, Health Pi, Wollzeile 1-3, 1010, Vienna, Austria.
Vienna Shoulder and Sports Clinic, Vienna, Austria.
Knee Surg Sports Traumatol Arthrosc. 2019 Dec;27(12):3920-3928. doi: 10.1007/s00167-019-05519-x. Epub 2019 May 6.
To compare functional outcomes and magnetic resonance image (MRI) tendon integrity following either the suture bridge or the knotless cinch-bridge technique used for arthroscopic double-layer rotator cuff repair.
37 prospectively enrolled patients (46-76 years), who were treated with arthroscopic double-layer rotator cuff repair (group 1: suture bridge n = 20, group 2: cinch bridge n = 17) were clinically and radiographically assessed before and at an average of 24.0 ± 4.7 months after the procedure. Shoulder function was evaluated by the constant score (CS), range of motion, and various patient-related scores. Repaired tendon integrity was evaluated by MRI. Peri- and postoperative complications were recorded.
All functional and patient-related scores significantly improved from pre- to postoperative. Significantly better postoperative CS (P = 0.037), flexion (P < 0.001), and abduction (P = 0.009) were detected after arthroscopic cinch compared to suture-bridge repair. The mean CS improvements from baseline to follow-up were not significantly different between the groups (n.s.). Patient-related scores did not show any statistical significant differences. The MRI healing rate following arthroscopic double-layer repair with the suture- and cinch-bridge technique was 95% and 94%, respectively. Fatty infiltration regarding the supraspinatus and infraspinatus increased in 55% and 35% (group 1) and in 53% and 48% (group 2), respectively. Muscle hypotrophy remained stable in all patients. Overall, 92% of the patients were very satisfied or satisfied with the procedure. No complications were detected.
Arthroscopic knotless double-layer rotator cuff repair with the cinch-bridge technique showed higher CS, forward flexion, and abduction values, as well as similar patient-related short-term outcome and MRI integrity compared to the suture-bridge technique. These results highlight the potential importance of less tendon strangulation for better clinical short-term outcome.
Level II, prospective comparative study.
比较关节镜下双层肩袖修复中使用缝合桥或无结紧缩桥技术的功能结果和磁共振成像（MRI）肌腱完整性。
前瞻性纳入 37 例患者（46-76 岁），均接受关节镜下双层肩袖修复（组 1：缝合桥 n=20，组 2：紧缩桥 n=17）。术前和术后平均 24.0±4.7 个月进行临床和影像学评估。采用 Constant 评分（CS）、关节活动度和各种患者相关评分评估肩部功能。通过 MRI 评估修复肌腱的完整性。记录围手术期并发症。
所有功能和患者相关评分均从术前到术后显著改善。与缝合桥修复相比，关节镜紧缩术后 CS（P=0.037）、屈曲（P<0.001）和外展（P=0.009）明显改善。从基线到随访，两组的 CS 改善均值无显著差异（n.s.）。患者相关评分无统计学差异。关节镜双层修复术后采用缝合桥和紧缩桥技术的 MRI 愈合率分别为 95%和 94%。冈上肌和冈下肌的脂肪浸润分别增加了 55%和 35%（组 1）和 53%和 48%（组 2）。所有患者的肌肉萎缩均保持稳定。总体而言，92%的患者对手术非常满意或满意。未发现并发症。
与缝合桥技术相比，关节镜无结双层肩袖修复采用紧缩桥技术具有更高的 CS、前屈和外展值，以及相似的患者短期结局和 MRI 完整性。这些结果强调了较少的肌腱绞窄对更好的临床短期结局的潜在重要性。
II 级，前瞻性比较研究。
