Feldman John J, Ostrander Brook, Ithurburn Matthew P, Fleisig Glenn S, Tatum Robert, Ochsner Mims G, Ryan Michael K, Rothermich Marcus A, Emblom Benton A, Dugas Jeffrey R, Lyle Cain E
American Sports Medicine Institute, Birmingham, Alabama, USA.
South Palm Orthopedics, Delray Beach, Florida, USA.
Orthop J Sports Med. 2024 Aug 7;12(8):23259671241262264. doi: 10.1177/23259671241262264. eCollection 2024 Aug.
The use of all-suture anchors for rotator cuff repair is increasing. Potential benefits include decreased bone loss and decreased damage to the chondral surface. Minimal evidence exists comparing outcomes among medial-row anchor fixation methods in double-row suture bridge rotator cuff repair.
To compare the clinical outcomes between all-suture and solid medial-row anchors in double-row suture bridge rotator cuff repair.
Case series; Level of evidence, 4.
A total of 352 patients (mean age at surgery, 60.3 years) underwent double-row suture bridge rotator cuff repair at our institution. Patients were separated into 2 groups based on whether they underwent all-suture (n = 280) or solid (n = 72) anchor fixation for the medial row. Outcomes data were collected via an ongoing longitudinal data repository or through telephone calls (minimum follow-up time, 2.0 years; mean follow-up time, 3.0 years). Outcomes were evaluated using the American Shoulder and Elbow Surgeons (ASES) standardized shoulder assessment form and the visual analog scale (VAS). The same rehabilitation protocol was administered to all patients. The proportions of patients meeting previously published Patient Acceptable Symptom State (PASS) thresholds were calculated for the outcome measures, and outcome scores and the proportions of patients meeting PASS thresholds between groups were compared using linear and logistic regression, respectively.
The groups did not differ in terms of age at surgery, sex distribution, rotator cuff tear size, or number of medial-row anchors used. The solid anchor group had a longer follow-up time compared with the all-suture anchor group (3.6 ± 0.7 vs 2.8 ± 0.8 years, respectively; < .01). After controlling for follow-up time, the solid and all-suture anchor groups did not differ in ASES scores (89.6 ± 17.8 vs 88.8 ± 16.7, respectively; = .44) or VAS scores (1.1 ± 2.1 vs 1.2 ± 2.1, respectively; = .37). Similarly, after controlling for follow-up time, the solid and all-suture anchor groups did not differ in the proportions of patients meeting PASS cutoffs for the ASES (84.7% vs 80.7%, respectively; = .44) or the VAS (80.6% vs 75.0%, respectively; = .83).
Double-row suture bridge rotator cuff repair using all-suture anchors for medial-row fixation demonstrated similar excellent clinical outcomes to rotator cuff repair using solid medial-row anchors.
全缝线锚钉用于肩袖修复的情况日益增多。潜在益处包括减少骨质流失以及减少对软骨表面的损伤。在双排缝线桥接肩袖修复中，比较内侧排锚钉固定方法之间的疗效的证据极少。
比较双排缝线桥接肩袖修复中全缝线与实心内侧排锚钉的临床疗效。
病例系列；证据等级，4级。
共有352例患者（手术时平均年龄60.3岁）在我们机构接受了双排缝线桥接肩袖修复。根据内侧排采用全缝线（n = 280）或实心（n = 72）锚钉固定，将患者分为两组。通过持续的纵向数据储存库或电话收集疗效数据（最短随访时间2.0年；平均随访时间3.0年）。使用美国肩肘外科医师（ASES）标准化肩部评估表和视觉模拟量表（VAS）评估疗效。所有患者均采用相同的康复方案。计算达到先前公布的患者可接受症状状态（PASS）阈值的患者比例作为疗效指标，并分别使用线性回归和逻辑回归比较两组之间的疗效评分以及达到PASS阈值的患者比例。
两组在手术年龄、性别分布、肩袖撕裂大小或使用的内侧排锚钉数量方面无差异。与全缝线锚钉组相比，实心锚钉组的随访时间更长（分别为3.6±0.7年和2.8±0.8年；P <.01）。在控制随访时间后，实心锚钉组和全缝线锚钉组的ASES评分（分别为89.6±17.8和88.8±16.7；P = 0.44）或VAS评分（分别为1.1±2.1和1.2±2.1；P = 0.37）无差异。同样，在控制随访时间后，实心锚钉组和全缝线锚钉组达到ASES（分别为84.7%和80.7%；P = 0.44）或VAS（分别为80.6%和75.0%；P = 0.83）PASS临界值的患者比例无差异。
双排缝线桥接肩袖修复中使用全缝线锚钉进行内侧排固定与使用实心内侧排锚钉进行肩袖修复的临床疗效相似，均非常出色。
