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Four Methods of Rotator Cuff Tear Repair Compared
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Posted on: 01/13/2006
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There are several ways to repair a torn rotator cuff in the shoulder. In this study, doctors used cadavers to compare four different arthroscopic repair methods. The results may be very important since the retear rate after RCT repair in humans is at least 50 percent. Some studies report this rate can be as high as 89 percent.
Sutures used to sew the torn tendon back to the bone can be in a single row or a double row. The single row technique was compared to three of the double-row methods. Results were measured by how much of the surface area was restored. Strength of the sutures and strength of the tendon repair were also measures used to judge the results. Since cadavers were used, the researchers could test the strength of the repair to its limits. This means they could apply loads until the repair tore.
The results showed no difference from one method to another. Double-row sutures cover more of the surface. It's not clear yet if there's any benefit to this. All methods could withstand loads up to and past 250 N. The authors explain 250 N is the load placed on the tendon repair after surgery with passive motion during early rehab.
The authors suggest using an open repair method (not arthroscopy) when a stronger repair is needed. There's less suture slippage and a smaller gap formation with open surgery. The open method may give better mechanical performance. In time with better materials and technique, the arthroscopic method of RCT repair may be equal to the open method in all cases.
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References:
Augustus D. Mazzocca, MD, et al. Arthroscopic Single-Row Versus Double-Row Suture Anchor Rotator Cuff Repair. In The American Journal of Sports Medicine. December 2005. Vol. 33. No. 12. Pp. 1861-1868.
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