Single-row Suture Research Articles

Biomechanical evaluation of an arthroscopic transosseous repair as a revision option for failed rotator cuff surgery

BackgroundThe number of revision rotator cuff cases is increasing. The literature is lacking guidance or biomechanical evaluation for fixation strength in a revision case scenario. Therefore, the aim of the study was to provide biomechanical data investigating primary fixation strength of a transosseous technique after anchor pullout failure of a single row reconstruction. It was hypothesized that an arthroscopic transosseous repair system as a procedure for rotator cuff revisions is providing equivalent stability compared to a primary single row suture anchor fixation due to change of fixation site.MethodsEight matched pairs (n = 16) of fresh frozen human shoulders were tested. The paired specimen shoulders were randomly divided into two repair groups (A single row and B primary transosseous repair). The potted specimens were mounted onto the Servohydraulic test system. Both groups were tested under cyclic loading followed by load to failure testing. Suture anchor repair shoulders (group A) that were tested to failure underwent a revision transosseous repair and were subsequently tested again using the same setup and protocol (group C).ResultsThe mean native footprint areas did not show a significant difference between groups. The reconstructed footprint area showed a significantly greater coverage in favor of the transosseous repair. Ultimate load to failure of reconstructions with the primary anchor fixation (344.73 N ± 63.19) and the primary transosseous device (375.36 N ± 70.27) was not significantly higher compared to the revision repair (332.19 N ± 119.01 p = 0.45, p = 0.53).ConclusionThe tested transosseous anchor device is a suitable option to widely used suture anchors, providing equivalent fixation properties even in a revision case scenario.Level of evidenceBasic Science Study, Biomechanics.

COMPARATIVE DESCRIPTION OF EXPERIMENTAL BILIODIGESTIVE ANASTOMOSIS, FORMED BY HIGH FREQUENCY ELECTRIC WELDING TISSUES METHOD AND LIGATURE METHOD (PATHOMORPHOLOGICAL RESEARCH)

In the experiment on 50 rabbits cholecysto-entero and entero-entero anastomoses were formed on intestinal Roux loop. Animals were divided into the main group (n = 35) and the comparison group (n = 15). In the main group a single layer everting anastomoses by using HF-electric welding method were formed, in the comparison group single row suture anastomoses has been done. Welding and suture anastomosis were performed both on the not inflamed tissues, and against a background of bile peritonitis. To establish the changes that occur in the tissue welding, histological investigations of weld area and surrounding tissues at different times postoperative period were performed.It was established that when carried out HF-electric welding connective tissue safety was achieved by termoadhesion. Electro-injuries area almost did not spread beyond the regions of direct thermal influence, coagulation scar was narrow, thermal damage walls was local (2700-3000 µm). The processes of regeneration in the area of weld were similar as in anastomosis formation by traditional suture method. Scar formation and completed its epithelization was fully completed in terms from 3 to 6 months.

Arthroscopic Anterior Shoulder Stabilization With Incorporation of a Comminuted Bony Bankart Lesion

Bony Bankart lesions are a common finding in patients with anterior glenohumeral dislocation. Although there are no defined guidelines, small bony Bankart fractures are typically treated arthroscopically with suture anchors. The 2 main techniques used are double- and single-row suture anchor stabilization, with debate over superiority. Biomechanical studies have shown improved reduction and stabilization with the double-row over the single-row suture anchor technique; however, this has not been reported for small or comminuted bony fragments. Both techniques have shown promising preliminary clinical outcomes. In this Technical Note, we describe our preferred technique for arthroscopic instability repair using a single-row all-suture anchor method with the incorporation of a comminuted bony Bankart fragment in the lateral decubitus position.

Repairing result of traumatic subscapularis injury and humeral lesser tuberosity avulsion in elderly patients with arthroscopic single row suture method

Repairing result of traumatic subscapularis injury and humeral lesser tuberosity avulsion in elderly patients with arthroscopic single row suture method

Experimental Substantiation Efficiency of new Polymer Membrane for Sealing the Suture Line During the Formation of Colonic Anastomoses

