Surface-holding repair: an original arthroscopic rotator cuff repair technique.

BACKGROUND: Arthroscopic rotator cuff repair provides satisfactory results; however, there is still a high rate of re-tear. The objective of this study was to present a surface-holding technique that we recently developed for arthroscopic rotator cuff repair in detail and to evaluate the clinical outcome as well as cuff repair integrity with this new method.

MATERIALS AND METHODS: A consecutive series of 116 patients with full-thickness rotator cuff tears underwent arthroscopic surface-holding repair and were monitored with the Japanese Orthopaedic Association, Constant-Murley, and University of California-Los Angeles scores to assess the clinical outcome. The mean follow-up period was 17.9 months (range, 12-40 months). Cuff repair integrity was evaluated by magnetic resonance imaging.

RESULTS: All 3 rating systems at the time of final follow-up reflected a significant improvement in functional recovery of the shoulder compared with the preoperative scores. The overall rate of rotator cuff retear was 19.0% (22 of 116 shoulders), and the rates were 13.6% (9 of 66 shoulders) for small and medium-sized tears and 26% (13 of 50 shoulders) for large and massive tears. The rate for large and massive tears was much higher in patients older than 70 years (58.3%) compared with those younger than 70 years (36.3%), whereas the retear rates were similar in these 2 groups (22.2% and 17.5%, respectively).

CONCLUSIONS: Arthroscopic surface-holding repair technique with medial suture and transosseous fixation improved rotator cuff healing. This method may be useful both for young patients and for elderly patients, who frequently have chronic large and massive tears, including osteoporotic bones.