Skip to main content
Top
Published in: International Orthopaedics 2/2015

01-02-2015 | Original Paper

Single-row arthroscopic cuff repair with double-loaded anchors provides good shoulder function in long-term follow-up

Authors: Mladen Miškulin, Goran Vrgoč, Goran Sporiš, Oliver Dulic, Gordan Gavrilovic, Zoran Milanović

Published in: International Orthopaedics | Issue 2/2015

Login to get access

Abstract

Purpose

The purpose of this study was to evaluate the results of arthroscopic cuff reconstruction, which is currently preferred in our service, and to compare functional outcome after arthroscopic cuff reconstruction comparing different types and sizes of rotator cuff tears. We switched completely from open repair to the full-arthroscopic repair > ten years ago, and since then, we are developing a technique that can produce the best results. Therefore, we decided to verify results.

Methods

Seventy-two patients with rotator cuff tear underwent arthroscopic shoulder surgery. Single-row arthroscopic repair using double-loaded metal anchors and margin-convergence sutures with concomitant procedures were performed in all cases. All patients were assessed and classified before and after surgery using the Constant scoring system and the Oxford Shoulder Score. Tears were measured and classified as medium (1–3 cm), large(3–5 cm) and massive (>5 cm).

Results

The average age of participants was 59 ± 9 years (33–76). There were five medium, 43 large and 23 massive tears. The average functional Constant score at the last follow-up was 91.68 ± 10.62, and the Oxford score averaged 43.23 ± 5.84 without statistically significant differences (p > 0.05) among groups Best results were in the massive-tear group, with an overall Constant score of 98.60 ± 2.61 and an average Oxford score of 47.60 ± 0.55. Full recovery was obtained between six months and one year. We used our own modified rehabilitation protocol and found no postoperative stiffness in this series.