В современной абдоминальной хирургии проблема поиска новых способов и методов профилактики несостоятельностишвов анастомозов при наложении на толстую кишку продолжает оставаться открытой и постоянно требует новыхусовершенствований. Использование полимерных пленочных материалов позволяет повысить механическую прочность ибиологическую герметичность межкишечных анастомозов.Цель настоящего исследования состояла в оценке эффективности герметизации линии однорядных швов толстокишеч-ных анастомозов с помощью новых образцов пленочных имплантатов на основе полимеров карбоксиметилцеллюлозы.Материалы и методы. Проведен эксперимент на 60 кроликах. Было сформировано 3 группы исследования: контрольнаягруппа 1 – межкишечный анастомоз с использованием техники двурядного кишечного шва – шов Шмидена (первый ряд) ишов Матешука (второй ряд); контрольная группа 2 – межкишечный анастомоз с использованием однорядного шва Шми-дена; экспериментальная группа 1 – межкишечный анастомоз с использованием однорядного шва Шмидена, герметизиро-ванный образцом полимерной мембраны. Механическая прочность на разных сроках эксперимента определялась методомпневмопрессии.Результаты и их обсуждение. Во время оперативного вмешательства установлено, что изучаемый образец полимерногопленочного импланта обладает оптимальными манипуляционными свойствами, необходимыми для герметизации линиикишечного шва (эластичность, прочность, адгезивность, не требуется дополнительной фиксации шовным материалом,простота наложения мембраны, сокращение времени формирования анастомоза). Снижается повышенная проницае-мость и увеличивается уровень герметичности кишечного шва, за счет высокой степени адгезии полимерной мембраны,на фоне еще не наступившей регенерации краев серозной оболочки (феномен «биологической негерметичности»).Заключение. Полученные доклинические данные подтверждают эффективность применения новых полимерных мембранпри герметизации однорядных швов толстокишечных анастомозов.Ключевые слова: полимерные мембраны, герметичность анастомоза, прочность швов, кишечный шов.

Difference between early versus delayed postoperative physical rehabilitation protocol following arthroscopic rotator cuff repair

Early passive motion exercise has been the standard rehabilitation protocol following rotator cuff repair. However, recent research studies show that longer immobilization may enhance tendon healing. The aim of this study was to compare early passive range of motion (ROM) exercise with a delayed rehabilitation protocol with regard to the effectiveness of stiffness reduction and functional improvements and rates of tendon healing in patients undergoing arthroscopic repair for torn rotator cuffs. This study was performed on 164 patients having a full-thickness tear of the supraspinatus muscle that was repaired using the arthroscopic single-row suture anchor technique along with subacromial decompression. The patients were divided into two groups, early (group 1) and delayed ROM (group 2). In group 1, 78 patients were started on passive elevation and rotation exercises on the second day after surgery. In group 2, 86 patients had their shoulder immobilized for 6 weeks, after which passive motion exercise was started. Patients were followed-up clinically for a minimum of 12 months, and rotator cuff healing was assessed using MRI. Both groups had a statistically significant difference between preoperative and postoperative results. As regards American Shoulder and Elbow Surgeon scores, the early group improved from 45.4 preoperatively to 90.9 postoperatively (P<0.0001) and the delayed group improved from 44.59 preoperatively to 91.6 postoperatively (P<0.0001). As regards Constant score, the early group improved from 35.7 preoperatively to 86.5 postoperatively (P<0.0001) and the delayed group improved from 37.8 preoperatively to 88.1 postoperatively (P<0.0001). However, there were no statistically significant differences in rotator cuff healing between the two groups. The follow-up mean of visual analog scale was significantly better in group 2 compared with group 1 at 6 weeks postoperatively but no difference was found after 3 months. In contrast, ROM was better in group 1 compared with group 2 at 6 months postoperatively but no difference was found after 1 year. Significant improvement in pain, ROM, and function after arthroscopic rotator cuff repair was seen at 1 year postoperatively, regardless of early or delayed postoperative rehabilitation protocols. However, early motion increases pain scores and may increase the possibility of rotator cuff retear but with early regain of ROM. A delayed rehabilitation protocol with immobilization for 6 weeks would be better for tendon healing without risk for retear or joint stiffness and easily convalescence with less postoperative pain.

All-Endoscopic Single-Row Repair of Full-Thickness Gluteus Medius Tears

Abductor tendon tears typically develop insidiously in middle-aged women and can lead to debilitating lateral hip pain and a Trendelenburg limp. The gluteus medius tendon is most commonly torn and may show fatty degeneration over time, similar to the rotator cuff muscles of the shoulder. Endoscopic repair offers a therapeutic alternative to traditional open techniques. This article describes the workup, examination, and endoscopic repair of a full-thickness gluteus medius tear presenting as lateral hip pain and weakness. The surgical repair for this case used a single-row suture anchor technique. In addition, the indications and technique for a double-row repair will be discussed.

