The Journal of Bone and Joint Surgery (American). 2008;90:275-286.
doi:10.2106/JBJS.H.00388
© 2008 The Journal of Bone and Joint Surgery, Inc.
The Outcome and Structural Integrity of Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor TechniqueSurgical Technique
Laurent Lafosse, MD1,
Roman Brzoska, MD1,
Bruno Toussaint, MD1 and
Reuben Gobezie, MD2
1 Alps Surgery Institute, Clinique Generale, 4 Ch. Tour Reine, 74000 Annecy,
France
2 The Shoulder and Elbow Service, Department of Orthopaedic Surgery, Case
Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland,
OH 44106. E-mail address:
reuben.gobezie{at}uhhs.com
Investigation performed at the Alps Surgery Institute, Annecy,
France
The original scientific article in which the surgical technique was
presented was published in JBJS Vol. 89-A, pp.
1533-41, July 2007
DISCLOSURE: The authors did not receive any outside funding or grants in
support of their research for or preparation of this work. Neither they nor a
member of their immediate families received payments or other benefits or a
commitment or agreement to provide such benefits from a commercial entity. No
commercial entity paid or directed, or agreed to pay or direct, any benefits
to any research fund, foundation, division, center, clinical practice, or
other charitable or nonprofit organization with which the authors, or a member
of their immediate families, are affiliated or associated.
A video supplement to this article has been produced by the Video
Journal of Orthopaedics (VJO). This production is included on the
bound-in DVD as part of this issue and will also be available in streaming
video format at the JBJS website,
www.jbjs.org.
VJO can be contacted at (805) 962-3410, web site:
www.vjortho.com.
The line drawings in this article are the work of Joanne Haderer
Müller of Haderer & Müller
(biomedart{at}haderermuller.com).
BACKGROUND: The reported rate of failure after arthroscopic rotator
cuff repair has varied widely. The influence of the repair technique on the
failure rates and functional outcomes after open or arthroscopic rotator cuff
repair remains controversial. The purpose of the present study was to evaluate
the functional and anatomic results of arthroscopic rotator cuff repairs
performed with the double-row suture anchor technique on the basis of computed
tomography or magnetic resonance imaging arthrography in order to determine
the postoperative integrity of the repairs.
METHODS: A prospective series of 105 consecutive shoulders
undergoing arthroscopic double-row rotator cuff repair of the supraspinatus or
a combination of the supraspinatus and infraspinatus were evaluated at a
minimum of two years after surgery. The evaluation included a routine history
and physical examination as well as determination of the preoperative and
postoperative strength, pain, range of motion, and Constant scores. All
shoulders had a preoperative and postoperative computed tomography arthrogram
(103 shoulders) or magnetic resonance imaging arthrogram (two shoulders).
RESULTS: There were thirty-six small rotator cuff tears, forty-seven
large isolated supraspinatus or combined supraspinatus and infraspinatus
tendon tears, and twenty-two massive rotator cuff tears. The mean Constant
score (and standard deviation) was 43.2 ± 15.1 points (range, 8 to 83
points) preoperatively and 80.1 ± 11.1 points (range, 46 to 100 points)
postoperatively. Twelve of the 105 repairs failed. Intact rotator cuff repairs
were associated with significantly increased strength and active range of
motion.
CONCLUSIONS: Arthroscopic repair of a rotator cuff tear with use of
the double-row suture anchor technique results in a much lower rate of failure
than has previously been reported in association with either open or
arthroscopic repair methods. Patients with an intact rotator cuff repair have
better pain relief than those with a failed repair. After repair, large and
massive rotator cuff tears result in more postoperative weakness than small
tears do.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors
for a complete description of levels of evidence.
ORIGINAL ABSTRACT CITATION: "The Outcome and Structural Integrity of
Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor
Technique"
(2007;89:1533-41).

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