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Published in: Journal of Orthopaedic Surgery and Research 1/2013

Open Access 01-12-2013 | Research article

The modified massive cuff stitch: functional and structural outcome in massive cuff tears

Authors: Masafumi Gotoh, Yasuhiro Mitsui, Kazuhiro Yoshimitsu, Kenjiro Nakama, Takahiro Okawa, Fujio Higuchi, Kensei Nagata

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2013

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Abstract

Background

The massive cuff stitch (MCS) is known to be a strong suture, suitable for rotator cuff repair. We modified this technique for massive cuff tears by employing a horizontal medial mattress suture from an anchor as well as a vertically crossing transosseous suture.

Methods

We included 42 patients with massive cuff tears suitable for repair: 22 were treated with the modified MCS (MCS group), and 20 with a simple transosseous suture (STS group). The range of motion (ROM), muscle strength, visual analog scale, and the Japanese Orthopaedic Association (JOA) scores were evaluated pre-operatively and 12 and 24 months post-operatively. The incidence of post-operative re-tears was examined at least 1 year post-operatively using Sugaya's classification.

Results

The ROM, muscle strength, degree of pain, and the JOA scores were much improved after surgery in both groups, and there was no significant intergroup difference throughout the pre- and post-operative periods. In contrast, post-operative MRI revealed a significantly lower re-tear rate in the MCS group than in the STS group (9.1% vs. 40%, P = 0.0296).

