The functional outcome of arthroscopic rotator cuff repair with double-row knotless vs knot-tying anchors
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ORTHOPAEDIC SURGERY
The functional outcome of arthroscopic rotator cuff repair with double‑row knotless vs knot‑tying anchors Pawel Zwolak1,2 · Philipp Meyer1 · Laszlo Molnar1 · Markus Kröber3 Received: 3 October 2019 / Accepted: 16 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract To date two main techniques are used in arthroscopic full-thickness rotator cuff tears, the conventional knot-tying suture bridge technique and the knotless technique. We evaluated whether there is a difference in clinical outcome using both techniques. Our patients underwent arthroscopic treatment of full-thickness rotator cuff tears, and we retrospectively evaluated clinical function, strength and surgery time. Eighty-three shoulders operated between September 2012 and December 2013 were included in the study. We had nineteen patients in the knotless group, and sixty-four in the knot-tying group. In addition, we performed preoperatively radiological (magnetic resonance imaging-MRI) conformation of full-thickness rotator cuff tear in our patients. For clinical evaluation, we used Quick Disabilities of the Arm, Shoulder and Hand score (q-DASH) and the Shoulder Pain and Disability (SPADI) score, and we measured the strength of a range of motion postoperatively using a conventional dynamometer. The patients were evaluated preoperatively, and at 6, 9, and 12 months postoperatively. The follow-up period was 12 months. The scores in both treatment groups improved at twelve months follow-up, but there was no statistical difference between both groups at twelve months after surgery; q-DASH score between groups (p = 0.092) and SPADI score (p = 0.700). Similarly, there was no statistical difference between the groups in regard to strength, surgery time, and range of motion at the twelve months follow-up. Our data confirm that both techniques may be used successfully to repair full-thickness rotator cuff tears with very good functional outcome. Level of evidence IV. Keywords Rotator cuff · Suture bridge technique · Full-thickness rotator cuff tear · Arthroscopic rotator cuff repair
Introduction: Rotator cuff disease represents a broad spectrum of rotator cuff pathologies, including partial-, full-thickness tear and rotator cuff arthropathy [7]. The rotator cuff tears can be caused by trauma, however, most of the tears occur as a result of progressing degeneration of the rotator cuff tendons [10]. Degenerative tears are often identified in an older patient population. Full-thickness tears of the rotator cuff are
* Pawel Zwolak [email protected] 1
Orthopädische Klinik Luzern AG, Lucerne, Switzerland
2
Department of Orthopaedics and Trauma Surgery, Alfried Krupp Hospital, Alfried‑Krupp‑Straße 21, 45131 Essen, Germany
3
Helios Klinik Rottweil, Rottweil, Germany
a common cause of decreased quality of life and progressing osteoarthritis of the shoulder joint [6, 17, 26]. The incidence of rotator cuff tears in general population increases significantly in the elderly population [1, 19]. In the last
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