Lee Woo-Yong, Cho Hoon-Hwe, Jeon Yoo-Sun, Kim Kyung-Cheon, Park Jae-Young, Kim Jiyoung, Chung Hyung-Jin
Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, South Korea.
Department of Materials Science and Engineering, Hanbat National University, Daejeon, Republic of Korea.
J Orthop Surg (Hong Kong). 2025 May-Aug;33(2):10225536251364198. doi: 10.1177/10225536251364198. Epub 2025 Jul 30.
BackgroundThe suture-bridge technique (SBT), with its various modifications, is frequently utilized in rotator cuff tear repairs. This study aimed to assess and compare the clinical and radiological tendon integrity outcomes of conventional and triple-row SBTs in patients with full-thickness rotator cuff tears (RCTs). Additionally, it evaluated the construct strength of each technique through biomechanical experiments. We hypothesized that the triple-row SBT would yield better clinical and radiological outcomes, as well as superior biomechanical properties, compared to the conventional SBT.MethodsA retrospective evaluation was conducted on 62 patients who underwent arthroscopic rotator cuff repair using either conventional or triple-row SBT from January to December 2019. The conventional SBT was performed on 26 patients, while the triple-row SBT was used on 36 patients. Clinical evaluations were conducted preoperatively, and at 1 and 2 years post-surgery using the ASES; UCLA; Constant scores; and VAS scores. Magnetic resonance imaging was performed before surgery, and the postoperative rotator cuff integrity was evaluated 6 months after surgery. Mechanical testing on seven pairs of sawbone and allodermal patch models was also performed. These specimens underwent horizontal and vertical axial load tests on a material testing machine, and the ultimate failure load was measured.ResultsBoth techniques significantly improved the clinical outcomes at postoperative 1 and 2 years ( < .001), with no significant difference between-group ( > .05). The retear rate was 19.2% in the conventional group and 11.1% in the triple-row group, but the difference was not statistically significant ( = .379). The failure load of the triple-row suture-bridge technique was higher than that of conventional suture-bridge technique.ConclusionBoth the conventional and triple-row SBT techniques were effective in achieving favorable clinical outcomes in patients with full-thickness rotator cuff tears, with no statistically significant differences between the two groups. Although the triple-row technique suggested a potential for a reduced retear rate, the difference was not statistically significant. However, in our biomechanical study, the triple-row SBT demonstrated superior mechanical stability compared to the conventional technique. Specifically, the triple-row configuration showed greater resistance to displacement under cyclic loading and improved load distribution across the repair site. These findings suggest that the triple-row SBT may offer biomechanical advantages that could contribute to enhanced structural integrity of the repair, especially in challenging cases.
缝线桥技术（SBT）及其各种改良方法在肩袖撕裂修复中经常被使用。本研究旨在评估和比较全层肩袖撕裂（RCT）患者中传统缝线桥技术和三排缝线桥技术的临床和影像学肌腱完整性结果。此外，通过生物力学实验评估了每种技术的结构强度。我们假设，与传统缝线桥技术相比，三排缝线桥技术将产生更好的临床和影像学结果，以及更好的生物力学性能。
对2019年1月至12月期间接受关节镜下肩袖修复手术，采用传统或三排缝线桥技术的62例患者进行回顾性评估。26例患者采用传统缝线桥技术，36例患者采用三排缝线桥技术。术前、术后1年和2年使用ASES、UCLA、Constant评分和VAS评分进行临床评估。术前进行磁共振成像，术后6个月评估肩袖完整性。还对7对人工骨和同种异体真皮补片模型进行了力学测试。这些标本在材料试验机上进行水平和垂直轴向载荷测试，并测量极限破坏载荷。
两种技术在术后1年和2年均显著改善了临床结果（P<0.001），组间无显著差异（P>0.05）。传统组的再撕裂率为19.2%，三排组为11.1%，但差异无统计学意义（P=0.379）。三排缝线桥技术的破坏载荷高于传统缝线桥技术。
传统和三排缝线桥技术在全层肩袖撕裂患者中均能有效实现良好的临床结果，两组之间无统计学显著差异。虽然三排技术显示出降低再撕裂率的潜力，但差异无统计学意义。然而，在我们的生物力学研究中，三排缝线桥技术与传统技术相比显示出更好的机械稳定性。具体而言，三排结构在循环载荷下对位移的抵抗力更强，并且改善了整个修复部位的载荷分布。这些发现表明，三排缝线桥技术可能具有生物力学优势，有助于增强修复的结构完整性，尤其是在具有挑战性的病例中。