The Double-Row Suture Technique: A Better Option for the Treatment of Haglund Syndrome.

Purpose. The purpose of this study is to investigate whether double-row suture technique is a better option for the treatment of Haglund syndrome than single-row suture technique regarding the surgical outcomes. Methods. Thirty-two patients with Haglund syndrome were recruited in this study. Patients were divided into Group 1 (treated with single-row suture technique) and Group 2 (treated with double-row suture technique). There were 16 patients in each group. The AOFAS-ankle-hindfoot scale, VISA-A scores, and Arner-Lindholm standard were used to assess the clinical outcomes. The pre- and postoperative X-rays were used to assess the radiological outcome. Results. Both AOFAS-ankle-hindfoot scale score and VISA-A score had varying degrees of improvement in both groups. In latest follow-up assessment, the Arner-Lindholm standard investigation showed there were 7 excellent, 7 good, and 2 bad outcomes in Group 1 and 12 excellent and 4 good outcomes in Group 2. In Group 2 patients, there were no more posterosuperior bony prominence of the calcaneum in post-op X-rays and there were no recurrent cases. The ankle-related scale score was statistically significantly higher in Group 2 than in Group 1 (P = 0.029). Conclusion. The double-row suture technique seems to be a better option to treat Haglund syndrome than single-row suture technique.

The first experience with the implantation of the prosthesis xenopericardial frame variable stiffness "Tiara" in the aortic position

Represents the results of a clinical trial implantation xenopericardial prosthesis mounted on a frame of variable stiffness "Tiara" in the aortic position. Prosthesis implanted in a single-row suture cubcoronary supraannulary position. Implantation performed two patients 71 and 75 years with a good clinical outcome. According to the control echocardiography peak gradients at rest were 9-15 mm Hg. According to the results of a clinical trial prosthesis can be recommended for implementation in everyday clinical practice.

Arthroscopic suture-bridge repair for moderate to massive full-thickness rotator cuff tear

Objective To evaluate the early clinical outcomes of arthroscopic suture-bridge repair of media to large full-thickness rotator cuff tear. Methods One hundred patients that underwent arthroscopic suture-bridge (suture-bridge group, n=50) or single-row repair (single-row suture group, n=50) for media to massive full-thickness rotator cuff tear from June 2010 to June 2014 were enrolled in this study. The patients (63 males and 37 females), aged 58.7 years (range, 46 to 75 years), were all available to the follow-up. Thirty-one patients were injured in traffic crashes, 30 in falls, 27 in strains and 12 with no apparent reasons. Early passive activity was allowed in suture-bridge group, while shoulder abduction was maintained for 6 weeks postoperatively in control group. Clinical and functional outcomes were measured using the visual analogue scale (VAS), range of motion, University of California at Los Angeles (UCLA) score, and American Shoulder and Elbow Surgeons (ASES) score. Results Mean duration of follow-up was 16.7 months (range, 8 to 24 months). Prior to the surgery, these measurements were similar between the two groups. After a follow-up of 3 months, the differences were significant in suture-bridge group compared to control group: VAS [(1.7±1.5) points vs (3.9±2.1) points], forward flexion [(168.3±30.2)° vs (120.2±51.6)°], external rotation [(47.0±11.0)° vs (31.8±13.8)°], UCLA score [(31.7±4.2) points vs (18.2±4.8) points], ASES score [(86.2±14.6) points vs (35.9±17.7) points] (P<0.05). No re-tear occurred after operation. Conclusion Arthroscopic suture-bridge repair of moderate to massive full-thickness rotator cuff tear results in significant improvement of function outcomes and clinical results, indicating a reliable and effective treatment technique. Key words: Arthroscopy; Shoulder; Suture bridge technique

Does Early Versus Delayed Active Range of Motion Affect Rotator Cuff Healing After Surgical Repair?

