and Traumatology, İstanbul Training and Research Hospital, İstanbul, Turkey
2Department of Orthopaedics and Traumatology, University of Kyrenia, Faculty of Medicine, Kyrenia, Cyprus
3Department of Orthopaedics and Traumatology, Dr. Akçiçek State Hospital, Kyrenia, Cyprus
Keywords: Double-row, knotless suture bridge, medial knotted suture bridge, rotator cuff repair, transosseous-equivalent repair.
Abstract
Objectives: This study aims to compare the clinical results and repair integrity of two of the commonly used transosseousequivalent arthroscopic rotator cuff repair techniques, which are the knotless and the medial knotted suture bridge, for patients with full-thickness medium to large-sized rotator cuff tears.
Patients and methods: The study included 121 patients (55 males, 66 females; mean age 56.7±7.3 years; range, 39 to 72 years) with cuff tears. In total, 64 shoulders were operated on using the conventional medial knotted suture bridge technique (group A) and 57 shoulders were operated on using the knotless suture bridge technique (group B). The Constant score, visual analog scale (VAS) and active forward flexion angle were assessed preoperatively and after a minimum of 12 months postoperatively. Postoperative rotator cuff integrity was evaluated by magnetic resonance imaging (MRI) after a mean of 19±4.7 months.
Results: There were no significant differences between the groups in terms of age, gender, body mass index, and anteroposterior extension of the tear on the sagittal MRIs. Postoperatively, the mean Constant score increased from 32.3±8.5 points to 84±11.6 points in group A and from 31.3±9.3 points to 86.4±8.7 points in group B (p<0.001), while the mean VAS score decreased from 6.0±1.0 to 1.3±1.2 in group A and from 6.4±1.0 to 1.0±0.8 in group B (p<0.001). According to the control MRIs, the re-tear rate was 10.9% (n=7) in group A and 8.8% (n=5) in group B. No statistically significant difference was found in either the clinical scores or re-tear rates between the groups (p>0.05).
Conclusion: In comparison to the medial knotted technique, less time-consuming and simpler knotless technique provides similar satisfactory outcomes after a minimum of one year postoperatively.