Arthroscopic Rotator Cuff Repair Using Modified Mason-Allen Medial Row Stitch: Knotless Versus Knot-Tying Suture Bridge Technique

Rhee, Yong Girl MD
Cho, Nam Su MD
Parke, Chong Suck MD

Investigation performed at Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
^*Address correspondence to Yong Girl Rhee, MD, and Nam Su Cho, MD, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130–702, Korea (e-mail: [email protected] and [email protected]).
^†Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea.

The authors declared that they have no conflicts of interest in the authorship and publication of this contribution.

The American Journal of Sports Medicine, Vol. 40, No. 11

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American Journal of Sports Medicine 40(11):p 2440-2447, November 2012. | DOI: 10.1177/0363546512459170

Background:

When using a method of suture bridge technique, there may be a possibility of strangulation of the rotator cuff tendon at the medial row. The style of knots chosen to secure the medial row might conceivably be a factor to reduce this possibility.

Purpose:

To compare the clinical results and repair integrity of arthroscopic rotator cuff repair between a knotless and a conventional knot-tying suture bridge technique for patients with full-thickness rotator cuff tears and to evaluate retear patterns in the cases with structural failure after arthroscopic repair by magnetic resonance imaging (MRI).

Study Design:

Cohort study; Level of evidence, 2.

Methods:

After arthroscopic repair for medium-sized rotator cuff tears, 110 patients available for postoperative MRI evaluation at least 6 months were enrolled in this study. According to the repair technique, 51 shoulders were enrolled in a knotless suture bridge technique group (group A) and 59 shoulders in a conventional knot-tying suture bridge technique group (group B). The mean age at the time of the operation was 61.0 years (range, 44–68 years) in group A and 57.6 years (range, 45–70 years) in group B. The mean follow-up period was 21.2 months (range, 12–34 months) and 22.1 months (range, 13–32 months), respectively.

Results:

The Constant score of group A increased from the preoperative mean of 65.2 points to 79.1 points at the last follow-up (P<.001). The corresponding figures for group B improved from 66.6 points to 76.3 points (P<.001). The preoperative Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score was 21.1 points in group A and 18.3 points in group B. The UCLA score at the last follow-up was 31.0 points in group A and 27.9 points in group B (P<.001, P<.001). Retear rate was significantly lower in group A (5.9%) than group B (18.6%) (P<.001). In group B, retear occurred at the musculotendinous junction in 72.7%, but group A had no medial cuff failure.

Conclusion:

In arthroscopic suture bridge repair of full-thickness rotator cuff tears, clinical results of both a knotless and a conventional knot-tying group showed improvement without significant difference between the 2 groups. However, the knotless group had a significantly lower retear rate compared with the conventional knot-tying group. A knotless suture bridge technique could be a new supplementary repair technique to conventional technique.