Arthroscopic repair of rotator cuff tear with anchor and transosseous suture

Abstract

Objective To discuss the surgical methods and techniques of rotator cuff tear repair with anchor and transosseous suture and evaluate the clinical outcomes. Methods From February 2007 to February 2009, 32 cases of various types of rotator cuff tear were treated arthroscopically. The rotator cuff was repaired with suture anchor and transosseous suture. Twenty-five cases had full thickness tear, 5 had partial bursa-side tear,and 2 had partial articular-side tear. Sixteen lesions were on the dominant side. Preoperatively X-rays of the shoulder at the anteroposterior and supraspinatus outlet projection were obtained in all cases. Eleven patients had undergone MRI examinations and 21 cases had MRA. All the patients underwent acromioplasty. Eighteen cases were treated by single roll suture anchor and 1 or 2 transosseous tunnel suture, while 14 cases were treated by double roll suture anchor and 1 or 2 transosseous tunnel suture. UCLA scoring system was adopted to evaluate shoulder function before the operation and at the final postoperative follow up. Results All 32 cases were followed up for 3 to 23 months, with a mean interval of 13.4 months. The average UCLA score was 13.3 preoperatively and 33. 1 postoperatively. Twenty-three cases were rated as good and 9 cases as fair. Pain disappeared in 21 cases, while occasional and mild pain and discomfort still existed in 5 cases. In 6 cases pain was triggered by massive movement or special maneuvers. Normal shoulder movement was achieved in 24 cases. Active forward flexion and abduction reached > 150° in 26 cases and 90° to 120° in 6 cases. Muscle power of forward flexion and abduction was M5 in 25 cases and M4 in 7 cases. All the patients were satisfied with the surgical outcomes. Conclusion Arthroscopic repair using anchor and transosseous suture is a good method for repairing rotator cuff tear. This technique leads to secure fixation and hence ensures rotator cuff to bone healing. It is especially suitable for patients with osteoporosis or for revision cases. Key words: Shoulder joint; Reconstructive surgical procedures; Arthroscopes