Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination
Introduction: Rotator cuff tear with delamination is considered a risk factor for postoperative retear. The purpose of this study was to compare clinical outcomes between three repair procedures for large or massive rotator cuff tears with delamination: conventional en masse suture bridge (EMSB), do...
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doaj-707b72575d8f4dbc9daaec959e8b55dd2021-08-17T08:41:24ZengEDP SciencesSICOT-J2426-88872021-01-0174110.1051/sicotj/2021039sicotj210030Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delaminationOkubo Atsushi0Yotsumoto Tadahiko1Watanabe Nobuyoshi2Kajikawa Teruyoshi3Nakajima Shun4Oshima Yasushi5Iizawa Norishige6Majima Tokifumi7Department of Orthopaedic Surgery, Kyoto Kujo HospitalDepartment of Orthopaedic Surgery, Kyoto Kujo HospitalDepartment of Orthopaedic Surgery, Kyoto Kujo HospitalDepartment of Orthopaedic Surgery, Kyoto Kujo HospitalDepartment of Orthopaedic Surgery, Kyoto Kujo HospitalDepartment of Orthopaedic Surgery, Nippon Medical SchoolDepartment of Orthopaedic Surgery, Nippon Medical SchoolDepartment of Orthopaedic Surgery, Nippon Medical SchoolIntroduction: Rotator cuff tear with delamination is considered a risk factor for postoperative retear. The purpose of this study was to compare clinical outcomes between three repair procedures for large or massive rotator cuff tears with delamination: conventional en masse suture bridge (EMSB), double-layer suture bridge (DLSB), and the combination of DLSB with modified Debyere-Patte (DLSB + DP). Methods: 53 shoulders of 52 patients who had massive rotator cuff tears with delamination were categorized into three groups: EMSB (18 shoulders), DLSB (24 shoulders), and DLSB + DP (11 shoulders). The mean postoperative follow-up period was 34.6 months. Pre- and postoperative evaluations included a range of motion (ROM), Constant scores, global fatty degeneration (GFDI), and tendon integrity according to Sugaya’s classification by magnetic resonance images (MRI). Results: In all groups, ROM significantly improved after the procedures. Mean constant scores significantly improved: from 45.5 to 77.4 after EMSB, from 45.5 to 87.6 after DLSB, and from 46.3 to 88.0 after DLSB + DP. Significant differences were noted in postoperative Constant scores (p = 0.018: DLSB vs. EMSB, and p = 0.045: DLSB + DP vs. EMSB). The Constant pain scores were better for DLSB + DP than for EMSB (p = 0.012). Global fatty degeneration index (GFDI) with DLSB + DP was significantly higher than that for either EMSB or DLSB, indicating significant preoperative fatty degeneration for DLSB + DP. Retear occurred in 27.8% of the EMSB group, 12.5% of the DLSB group, and 9.1% of the DLSB + DP group. Discussion: Comparisons of the three groups demonstrated that DLSB and DLSB + DP achieved better clinical outcomes than EMSB for the repair of large or massive rotator cuff tears. DLSB + DP is useful for massive rotator cuff tears with severe fatty degeneration or for cases where the presence of excessive tension is anticipated when repairing the torn cuff.https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj210030/sicotj210030.htmlrotator cuff teardelaminationsuture-bridgeen masse repairdouble-layer repair |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Okubo Atsushi Yotsumoto Tadahiko Watanabe Nobuyoshi Kajikawa Teruyoshi Nakajima Shun Oshima Yasushi Iizawa Norishige Majima Tokifumi |
spellingShingle |
Okubo Atsushi Yotsumoto Tadahiko Watanabe Nobuyoshi Kajikawa Teruyoshi Nakajima Shun Oshima Yasushi Iizawa Norishige Majima Tokifumi Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination SICOT-J rotator cuff tear delamination suture-bridge en masse repair double-layer repair |
author_facet |
Okubo Atsushi Yotsumoto Tadahiko Watanabe Nobuyoshi Kajikawa Teruyoshi Nakajima Shun Oshima Yasushi Iizawa Norishige Majima Tokifumi |
author_sort |
Okubo Atsushi |
title |
Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination |
title_short |
Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination |
title_full |
Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination |
title_fullStr |
Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination |
title_full_unstemmed |
Comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination |
title_sort |
comparison of three suture-bridge techniques for large or massive rotator cuff tear with delamination |
publisher |
EDP Sciences |
series |
SICOT-J |
issn |
2426-8887 |
publishDate |
2021-01-01 |
description |
Introduction: Rotator cuff tear with delamination is considered a risk factor for postoperative retear. The purpose of this study was to compare clinical outcomes between three repair procedures for large or massive rotator cuff tears with delamination: conventional en masse suture bridge (EMSB), double-layer suture bridge (DLSB), and the combination of DLSB with modified Debyere-Patte (DLSB + DP). Methods: 53 shoulders of 52 patients who had massive rotator cuff tears with delamination were categorized into three groups: EMSB (18 shoulders), DLSB (24 shoulders), and DLSB + DP (11 shoulders). The mean postoperative follow-up period was 34.6 months. Pre- and postoperative evaluations included a range of motion (ROM), Constant scores, global fatty degeneration (GFDI), and tendon integrity according to Sugaya’s classification by magnetic resonance images (MRI). Results: In all groups, ROM significantly improved after the procedures. Mean constant scores significantly improved: from 45.5 to 77.4 after EMSB, from 45.5 to 87.6 after DLSB, and from 46.3 to 88.0 after DLSB + DP. Significant differences were noted in postoperative Constant scores (p = 0.018: DLSB vs. EMSB, and p = 0.045: DLSB + DP vs. EMSB). The Constant pain scores were better for DLSB + DP than for EMSB (p = 0.012). Global fatty degeneration index (GFDI) with DLSB + DP was significantly higher than that for either EMSB or DLSB, indicating significant preoperative fatty degeneration for DLSB + DP. Retear occurred in 27.8% of the EMSB group, 12.5% of the DLSB group, and 9.1% of the DLSB + DP group. Discussion: Comparisons of the three groups demonstrated that DLSB and DLSB + DP achieved better clinical outcomes than EMSB for the repair of large or massive rotator cuff tears. DLSB + DP is useful for massive rotator cuff tears with severe fatty degeneration or for cases where the presence of excessive tension is anticipated when repairing the torn cuff. |
topic |
rotator cuff tear delamination suture-bridge en masse repair double-layer repair |
url |
https://www.sicot-j.org/articles/sicotj/full_html/2021/01/sicotj210030/sicotj210030.html |
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