Wednesday, March 29, 2017

Rotator cuff repair. Does technique matter? Does integrity matter?

Advantages of Arthroscopic Rotator Cuff Repair With a Transosseous Suture Technique. A Prospective Randomized Controlled Trial

These authors conducted a randomized controlled trial of two rotator cuff repair techniques: (a) single-row anchor fixation and (b) transosseous hardware-free suture repair. Sixty-nine patients with rotator cuff tears were enrolled: 35 patients were operated with metal anchors and 34 with standardized transosseous repair. 

Patients operated with the transosseous technique had significantly less pain, especially from the 15th postoperative day, however no differences in functional outcome were noted between the 2 groups at the final evaluation. In the evaluation of rotator cuff repair integrity, based on Sugaya magnetic resonance imaging classification, no significant difference was found between the 2 techniques in terms of retear rate.

Comment: In this randomized study, repair technique did not have a significant effect on outcome. Furthermore, at followup the 88% of the repairs that were intact (Sugaya classes I, II, III) had similar outcomes to the 12% that were retorn ( Sugaya classes IV and V = retorn).