Abstract
BackgroundsRepair of full-thickness rotator cuff (RC) tears is routinely performed using suture anchors, which produce secure and effective soft tissue fixation to bone. The aim of this prospective study is to compare the long-term outcomes of single row arthroscopic rotator cuff repair (RCR) performed using metal or biodegradable suture anchors. The null hypothesis is that there is no difference in shoulder function using metal or biodegradable suture anchors as evaluated by UCLA shoulder score, Wolfgang criteria, and Oxford shoulder score.MethodsArthroscopic RCR was performed in 110 patients included in this case control study. They were divided into 2 groups of 51 and 59 patients respectively. Metal suture anchors were used in group 1, and biodegradable suture anchors in group 2. Results were obtained at a mean follow up of 4.05 + 2 years. Clinical outcomes and functional outcomes were evaluated.ResultsThe mean modified UCLA shoulder score was 26.9 + 7.1 in group 1, and 27.7 + 6.5 in group 2 (P = 0.5); the mean Wolfgang score was 13.3 + 3.3 in group 1, and 14 + 2.6 in group 2 (P = 0.3); the mean OSS was 23.7 + 11.4 in group 1, and 20.7 + 9.2 points in group 2 (P = 0.1). The mean active anterior elevation was 163.5° + 28.2° in group 1 and 163.6° + 26.9 in group 2 (P = 0.9); the mean active external rotation was 46° + 19.7° in group 1 and 44.6° + 16.3° in group 2 (P = 0.7). The mean strength in anterior elevation was 4.8.02 + 23.52 N in group 1, and 43.12 + 17.64 N in group 2 (P = 0.2); the mean strength in external rotation was 48.02 + 22.54 N in group 1 and 46.06 + 17.64 N in group 2 (P = 0.6); the mean strength in internal rotation was 67.62 + 29.4 N in group 1, and 68.6 + 25.48 N in group 2 (P = 0.9).ConclusionsThere are no statistically significant differences at a mean follow-up of 4.05 + 2 years in clinical and functional outcomes of single row arthroscopic RCR using metallic or biodegradable suture anchors for RC < 5 cm.
Highlights
Repair of full-thickness rotator cuff (RC) tears is routinely performed using suture anchors, which produce secure and effective soft tissue to bone repair [1,2,3]
Only one short term follow up randomized control trial [24] compared the clinical and functional outcome of arthroscopic rotator cuff repair (RCR) performed with metal or biodegradable suture anchors
Eligibility criteria Patients were included in the study if they underwent arthroscopic RCR and the following conditions were present at the time of surgery: RC tear, absence of shoulder instability, absence of shoulder’s fractures, MRI evidence of full-thickness RC tear, duration of symptoms of at least 3 months, inadequate response to non-operative management, a repairable RC tear found at the time of surgery
Summary
Repair of full-thickness rotator cuff (RC) tears is routinely performed using suture anchors, which produce secure and effective soft tissue to bone repair [1,2,3]. Metal suture anchors provide a good long term fixation but are often associated with well documented complications such as migration, chondral damage, imprisonment of the anchor within the joint, major technical difficulty with revision surgery and problems with magnetic resonance (MRI) imaging [12,13,14]. The use of biodegradable implants in arthroscopic rotator cuff repair (RCR) procedures is relatively recent. Biomechanical studies demonstrated that metal anchors present a better fixation strength when compared with biodegradable anchors [20]. Only one short term follow up randomized control trial [24] compared the clinical and functional outcome of arthroscopic RCR performed with metal or biodegradable suture anchors. The aim of the study is to compare the long-term clinical outcomes of arthroscopic RCR performed with metal or biodegradable suture anchors
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