Department of Orthopedic Surgery, Osaka Medical College, Takatsuki, Osaka, Japan.
Am J Sports Med. 2011 Oct;39(10):2091-8. doi: 10.1177/0363546511415660. Epub 2011 Jul 22.
Although previous biomechanical research has demonstrated the superiority of the suture-bridge rotator cuff repair over double-row repair from a mechanical point of view, no articles have described the structural and functional outcomes of this type of procedure.
The structural and functional outcomes after arthroscopic rotator cuff repair may be different between the single-row, double-row, and combined double-row and suture-bridge (compression double-row) techniques.
Cohort study; Level of evidence, 3.
There were 206 shoulders in 201 patients with full-thickness rotator cuff tears that underwent arthroscopic rotator cuff repair. Eleven patients were lost to follow-up. Sixty-five shoulders were repaired using the single-row, 23 shoulders using the double-row, and 107 shoulders using the compression double-row techniques. Clinical outcomes were evaluated at an average of 38.5 months (range, 24-74 months) after rotator cuff repair. Postoperative cuff integrity was determined using Sugaya's classification of magnetic resonance imaging (MRI).
The retear rates after arthroscopic rotator cuff repair were 10.8%, 26.1%, and 4.7%, respectively, for the single-row, double-row, and compression double-row techniques. In the subcategory of large and massive rotator cuff tears, the retear rate in the compression double-row group (3 of 40 shoulders, 7.5%) was significantly less than those in the single-row group (5 of 8 shoulders, 62.5%, P < .001) and the double-row group (5 of 12 shoulders, 41.7%, P < .01). Postoperative clinical outcomes in patients with a retear were significantly lower than those in patients without a retear for all 3 techniques.
The additional suture bridges decreased the retear rate for large and massive tears. The combination of the double-row and suture-bridge techniques, which had the lowest rate of postoperative retear, is an effective option for arthroscopic repair of the rotator cuff tendons because the postoperative functional outcome in patients with a retear is inferior to that without retear.
尽管先前的生物力学研究已经从力学角度证明了缝合桥肩袖修复优于双排修复，但尚无文献描述这种手术的结构和功能结果。
关节镜肩袖修复后，单排、双排和双排与缝合桥（压缩双排）技术的结构和功能结果可能不同。
队列研究；证据水平，3 级。
201 例全层肩袖撕裂患者的 206 例肩接受了关节镜肩袖修复。11 例患者失访。65 例肩采用单排修复，23 例肩采用双排修复，107 例肩采用压缩双排技术修复。肩袖修复后平均 38.5 个月（范围，24-74 个月）进行临床评估。术后肩袖完整性采用 MRI 下 Sugaya 分类确定。
关节镜肩袖修复后，单排、双排和压缩双排技术的再撕裂率分别为 10.8%、26.1%和 4.7%。在大、巨大肩袖撕裂的亚组中，压缩双排组（40 肩 3 例，7.5%）的再撕裂率明显低于单排组（8 肩 5 例，62.5%，P <.001）和双排组（12 肩 5 例，41.7%，P <.01）。所有 3 种技术中，再撕裂患者的术后临床结果均明显低于无再撕裂患者。
附加缝合桥可降低大、巨大撕裂的再撕裂率。双排与缝合桥技术的结合（术后再撕裂率最低）是关节镜肩袖修复的有效选择，因为再撕裂患者的术后功能结果不如无再撕裂患者。
