Comparison of clinical outcomes of arthroscopic repair of rotator cuff tear with modified or traditional knotless suture bridge technique / 中华创伤杂志

ABSTRACT

Objective:To compare the clinical prognosis of modified and traditional knotless suture bridge technique in treatment of rotator cuff tear under shoulder arthroscopy.Methods:A retrospective case-control study was conducted to analyze 60 patients with rotator cuff tear admitted to Affiliated Hospital of Qingdao University from June 2018 to June 2019，including 19 males and 41 females，aged 32-74 years［（59.3±10.1）years］. There were 26 patients on the left side and 34 patients on the right side，with the body mass index（BMI）of 19.5-32.4 kg/m 2［（25.5±2.6）kg/m 2］，rotator cuff tear of 2.0-3.7 cm［（2.7±0.4）cm］and pain duration of 2-88 days［（26.2±17.1）days］. A total of 31 patients were repaired with a modified knotless suture bridge（modified group）and 29 patients with a traditional knotless suture bridge（traditional group）. Comparison was made between the two groups in aspects of range of motion of shoulder flexion，abduction and external rotation，visual analog scale（VAS），University of California Los Angeles（UCLA）should function score，Constant shoulder function score，retear and complications at postoperative 3 and 12 months. Results:All patients were followed up for 9-15 months［（12.0±1.8）months］. Three months after operation，the two groups showed no significant differences in shoulder range of motion of abduction，flexion，external rotation，UCLA shoulder function score or Constant shoulder function score（ P>0.05）；while VAS was（2.7±1.2）points in modified group，significantly lower than（3.4±1.2）points in traditional group（ P<0.05）. Twelve months after operation，the shoulder range of motion of abduction and flexion in modified group was（146.9±21.4）° and（150.4±16.2）°，significantly higher than that in traditional group［（130.7±27.4）°，（140.6±18.4）°］（ P<0.05）；There was no significant difference in external rotation activity between the two groups（ P>0.05）；VAS，UCLA shoulder function score and Constant shoulder function score［（1.2±0.5）points，（29.5±2.3）points，（80.4±5.4）points，respectively］in modified group were significantly higher than those in traditional group［（1.5±0.5）points，（27.2±2.7）points，（76.3±6.6）points，respectively］（ P<0.05）. Three months after operation，there was no significant difference in the classification of Sugaya between the two groups（ P>0.05）. Twelve months after operation，the classification of Sugaya was significantly different between the two groups（ P<0.05），with no retear in modified group but 3 patients with retear in traditional group. No postoperative complications occurred，such as non-healing，infection or persistent swelling. Conclusion:For patients with rotator cuff tear，the modified knotless suture bridge technique under shoulder arthroscopy has better range of motion and function，more obvious pain relief and a lower rate of retear than the traditional technique.