Arthroscopic Rotator Cuff Repair With Absorbable Sutures in the Medial-Row Anchors

Makoto Tanaka, Kenji Hayashida, Atsushi Kobayashi, Masaaki Kakiuchi
Arthroscopy: the Journal of Arthroscopic & related Surgery 2015, 31 (11): 2099-105

PURPOSE: To report the retear rate and retear pattern after double-row arthroscopic rotator cuff repair (DR-ARCR) with the use of absorbable sutures as medial anchor sutures and to address the advantage of the use of absorbable sutures in medial-row anchors.

METHODS: Fifty-seven shoulders (22 male and 35 female patients; mean age, 66.1 years) with complete rotator cuff tears treated with DR-ARCR using absorbable mattress sutures as medial-row anchor sutures were included in the study. They included 35 medium, 17 large, and 5 massive tears. For the medial row, medial anchor sutures were replaced with absorbable mattress sutures. High-strength simple sutures were used for the lateral anchors. We evaluated retear patterns by magnetic resonance imaging examinations performed at 1 month, 3 months, 6 months, and 1 year postoperatively. The clinical conditions of all patients preoperatively and 2 years postoperatively were assessed by the University of California, Los Angeles rating scale and the American Shoulder and Elbow Surgeons shoulder index.

RESULTS: A complete retear of the tendon at the footprint was observed in 5 shoulders. Complete discontinuity at the middle of the tendon around the medial-row anchors with a footprint remnant was observed in 1 shoulder. A thinned repaired rotator cuff was observed in 2 shoulders because of a partial retear of the deep layer. The overall retear rate was 14%. From before to after surgery, the University of California, Los Angeles score significantly improved from 18.4 to 32.9 (P < .0001) and the American Shoulder and Elbow Surgeons index improved from 55.1 to 87.7 (P < .0001). No complications were observed.

CONCLUSIONS: The retear rates after DR-ARCR with absorbable sutures as medial-row anchors were 8.8% for complete retears of the tendon at the footprint and 1.7% for complete discontinuity of tendon around the medial-row anchors. This procedure provided a low retear rate around the medial-row anchors.

LEVEL OF EVIDENCE: Level IV, therapeutic case series.

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