Thursday, May 31, 2018

Does the technique of rotator cuff repair matter?

Clinical outcomes and repair integrity after arthroscopic full-thickness rotator cuff repair: suture-bridge versus double-row modified Mason-Allen technique

These authors compared the clinical and radiologic outcomes of patients who underwent arthroscopic rotator cuff repairs by the suture-bridge and double-row modified Mason-Allen techniques.
76 consecutive cases of full-thickness rotator cuff tear, 1 to 4 cm in the sagittal plane, for which arthroscopic rotator cuff repair was performed, were included. The suture-bridge technique was used in 37 consecutive shoulders; and the double-row modified Mason- Allen technique, in 39 consecutive shoulders. 

Clinical outcomes at a minimum of 2 years (mean, 35.7 months) were not different between the two groups. Postoperative cuff integrity at a mean of 17.7 months by magnetic resonance imaging showed a retear rate of 18.9% in the shoulders having suture-bridge repair and 12.8% in those having double-row modified Mason-Allen repair.

Comment: Unfortunately, this paper does not present the clinical outcomes of the failed repairs, which, in other studies have been shown to be comparable to those of intact repairs.

In their discussion the authors reference papers showing rehear rates approaching 60% in some settings. Thus the clinical significance of a retear needs careful investigation.

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