The Outcome and Structural Integrity of Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor Technique

TLDR

Failure rates after arthroscopic rotator cuff repair vary widely and the impact of repair technique on outcomes remains controversial. The study evaluated functional and anatomic results of arthroscopic double‑row suture anchor repairs using CT or MRI arthrograms in 105 shoulders at a minimum of two years post‑surgery. Patients underwent history, physical examination, strength, pain, range‑of‑motion, and Constant score assessments, with pre‑ and postoperative imaging to classify tear size and confirm repair integrity. At two years, the mean Constant score rose from 43.2 to 80.1, 12 of 105 repairs failed, intact repairs showed higher strength, ROM, and pain relief, large/massive tears had more weakness, and the overall failure rate was lower than previously reported.

Abstract

The reported rate of failure after arthroscopic rotator cuff repair has varied widely. The influence of the repair technique on the failure rates and functional outcomes after open or arthroscopic rotator cuff repair remains controversial. The purpose of the present study was to evaluate the functional and anatomic results of arthroscopic rotator cuff repairs performed with the double-row suture anchor technique on the basis of computed tomography or magnetic resonance imaging arthrography in order to determine the postoperative integrity of the repairs.A prospective series of 105 consecutive shoulders undergoing arthroscopic double-row rotator cuff repair of the supraspinatus or a combination of the supraspinatus and infraspinatus were evaluated at a minimum of two years after surgery. The evaluation included a routine history and physical examination as well as determination of the preoperative and postoperative strength, pain, range of motion, and Constant scores. All shoulders had a preoperative and postoperative computed tomography arthrogram (103 shoulders) or magnetic resonance imaging arthrogram (two shoulders).There were thirty-six small rotator cuff tears, forty-seven large isolated supraspinatus or combined supraspinatus and infraspinatus tendon tears, and twenty-two massive rotator cuff tears. The mean Constant score (and standard deviation) was 43.2+/-15.1 points (range, 8 to 83 points) preoperatively and 80.1+/-11.1 points (range, 46 to 100 points) postoperatively. Twelve of the 105 repairs failed. Intact rotator cuff repairs were associated with significantly increased strength and active range of motion.Arthroscopic repair of a rotator cuff tear with use of the double-row suture anchor technique results in a much lower rate of failure than has previously been reported in association with either open or arthroscopic repair methods. Patients with an intact rotator cuff repair have better pain relief than those with a failed repair. After repair, large and massive rotator cuff tears result in more postoperative weakness than small tears do.