Conclusions

Single-row arthroscopic rotator cuff repair using double-loaded metal anchors and margin-convergence sutures with concomitant procedures, when necessary, provides excellent results. Pain, range of motion, muscle strength and function were significantly improved after single-row repair among all morphological types of cuff lesions.
Literature
2.
go back to reference Burkhart SS, Danaceau SM, Pearce CE Jr (2001) Arthroscopic rotator cuff repair: analysis of results by tear size and by repair technique-margin convergence versus direct tendon-to-bone repair. Arthroscopy 17(9):905–912. doi:10.1053/jars.2001.26821 PubMedCrossRef Burkhart SS, Danaceau SM, Pearce CE Jr (2001) Arthroscopic rotator cuff repair: analysis of results by tear size and by repair technique-margin convergence versus direct tendon-to-bone repair. Arthroscopy 17(9):905–912. doi:10.​1053/​jars.​2001.​26821 PubMedCrossRef
6.
7.
go back to reference Bartolozzi A, Andreychik D, Ahmad S (1994) Determinants of outcome in the treatment of rotator cuff disease. Clin Orthop Relat Res 308(308):90–97PubMed Bartolozzi A, Andreychik D, Ahmad S (1994) Determinants of outcome in the treatment of rotator cuff disease. Clin Orthop Relat Res 308(308):90–97PubMed
8.
go back to reference Yamaguchi K, Levine WN, Marra G, Galatz LM, Klepps S, Flatow EL (2003) Transitioning to arthroscopic rotator cuff repair: the pros and cons. Instr Course Lect 52(1):81–92, PMID: 12690842PubMed Yamaguchi K, Levine WN, Marra G, Galatz LM, Klepps S, Flatow EL (2003) Transitioning to arthroscopic rotator cuff repair: the pros and cons. Instr Course Lect 52(1):81–92, PMID: 12690842PubMed
10.
go back to reference Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214(214):160–164, PMID: 3791738PubMed Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214(214):160–164, PMID: 3791738PubMed
12.
go back to reference Burks RT, Crim J, Brown N, Fink B, Greis PE (2009) A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med 37(4):674–682. doi:10.1177/0363546508328115 PubMedCrossRef Burks RT, Crim J, Brown N, Fink B, Greis PE (2009) A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med 37(4):674–682. doi:10.​1177/​0363546508328115​ PubMedCrossRef
13.
go back to reference Franceschi F, Ruzzini L, Longo UG, Martina FM, Zobel BB, Maffulli N, Denaro V (2007) Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. Am J Sports Med 35(8):1254–1260. doi:10.1177/0363546507302218 PubMedCrossRef Franceschi F, Ruzzini L, Longo UG, Martina FM, Zobel BB, Maffulli N, Denaro V (2007) Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. Am J Sports Med 35(8):1254–1260. doi:10.​1177/​0363546507302218​ PubMedCrossRef
16.
go back to reference McCormick F, Gupta A, Bruce B, Harris J, Abrams G, Wilson H, Hussey K, Cole BJ (2014) Single-row, double-row, and transosseous equivalent techniques for isolated supraspinatus tendon tears with minimal atrophy: a retrospective comparative outcome and radiographic analysis at minimum 2-year followup. Int J Shoulder Surg 8(1):15–20. doi:10.4103/0973-6042.131850 PubMedCentralPubMedCrossRef McCormick F, Gupta A, Bruce B, Harris J, Abrams G, Wilson H, Hussey K, Cole BJ (2014) Single-row, double-row, and transosseous equivalent techniques for isolated supraspinatus tendon tears with minimal atrophy: a retrospective comparative outcome and radiographic analysis at minimum 2-year followup. Int J Shoulder Surg 8(1):15–20. doi:10.​4103/​0973-6042.​131850 PubMedCentralPubMedCrossRef
17.
go back to reference Zhang Q, Ge H, Zhou J, Yuan C, Chen K, Cheng B (2013) Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis. PLoS One 8(7):e68515PubMedCentralPubMedCrossRef Zhang Q, Ge H, Zhou J, Yuan C, Chen K, Cheng B (2013) Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis. PLoS One 8(7):e68515PubMedCentralPubMedCrossRef
19.
go back to reference Mascarenhas R, Chalmers PN, Sayegh ET, Bhandari M, Verma NN, Cole BJ, Romeo AA (2014) Is double-row rotator cuff repair clinically superior to single-row rotator cuff repair: a systematic review of overlapping meta-analyses. Arthroscopy 30(9):1156–1165. doi:10.1016/j.arthro.2014.03.015 PubMedCrossRef Mascarenhas R, Chalmers PN, Sayegh ET, Bhandari M, Verma NN, Cole BJ, Romeo AA (2014) Is double-row rotator cuff repair clinically superior to single-row rotator cuff repair: a systematic review of overlapping meta-analyses. Arthroscopy 30(9):1156–1165. doi:10.​1016/​j.​arthro.​2014.​03.​015 PubMedCrossRef
20.
go back to reference Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A(2):219–224, PMID: 14960664PubMed Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A(2):219–224, PMID: 14960664PubMed
21.
go back to reference Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL (2006) Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg 15(3):290–299PubMedCrossRef Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL (2006) Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg 15(3):290–299PubMedCrossRef
22.
go back to reference Miller BS, Downie BK, Kohen RB, Kijek T, Lesniak B, Jacobson JA, Hughes RE, Carpenter JE (2011) When do rotator cuff repairs fail? serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med 39(10):2064–2070. doi:10.1177/0363546511413372 PubMedCrossRef Miller BS, Downie BK, Kohen RB, Kijek T, Lesniak B, Jacobson JA, Hughes RE, Carpenter JE (2011) When do rotator cuff repairs fail? serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med 39(10):2064–2070. doi:10.​1177/​0363546511413372​ PubMedCrossRef
23.
go back to reference Russell RD, Knight JR, Mulligan E, Khazzam MS (2014) Structural integrity after rotator cuff repair does not correlate with patient function and paina meta-analysis. J Bone Jt Surg 96(4):265–271. doi:10.2106/JBJS.M.00265 CrossRef Russell RD, Knight JR, Mulligan E, Khazzam MS (2014) Structural integrity after rotator cuff repair does not correlate with patient function and paina meta-analysis. J Bone Jt Surg 96(4):265–271. doi:10.​2106/​JBJS.​M.​00265 CrossRef
24.
go back to reference J. Kukkonen, T. Kauko, P. Virolainen, and V. Aärimaa (2013) The effect of tear size on the treatment outcome of operatively treated rotator cuff tears. Knee Surg. Sports Traumatol. Arthrosc.:1–6. doi: 10.1007/s00167-013-2647-0 J. Kukkonen, T. Kauko, P. Virolainen, and V. Aärimaa (2013) The effect of tear size on the treatment outcome of operatively treated rotator cuff tears. Knee Surg. Sports Traumatol. Arthrosc.:1–6. doi: 10.​1007/​s00167-013-2647-0
25.
go back to reference Koo SS, Parsley BK, Burkhart SS, Schoolfield JD (2011) Reduction of postoperative stiffness after arthroscopic rotator cuff repair: results of a customized physical therapy regimen based on risk factors for stiffness. Arthroscopy 27(2):155–160. doi:10.1016/j.arthro.2010.07.007 PubMedCrossRef Koo SS, Parsley BK, Burkhart SS, Schoolfield JD (2011) Reduction of postoperative stiffness after arthroscopic rotator cuff repair: results of a customized physical therapy regimen based on risk factors for stiffness. Arthroscopy 27(2):155–160. doi:10.​1016/​j.​arthro.​2010.​07.​007 PubMedCrossRef
Metadata
Title
Single-row arthroscopic cuff repair with double-loaded anchors provides good shoulder function in long-term follow-up
Authors
Mladen Miškulin
Goran Vrgoč
Goran Sporiš
Oliver Dulic
Gordan Gavrilovic
Zoran Milanović
Publication date
01-02-2015
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 2/2015
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2557-x

Other articles of this Issue 2/2015

International Orthopaedics 2/2015 Go to the issue