Background: The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery.
Methods: Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time.
Results: Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group.
Conclusions: At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.
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http://dx.doi.org/10.1177/1758573215581775 | DOI Listing |
Am J Sports Med
January 2025
Rothman Orthopaedic Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Background: Arthroscopic labral repair of the hip is successfully performed with increasing frequency using either knotless or knotted suture anchors, each with its own risks and benefits.
Purpose: To examine biomechanical and clinical outcomes for labral repair of the hip based on the use of knotted or knotless suture anchors.
Study Design: Systematic review; Level of evidence, 4.
Arthrosc Tech
December 2024
Division of Sports Medicine, Department of Orthopaedic Surgery, Virginia Commonwealth University Health Systems, Richmond, Virginia, U.S.A.
Remplissage is a procedure that decreases the rate of recurrent instability after arthroscopic stabilization in patients with an engaging Hill-Sachs lesion. This technique involves capsulotenodesis of the infraspinatus tendon and posterior capsule into the Hill-Sachs lesion using 2 knotless anchors with suture passage through the infraspinatus tendon guided by a percutaneous needle. Previously described techniques use knots or anchor placement through the infraspinatus, which can be challenging to control and irreversible if tendon penetration occurs in an undesirable location.
View Article and Find Full Text PDFWorld J Orthop
December 2024
Department of Clinical Affairs, Healthium Medtech Limited, Bangalore 560058, Karnātaka, India.
Arthrosc Tech
November 2024
The Second Affiliated Hospital, Department of Joint Surgery, Hengyang Medical School, University of South China, Hengyang, China.
At present, suture bridge is a feasible choice in the treatment of massive rotator cuff tears (MRCTs). However, high tension on the repair site and medial tension during suture tightening and after medial knotting are unavoidable problems in MRCT repair with a suture bridge. Arthroscopic V-shaped double-pulley suture-bridge repair is a pragmatic surgical technique for the repair of MRCTs.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Orthopaedic and Trauma Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland.
Introduction: According to current clinical practice, a minimum of 7 knots are required to provide secure hold in high-strength sutures. A new technology featuring a suture tape with a salt-infused silicon core has been recently developed, potentially reducing the number of needed knots.
Aims: to (1) assess the influence of number of knots on tape security, (2) evaluate the effect of different ambient conditions on knot security, and (3) compare the biomechanical competence of the novel versus a conventional suture tape.
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