Résumé
The arthroscopic rotator cuff repair is now considered a mainstream technique with highly satisfactory clinical results. However, concerns remain regarding healing failures for large and massive tears and high revision rate. In recent decades, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. The focus of biomechanical test in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. Recent studies have shown that a transosseous tunnel technique provides improved contact area and pressure between rotator cuff tendon and insertion footprint, and the technique of using double rows of suture anchors to recreate the native footprint attachment has been recently described. The transosseous equivalent suture bridge technique has the highest contact pressure and fixation force. In this review, the biomechanical tests about repair techniques of rotator cuff tear will be reviewed and discussed.
Sujets)
Réadaptation , Coiffe des rotateurs , Ancres de suture , Matériaux de suture , Larmes , TendonsRésumé
The arthroscopic rotator cuff repair is now considered a mainstream technique with highly satisfactory clinical results. However, concerns remain regarding healing failures for large and massive tears and high revision rate. In recent decades, various repair strategies and construct configurations have been developed for rotator cuff repair with the understanding that many factors contribute to the structural integrity of the repaired construct. The focus of biomechanical test in arthroscopic repair has been on increasing fixation strength and restoration of the footprint contact characteristics to provide early rehabilitation and improve healing. These include repaired rotator cuff tendon-footprint motion, increased tendon-footprint contact area and pressure, and tissue quality of tendon and bone. Recent studies have shown that a transosseous tunnel technique provides improved contact area and pressure between rotator cuff tendon and insertion footprint, and the technique of using double rows of suture anchors to recreate the native footprint attachment has been recently described. The transosseous equivalent suture bridge technique has the highest contact pressure and fixation force. In this review, the biomechanical tests about repair techniques of rotator cuff tear will be reviewed and discussed.
Sujets)
Réadaptation , Coiffe des rotateurs , Ancres de suture , Matériaux de suture , Larmes , TendonsRésumé
PURPOSE: We wanted to evaluate the usefulness of arthroscopic repair using the modified Mason-Allen Massive Cuff Stitch for medium sized full thickness rotator cuff tear. We verified the clinical results and evaluated the repair integrity after short term follow up. MATERIALS AND METHODS: Twenty-three cases of arthroscopically repaired full thickness tear of the rotator cuff of an estimated medium size were evaluated between December 2004 to May 2005. The average patient age was 54 years old (range: 43-69 years old), and the mean follow-up was 14 months (range: 12-17 months). We analyzed the results by paired t-test. The follow up MRIs were checked in 11 cases. RESULTS: The VAS pain score was improved from a preoperative average of 7.0 to a postoperative average of 0.9, the ADL was improved from 11.1 to 26.0 and the UCLA score was improved from 13.6 to 32.5 (all p<0.05). 91.3% showed an excellent or good result at the final follow-up. The satisfied rate was 95.7% (22 cases). There was re-rupture of the repaired rotator cuff in one out of 11 cases (9.1%). CONCLUSION: Arthroscopic repairs using a modified Mason-Allen Massive Cuff Stitch for full thickness rotator cuff tear of an estimated medium size showed good clinical outcomes.