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ARTHROSCOPIC DOUBLE-ROW ROTATOR CUFF REPAIR: IS THE TECHNIQUE A PREDICTIVE FACTOR OF BETTER CLINICAL AND ANATOMICAL RESULTS?

Authors: MA Zumstein; B Bugnas; N Brassart; P Boileau;

References: Presented at SECEC 2009

Purpose
The rate of complete watertight healing in arthroscopic simple row (SR) tension-band technique of posterosuperior rotator cuff tears is 70%. We hypothesized that arthroscopic double row (DR) rotator cuff repair using a tension band technique yields a higher healing rate than the reported SR repairs. The second aim of our study was to analyze the clinical influence and the healing rates of two different DR techniques.

Material and Methods
Forty consecutive patients underwent arthroscopic rotator cuff repair for the treatment of chronic rotator cuff tears. Two different tension band suture techniques were used : In group A (15 pts) both rows were independently knotted and in group B (25 pts) a knotless-technique (MTB) was used. Thirty five (88%) patients were followed at least 12 mts including the SSV, VAS, Constant- and the SST scores. Anatomic healing was controlled at 6 mts postoperatively by CT- (91%) or MRI-arthrogram (n = 34).

Results
Ninety-seven percent of the patients were very satisfied or satisfied with the result. There was one biceps tenodesis failure subsequent to an eccentric loading trauma. The mean score of SSV (p = 0.001), VAS (p = 0.0001), Constant (p = 0.0001), and SST (p = 0.001) increased in both groups significantly from pre- to postoperatively. The rotator cuff was completely watertight healed in 24 (71%) of the 34 patients. The Constant- and SST scores were significantly better (p = 0.001) when the tendon had healed than when it had not (82/100 vs 75/100 for the Constant ; p = 0.04, and 12/12 vs 9.5/12 for the SST ; p = 0.03). There were no significant differences regarding the clinical results and the healing rates in between the two DR techniques (group-A and -B).

Conclusion
Arthroscopic DR repair for posterosuperior rotator cuff tears yielded clinically excellent results with high patient satisfaction and complete watertight healing in 71%. However, both techniques showed no differences and equal healing rates to the reported SR technique.

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