Tanaka Makoto, Hanai Hiroto, Kotani Yuki, Kuratani Kosuke, Koizumi Kota, Hayashida Kenji
Center for Sports Medicine, Osaka, Japan.
Daini Osaka Police Hospital, Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Arthroscopy. 2021 Oct;37(10):3053-3061. doi: 10.1016/j.arthro.2021.04.045. Epub 2021 May 4.
To compare the structural and clinical results between the knotless suture bridge (SB) and triple-row (TR) techniques.
This study is a retrospective study and included 212 shoulders with repairable rotator cuff tears treated with the SB technique and 206 shoulders treated with the TR technique. In the TR technique, medial and lateral anchors were placed as they would be for the SB technique, with a middle row anchor added on the edge of footprint to reduce the torn tendons. All patients underwent primary arthroscopic rotator cuff repair and had magnetic resonance imaging 6 months postoperatively to evaluate for retear. Sugaya's classification was used to classify the retear pattern. The function of all patients preoperatively and 2 years postoperatively were assessed by the American Shoulder and Elbow Surgeons shoulder index and the University of California at Los Angeles rating scale.
According to Sugaya's classification, 24 (11.3%), 6 (2.8%), and 20 (9.4%) in SB-treated shoulders and 16 (7.8%), 12 (5.8%), and 8 (3.9%) in TR-treated shoulders, respectively had types 3, 4, and 5. There was a statistically significant greater type 5 retear in SB-treated shoulders (P = .038) than in TR-treated shoulders. The average clinical outcome scores at the final follow-up improved significantly relative to those before the surgeries in both groups. There were no statistical differences in the clinical outcome scores at the final follow-up between SB and TR groups.
The use of the TR technique in arthroscopic rotator cuff repair resulted in a lower large-size retear rate when compared with the use of the SB technique. No clinical differences were noted in the outcomes between the 2 groups.
Level III, therapeutic, retrospective cohort study.
比较无结缝线桥（SB）技术与三排（TR）技术的结构和临床结果。
本研究为回顾性研究，纳入了212例采用SB技术治疗的可修复性肩袖撕裂肩和206例采用TR技术治疗的肩。在TR技术中，内侧和外侧锚钉的放置方式与SB技术相同，在足迹边缘增加一个中间排锚钉以减少撕裂的肌腱。所有患者均接受了初次关节镜下肩袖修复，并在术后6个月进行磁共振成像以评估再撕裂情况。采用Sugaya分类法对再撕裂模式进行分类。术前及术后2年，采用美国肩肘外科医师协会肩部指数和加州大学洛杉矶分校评分量表对所有患者的功能进行评估。
根据Sugaya分类法，SB治疗组的肩中分别有24例（11.3%）、6例（2.8%）和20例（9.4%）出现3型、4型和5型，TR治疗组的肩中分别有16例（7.8%）、12例（5.8%）和8例（3.9%）出现3型、4型和5型。SB治疗组的5型再撕裂发生率在统计学上显著高于TR治疗组（P = 0.038）。两组最终随访时的平均临床结果评分相对于手术前均有显著改善。SB组和TR组在最终随访时的临床结果评分无统计学差异。
与SB技术相比，在关节镜下肩袖修复中使用TR技术可降低大尺寸再撕裂率。两组之间的临床结果未发现差异。
III级，治疗性回顾性队列研究。