Background: The timing of passive range of motion (ROM) after surgical repair of the rotator cuff (RC) has been shown to affect healing. However, it is unknown if early or delayed active ROM affects healing. Purpose: To determine whether early versus delayed active ROM affects structural results of RC repair surgery. Study Design: Systematic review and meta-analysis. Methods: A systematic review of articles published between January 2004 and April 2014 was conducted. Structural results were compared for early (<6 weeks after surgery) versus delayed (≥6 weeks after surgery) active ROM using chi-square and Fisher exact tests, as well as relative risks (RRs) and 95% CIs. The analyses were stratified by tear size and repair method. Results: A total of 37 studies (2251 repairs) were included in the analysis, with 10 (649 repairs) in the early group and 27 (1602 repairs) in the delayed group. For tears ≤3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for transosseous plus single-row suture anchor repairs (39.7% vs 24.3%; RR, 1.63 [95% CI, 1.28-2.08]). For tears >3 cm, the risk of a structural tendon defect was higher in the early versus delayed group for suture bridge repairs (48% vs 17.5%; RR, 2.74 [95% CI, 1.59-4.73]) and all repair methods combined (40.5% vs 26.7%; RR, 1.52 [95% CI, 1.17-1.97]). For tears >5 cm, the risk of structural tendon defect was higher in the early versus delayed group for suture bridge repairs (100% vs 16.7%; RR, 6.00 [95% CI, 1.69-21.26]). There were no statistically significant associations for tears measuring ≤1, 1-3, or 3-5 cm. Conclusion: Early active ROM was associated with increased risk of a structural defect for small and large RC tears, and thus might not be advisable after RC repair.

A Biomechanical Analysis of a Single-Row Suture Anchor Fixation of a Large Bony Bankart Lesion

This study was conducted to assess whether a single-row suture anchor repair of a bony Bankart lesion comprising 19% of the glenoid length restores peak translational force and glenoid depth compared with the intact shoulder. Nine thawed adult cadaveric shoulders were dissected and mounted in 45° of abduction and 30° of external rotation. A bony Bankart lesion was simulated with an anterior longitudinal osteotomy, parallel to the superoinferior axis of the glenoid, equivalent to 19% of the glenoid length. The humeral head was displaced 10mm anteriorly at a speed of 2mm/s with a 50-N compressive load applied. Testing was performed with the glenoid intact, a simulated lesion, and the lesion repaired with 3 single-row suture anchors. Median (interquartile range [IQR]) peak translational force and glenoid depth were reported. The Friedman test and post hoc comparisons with the Wilcoxon signed rank test were used for between-group analyses. Peak translational force decreased after osteotomy (13.7N; IQR, 9.6 to 15.5N; P= .01) and increased after the repair (18.3N; IQR, 18.3 to 20.6N; P= .01) compared with the intact shoulder (23.7N; IQR, 16.4 to 29.9N). Glenoid depth significantly decreased after the osteotomy (0.2mm; IQR,-0.6 to 0.7mm) compared with baseline (1.7mm; IQR, 1.3 to 2.0mm; P= .01) and increased after repair (0.8mm; IQR, 0.1 to 1.0mm; P= .03) compared with the osteotomized shoulder. The glenoid depth of the repair was less than the baseline value (P= .01). Repair of an anterior bony Bankart lesion equivalent to 19% of the glenoid length with 3 suture anchors restored the peak translational force needed to anteriorly displace the humerus relative to the glenoid; however, this technique failed to restore the natural glenoid depth in a laboratory setting. Our findings describe the inability of a single-row suture anchor repair to provide anatomic fixation of the bony Bankart lesion equivalent to 19% of the glenoid length.

Arthroscopic Single-Row Versus Double-Row Repair for Full-Thickness Posterosuperior Rotator Cuff Tears: A Critical Analysis Review.

Over the past two decades, arthroscopic rotator cuff repair has become one of the most popular orthopaedic surgical procedures because of its proven ability to diminish pain and improve function in patients with symptomatic rotator cuff tears. As a result of this increasing demand, arthroscopic techniques have evolved rapidly in an effort to improve structural integrity, biomechanical function, and, ultimately, clinical outcomes. With the increasing number of techniques available for the repair of full-thickness rotator cuff tears, debate has arisen regarding the clinical superiority of any one of these methods over the others. Specifically, this debate has centered on traditional single-row versus traditional double-row repair constructs (Fig. 1). Therefore, the purpose of this article is to present a critical review of the most relevant evidence and to provide clinical care recommendations regarding arthroscopic single-row versus double-row rotator cuff repair constructs. Fig. 1 Traditional single-row suture configuration utilizes two lateral anchors tied in a simple stitch pattern ( Fig. 1 , A ). Traditional double-row suture configuration utilizes an additional medial row of anchors with mattress stitches ( Fig. 1 , B ). The rotator cuff represents a confluence of four tendons that envelop the humeral …

Single-rowversusdouble-row suture in rotator cuff repair: a meta-analysis

AbstractBACKGROUND:Single-row and double-row suture method are commonly used in the rotator cuff repair. Previous studies have shown that, double-row suture is not better than single-row suture in clinics.OBJECTIVE:To compare clinical outcomes of single-row suture and double-row suture for rotator c