Conclusions

The techniques tested were comparable in terms of functional outcome after surgical repair of massive cuff tears; however, the modified MCS repair technique produced superior structural outcomes with a significantly lower re-tear rate.
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Literature
1.
go back to reference Liu SH, Baker CL: Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994, 10: 54-60. 10.1016/S0749-8063(05)80293-2.CrossRefPubMed Liu SH, Baker CL: Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994, 10: 54-60. 10.1016/S0749-8063(05)80293-2.CrossRefPubMed
2.
go back to reference Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K: The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004, 86: 219-224.PubMed Galatz LM, Ball CM, Teefey SA, Middleton WD, Yamaguchi K: The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am. 2004, 86: 219-224.PubMed
3.
go back to reference Ko SH, Friedman D, Seo DK, Jun HM, Warner JJ: A prospective therapeutic comparison of simple suture repairs to massive cuff stitch repairs for treatment of small- and medium-sized rotator cuff tears. Arthroscopy. 2009, 25: 583-589. 10.1016/j.arthro.2008.11.001.CrossRefPubMed Ko SH, Friedman D, Seo DK, Jun HM, Warner JJ: A prospective therapeutic comparison of simple suture repairs to massive cuff stitch repairs for treatment of small- and medium-sized rotator cuff tears. Arthroscopy. 2009, 25: 583-589. 10.1016/j.arthro.2008.11.001.CrossRefPubMed
4.
go back to reference Kim JR, Cho YS, Ryu KJ, Kim JH: Clinical and radiographic outcomes after arthroscopic repair of massive rotator cuff tears using a suture bridge technique: assessment of repair integrity on magnetic resonance imaging. Am J Sports Med. 2012, 40: 786-793. 10.1177/0363546511434546.CrossRefPubMed Kim JR, Cho YS, Ryu KJ, Kim JH: Clinical and radiographic outcomes after arthroscopic repair of massive rotator cuff tears using a suture bridge technique: assessment of repair integrity on magnetic resonance imaging. Am J Sports Med. 2012, 40: 786-793. 10.1177/0363546511434546.CrossRefPubMed
5.
go back to reference Bigliani LU, Cordasco FA, McLlveen SJ, Musso ES: Operative repair of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg. 1992, 1: 120-30. 10.1016/1058-2746(92)90089-L.CrossRefPubMed Bigliani LU, Cordasco FA, McLlveen SJ, Musso ES: Operative repair of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg. 1992, 1: 120-30. 10.1016/1058-2746(92)90089-L.CrossRefPubMed
6.
go back to reference Gerber C, Fuchs B, Hodler J: The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000, 82: 505-515.PubMed Gerber C, Fuchs B, Hodler J: The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000, 82: 505-515.PubMed
7.
go back to reference Yamaguchi H, Suenaga N, Oizumi N, Hosokawa Y, Kanaya F: Open repair for massive rotator cuff tear with a modified transosseous-equivalent procedure: preliminary results at short-term follow-up. J Orthop Sci. 2011, 16: 398-404. 10.1007/s00776-011-0092-9.CrossRefPubMed Yamaguchi H, Suenaga N, Oizumi N, Hosokawa Y, Kanaya F: Open repair for massive rotator cuff tear with a modified transosseous-equivalent procedure: preliminary results at short-term follow-up. J Orthop Sci. 2011, 16: 398-404. 10.1007/s00776-011-0092-9.CrossRefPubMed
8.
go back to reference Waltrip RL, Zheng N, Dugas JR, Andrews JR: Rotator cuff repair. A biomechanical comparison of three techniques. Am J Sports Med. 2003, 31: 493-497.PubMed Waltrip RL, Zheng N, Dugas JR, Andrews JR: Rotator cuff repair. A biomechanical comparison of three techniques. Am J Sports Med. 2003, 31: 493-497.PubMed
9.
go back to reference Sileo MJ, Ruotolo CR, Nelson CO, Serra-Hsu F, Panchal AP: A biomechanical comparison of the modified Mason-Allen stitch and massive cuff stitch in vitro. Arthroscopy. 2007, 23: 235-240. 10.1016/j.arthro.2006.11.007.CrossRefPubMed Sileo MJ, Ruotolo CR, Nelson CO, Serra-Hsu F, Panchal AP: A biomechanical comparison of the modified Mason-Allen stitch and massive cuff stitch in vitro. Arthroscopy. 2007, 23: 235-240. 10.1016/j.arthro.2006.11.007.CrossRefPubMed
10.
go back to reference Ma CB, MacGillivray JD, Clabeaux J, Lee S, Otis JC: Biomechanical evaluation of arthroscopic rotator cuff stitches. J Bone Joint Surg Am. 2004, 86: 1211-1216.PubMed Ma CB, MacGillivray JD, Clabeaux J, Lee S, Otis JC: Biomechanical evaluation of arthroscopic rotator cuff stitches. J Bone Joint Surg Am. 2004, 86: 1211-1216.PubMed
11.
go back to reference Shirachi I, Gotoh M, Mitsui Y, Yamada T, Nakama K, Kojima K, Okawa T, Higuchi F, Nagata K: Collagen production at the edge of ruptured rotator cuff tendon is correlated with postoperative cuff integrity. Arthroscopy. 2011, 27: 1173-1179. 10.1016/j.arthro.2011.03.078.CrossRefPubMed Shirachi I, Gotoh M, Mitsui Y, Yamada T, Nakama K, Kojima K, Okawa T, Higuchi F, Nagata K: Collagen production at the edge of ruptured rotator cuff tendon is correlated with postoperative cuff integrity. Arthroscopy. 2011, 27: 1173-1179. 10.1016/j.arthro.2011.03.078.CrossRefPubMed
12.
go back to reference Gotoh M, Hamada K, Yamakawa H, Nakamura M, Yamazaki H, Ueyama Y, Tamaoki N, Inoue A, Fukuda H: Perforation of rotator cuff increases interleukin 1beta production in the synovium of glenohumeral joint in rotator cuff diseases. J Rheumatol. 2000, 27: 2886-2892.PubMed Gotoh M, Hamada K, Yamakawa H, Nakamura M, Yamazaki H, Ueyama Y, Tamaoki N, Inoue A, Fukuda H: Perforation of rotator cuff increases interleukin 1beta production in the synovium of glenohumeral joint in rotator cuff diseases. J Rheumatol. 2000, 27: 2886-2892.PubMed
13.
go back to reference Sugaya H, Maeda K, Matsuki K, Moriishi J: Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy. 2005, 21: 1307-16. 10.1016/j.arthro.2005.08.011.CrossRefPubMed Sugaya H, Maeda K, Matsuki K, Moriishi J: Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy. 2005, 21: 1307-16. 10.1016/j.arthro.2005.08.011.CrossRefPubMed
14.
go back to reference R Development Core Team: R: A Language and Environment for Statistical Computing. 2011, Vienna, Austria: R oundation for Statistical Computing R Development Core Team: R: A Language and Environment for Statistical Computing. 2011, Vienna, Austria: R oundation for Statistical Computing
15.
go back to reference Kai Y, Gotoh M, Nagata K, Shiba N: Infraspinatus fatigue during resisted arm elevation with isometric contraction: an electromyographic study. J Shoulder Elbow Surg. 2012, 21: 1104-1109. 10.1016/j.jse.2011.07.021.CrossRefPubMed Kai Y, Gotoh M, Nagata K, Shiba N: Infraspinatus fatigue during resisted arm elevation with isometric contraction: an electromyographic study. J Shoulder Elbow Surg. 2012, 21: 1104-1109. 10.1016/j.jse.2011.07.021.CrossRefPubMed
16.
go back to reference Sugaya H, Maeda K, Matsuki K, Moriishi J: Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007, 89: 953-60. 10.2106/JBJS.F.00512.CrossRefPubMed Sugaya H, Maeda K, Matsuki K, Moriishi J: Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007, 89: 953-60. 10.2106/JBJS.F.00512.CrossRefPubMed
17.
go back to reference Harryman DT, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA: Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991, 73: 982-989.PubMed Harryman DT, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA: Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991, 73: 982-989.PubMed
18.
go back to reference Rokito AS, Cuomo F, Gallagher MA, Zuckerman JD: Long-term functional outcome of repair of large and massive chronic tears of the rotator cuff. J Bone Joint Surg Am. 1999, 81: 991-997. 10.1302/0301-620X.81B6.8940.CrossRefPubMed Rokito AS, Cuomo F, Gallagher MA, Zuckerman JD: Long-term functional outcome of repair of large and massive chronic tears of the rotator cuff. J Bone Joint Surg Am. 1999, 81: 991-997. 10.1302/0301-620X.81B6.8940.CrossRefPubMed
19.
go back to reference Scheibel MT, Habermeyer P: A modified Mason-Allen technique for rotator cuff repair using suture anchors. Arthroscopy. 2003, 19: 330-333. 10.1053/jars.2003.50079.CrossRefPubMed Scheibel MT, Habermeyer P: A modified Mason-Allen technique for rotator cuff repair using suture anchors. Arthroscopy. 2003, 19: 330-333. 10.1053/jars.2003.50079.CrossRefPubMed
20.
go back to reference Bisson LJ, Manohar LM: A biomechanical comparison of transosseous-suture anchor and suture bridge rotator cuff repairs in cadavers. Am J Sports Med. 2009, 37: 1991-1995. 10.1177/0363546509336260.CrossRefPubMed Bisson LJ, Manohar LM: A biomechanical comparison of transosseous-suture anchor and suture bridge rotator cuff repairs in cadavers. Am J Sports Med. 2009, 37: 1991-1995. 10.1177/0363546509336260.CrossRefPubMed
Metadata
Title
The modified massive cuff stitch: functional and structural outcome in massive cuff tears
Authors
Masafumi Gotoh
Yasuhiro Mitsui
Kazuhiro Yoshimitsu
Kenjiro Nakama
Takahiro Okawa
Fujio Higuchi
Kensei Nagata
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2013
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/1749-799X-8-26

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