Deformities Associated With the Suture-Bridge Technique for Full-Thickness Rotator Cuff Tears

Abstract

This study was performed to evaluate the incidence and cause of deformities associated with the suture-bridge technique in rotator cuff tears. We performed a prospective review of a consecutive series of 100 shoulders with full-thickness tears (50 with medium tears, 43 with large tears, and 7 with massive tears) treated by use of the suture-bridge technique in 2007. The surgical technique was classified according to the number of suture anchors inserted in the medial and lateral rows (2 x 2 suture bridges in 82 cases, 3 x 2 in 12, and 3 x 3 in 6). On arthroscopy, the development of a marginal dog-ear deformity and central bird-beak deformity during the repair was investigated. These deformities were corrected by use of the modified suture-bridge technique or by insertion of an additional suture anchor. Dog-ear deformities occurred in 47 cases and were most frequent in large tears treated with a 2 x 2 suture bridge (21 cases). Dog-ear deformities in 2 x 2 suture bridges were more frequent in large tears than in medium tears (P < .05), and with large tears, they were more frequent with 2 x 2 suture bridges than with 3 x 2 suture bridges (P < .05). Bird-beak deformities occurred in 13 cases and were most frequent in large tears treated with 2 x 2 suture bridges (9 cases). Bird-beak deformities with 2 x 2 suture bridges were more frequent in large tears than in medium tears (P < .05), and with large tears, they were more frequent with 2 x 2 suture bridges than with 3 x 2 suture bridges (P < .05). To reduce deformities associated with the suture-bridge technique during rotator cuff repair, individualized repair methods may be applied according to the size and pattern of the rotator cuff tear. Level IV, therapeutic case series.