Дифференцированное применение однорядного шва в абдоминальной хирургии для профилактики хирургической инфекции

Дифференцированное применение однорядного шва в абдоминальной хирургии для профилактики хирургической инфекции

Biomechanical Properties of Double- and Single-Row Suture Anchor Repair for Surgical Treatment of Insertional Achilles Tendinopathy

Background: Because of intratendinous ossifications, retrocalcaneal bursitis, or intratendinous necrosis commonly found in insertional tendinosis, it is often necessary to detach the tendon partially or entirely from its tendon-to-bone junction. Hypothesis: Double-row repair for insertional Achilles tendinopathy will generate an increased contact area and demonstrate higher biomechanical stability. Study Design: Controlled laboratory study. Methods: Eighteen cadaver Achilles tendons were split longitudinally and detached, exposing the calcaneus; an ostectomy was performed and the tendon was reattached to the calcaneus in 1 of 2 ways: 2 suture anchors (single row) or a 4-anchor (double row) construct. Footprint area measurements over time, displacement after cyclic loading (2000 cycles), and final load to failure were measured. Results: The double-row refixation technique was statistically superior to the single-row technique in footprint area measurement initially and 5 minutes after repair (P = .009 and P = .01, respectively) but not after 24 hours (P = .713). The double-row construct demonstrated significantly improved measures for peak load (433.9 ± 84.3 N vs 212.0 ± 49.7 N; P = .042), load at yield (354.7 ± 106.2 N vs 198.7 ± 39.5 N; P = .01), and slope (51.8 ± 9.9 N/mm vs 66.7 ± 16.2 N/mm; P = .021). Cyclic loading did not demonstrate significant differences between the 2 constructs. Conclusion: Double-row construct for reinsertion of a completely detached Achilles tendon using proximal and distal rows resulted in significantly larger contact area initially and 5 minutes after repair and led to significantly higher peak load to failure on destructive testing. Clinical Relevance: In treatment for insertional Achilles tendinosis, the tendon often has to be detached and anatomically reattached to its insertion at the calcaneus. To our knowledge there is a lack of biomechanical studies supporting either a number or a pattern of suture anchor fixation. Because the stresses going across the insertion site of the Achilles tendon are significant during rehabilitation and weightbearing activities, it is imperative to have a strong construct that allows satisfactory healing during the early postoperative process.

Comparison of repair techniques in small and medium-sized rotator cuff tears in cadaveric sheep shoulders

The aim of this study was to compare new knotless single-row and double-row suture anchor techniques with traditional transosseous suture techniques for different sized rotator cuff tears in an animal model. The study included 56 cadaveric sheep shoulders. Supraspinatus cuff tears of 1 cm repaired with new knotless single-row suture anchor technique and supraspinatus and infraspinatus rotator cuff tears of 3 cm repaired with double-row suture anchor technique were compared to traditional transosseous suture techniques and control groups. The repaired tendons were loaded with 5 mm/min static velocity with 2.5 kgN load cell in Instron 8874 machine until the repair failure. The 1 cm transosseous group was statistically superior to 1 cm control group (p=0.021, p<0.05) and the 3 cm SpeedBridge group was statistically superior to the 1 cm SpeedFix group (p=0.012, p<0.05). The differences between the other groups were not statistically significant. No significant difference was found between the new knotless suture anchor techniques and traditional transosseous suture techniques.

An in-vitro study of rotator cuff tear and repair kinematics using single- and double-row suture anchor fixation

Purpose:Double-row suture anchor fixation of the rotator cuff was developed to reduce repair failure rates. The purpose of this study was to determine the effects of simulated rotator cuff tears and subsequent repairs using single- and double-row suture anchor fixation on three-dimensional shoulder kinematics. It was hypothesized that both single- and double-row repairs would be effective in restoring active intact kinematics of the shoulder.Materials and Methods:Sixteen fresh-frozen cadaveric shoulder specimens (eight matched pairs) were tested using a custom loading apparatus designed to simulate unconstrained motion of the shoulder. In each specimen, the rotator cuff was sectioned to create a medium-sized (2 cm) tear. Within each pair, one specimen was randomized to a single-row suture anchor repair, while the contralateral side underwent a double-row suture anchor repair. Joint kinematics were recorded for intact, torn, and repaired scenarios using an electromagnetic tracking device.Results:Active kinematics confirmed that a medium-sized rotator cuff tear affected glenohumeral kinematics when compared to the intact state. Single- and double-row suture anchor repairs restored the kinematics of the intact specimen.Conclusions:This study illustrates the effects of medium-sized rotator cuff tears and their repairs on active glenohumeral kinematics. No significant difference (P ≥ 0.10) was found between the kinematics of single- and double-row techniques in medium-sized rotator cuff repairs.Clinical Relevance:Determining the relative effects of single- and double-row suture anchor repairs of the rotator cuff will allow physicians to be better equipped to treat patients with rotator cuff disease.

Quadriceps Tendon Rupture: A Biomechanical Comparison of Transosseous Equivalent Double-Row Suture Anchor Versus Transosseous Tunnel Repair

Quadriceps rupture off the patella is traditionally repaired by a transosseous tunnel technique, although a single-row suture anchor repair has recently been described. This study biomechanically tested a new transosseous equivalent (TE) double-row suture anchor technique compared with the transosseous repair for quadriceps repair. After simulated quadriceps-patella avulsion in 10 matched cadaveric knees, repairs were completed by either a three tunnel transosseous (TT = 5) or a TE suture anchor (TE = 5) technique. Double-row repairs were done using two 5.5 Bio-Corkscrew FT (fully threaded) (Arthrex, Inc., Naples, FL, USA) and two 3.5 Bio-PushLock anchors (Arthrex, Inc., Naples, FL, USA) with all 10 repairs done with #2 FiberWire suture (Arthrex, Inc., Naples, FL). Cyclic testing from 50 to 250 N for 250 cycles and pull to failure load (1 mm/s) were undertaken. Gap formation and ultimate tensile load (N) were recorded and stiffness data (N/mm) were calculated. Statistical analysis was performed using a Mann-Whitney U test and survival characteristics examined with Kaplan-Meier test. No significant difference was found between the TE and TT groups in stiffness (TE = 134 +/- 15 N/mm, TT = 132 +/- 26 N/mm, p = 0.28). The TE group had significantly less ultimate tensile load (N) compared with the TT group (TE = 447 +/- 86 N, TT = 591 +/- 84 N, p = 0.04), with all failures occurring at the suture eyelets. Although both quadriceps repairs were sufficiently strong, the transosseous repairs were stronger than the TE suture anchor repairs. The repair stiffness and gap formation were similar between the groups.

Early Structural and Functional Outcomes for Arthroscopic Double Row Transosseous Equivalent Rotator Cuff Repair (SS-02)

Several investigators have studied the clinical outcomes after arthroscopic repair and have reported that the short-term clinical outcomes are comparable. However, the influence of the repair technique on the failure rates and functional outcomes after open or arthroscopic rotator cuff repair remains controversial. Several studies have evaluated biomechanical strength, contact area, and failure modes of single-row suture anchor, double-row suture anchor, as well as transosseous repairs and their ability to restore native the native rotator cuff. We present here out data from 155 consecutive patients who underwent double-row transosseous equivalent (suture bridge technique) rotator cuff repairs. Between June 2006 and October 2007, 225 patients underwent the arthroscopic double-row transosseous equivalent repair of a torn rotator cuff at two surgical centers. One hundred and fifty-five of these patients were available for follow up at an average of 15 months postoperatively. At this evaluation, patients had either an MRI or CT arthrogram of the operative shoulder. The Constant scores, pain ranking (0-15 scale), forward flexion and strength were also collected at the follow up examination. Failure rates were determined based on analysis of the radiographic outcomes. During this period 155 patients were clinically and radiologically evaluated at a mean of 15 months (5.5-26.1). 54% male 46% female at an average age of 57.73 years (18-80). 47, 89, 19 patients had Patte type I, II, III lesions (respectively). Mean preoperative Constant Score improved from 44.21 (23-66) to 80.41 (40-96) p<0.001 at follow up. Mean preoperative pain score improved from 3.83 (0-10) to 12.83 (5-15) p<0.001 at follow up. Mean preoperative forward flexion improved form 122.22 (60-170) to 162.44 (15-170) p<0.001. 35% (54 patients) had an arthrogram, 65% (100 patients) had an MRI and 0.7% (1 patient) during or after their follow up evaluation. Imaging demonstrated that 92%, 80%, 58% of the Type I, II, III lesions respectively were intact at follow up. The results of this study indicate that the transosseous equivalent double-row rotator cuff repair (the suture bridge technique) has excellent results at greater than 1 year follow up.