• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.77-81
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• 2008

The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. Single row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs (suture bridge technique) have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. Even though the superior advantages of double row and transosseous equivalent repairs, those techniques take longer surgical time and are more expensive than single row repairs. Therefore single row repairs can be useful in bursal side partial thickness or small size full thickess rotator cuff tear.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.155-159
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• 2007

Arthroscopic single-row rotator cuff repair is a well established surgical technique for the treatment of rotator cuff tears. However, the problem of postoperative retear remains a concern. Various avenues are being explored to address this problem. Some studies have suggested that restoring the anatomical footprint may improve the healing and initial strength of the repaired rotator cuff tendon. The double-row technique was introduced as a method of reconstructing the anatomical footprint. According to biomechanical studies on cadavers, this technique improved mechanical strength and reduced gap formation. However, the biological properties of reattached tendon such as tension, and vascularity have not been proved yet. Furthermore, the apparent mechanical superiority of the double-row over the single-row construction has not resulted in better functional outcomes. Therefore, the less complicated and less costly single-row technique is still the recommended treatment for rotator cuff repairs.

• Journal of the Korean Orthopaedic Association
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• v.55 no.1
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• pp.38-45
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• 2020

Purpose: To examine the clinical and structural outcomes of an at least two-year follow-up of arthroscopic full-thickness rotator cuff repairs with a single-row or suture-bridge technique in patients more than 65 years of age. Materials and Methods: Patients diagnosed with a full-thickness rotator cuff tear who were more than 65 years of age, underwent arthroscopic rotator cuff repair after at least six months of conservative treatment, agreed to take a follow-up magnetic resonance imaging (MRI) six months postoperatively, and visited outpatient for at least two years were enrolled in this study. Clinical evaluations were done using The University of California Los Angeles score, Constant Shoulder Score, and visual analogue scale evaluated two years after the surgery. The structural integrity was analyzed using follow-up MRI. During surgery, a suture-bridge technique was used if the rotator cuff tendon could cover half of the footprint under constant tension. Otherwise, single-row repair was performed. Results: The samples were 158 cases, consisting of 93 single-repairs and 65 suture-bridge repairs. A preoperative comparison of the age distribution, fatty degeneration of supraspinatus and infraspinatus muscle, medial retraction of torn cuff tendon, and tear size between the two groups were not significant. The clinical scores were improved significantly in all cases. The distribution of the structural integrity by Sugaya classification were 49 cases in type 1 (31.0%), 62 cases in type 2 (39.2%), 30 cases in type 3 (19.0%), 11 cases in type 4 (7.0%), and six cases in type 5 (3.8%). The re-tear rate of the single-row group was 9.7% (nine out of 93 cases) and 12.3% (eight out of 65 cases) for the suture-bridge group. Conclusion: Satisfactory clinical and radiological outcomes were achieved after arthroscopic full-thickness rotator cuff repair in patients more than 65 years of age. Both single-row and suture-bridge techniques would be beneficial for the elderly.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.117-124
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• 2011

Purpose: We reviewed arthroscopic reconstruction among the several treatment options for anterior shoulder instability with a bony Bankart lesion. Materials and Methods: Although open Bankart repair has long been considered the optimal surgical management of anterior shoulder instability, advancements in arthroscopic techniques have led to a recent shift to arthroscopic Bankart repair. However, for cases of a glenoid bony defect, several authors have reported various methods to accurately measure the amount of bony defect. Results: The arthroscopic technique of bony Bankart reconstruction continues to evolve and various methods have followed. To overcome the limitations of single fixation of a Bankart lesion, arthroscopic dual fixation (2 point fixation) has recently been tried to anatomically repair and restore the rigid fixation of a bony fragment. The concept of performing the Bristow-Latarjet transfer procedure under arthroscopy has also recently emerged. However, a large series of cases and long term follow up are required to prove the better results. Conclusion: To obtain a successful outcome for patients with anterior instability with a glenoid bony defect, it is imperative that the surgeon be aware of the accurate status of the bony defect and the intraoperative, postoperative factors associated with the proper treatment of this unstable pathology.

• Clinics in Shoulder and Elbow
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• v.15 no.1
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• pp.16-24
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• 2012

Purpose: This study was designed to investigate the rate of incidence, location and the clinical value of the rotator cuff retear by analyzing MRI scans, which was taken after an arthroscopic rotator cuff repair. Materials and Methods: This study included a total of 109 patients, who underwent a shoulder MRI scan after an average of 10.6 months later from the arthroscopic rotator cuff repair. We only defined the 'retear' when the Sugaya type IV and V was observed in the sagittal section of the MRI. The location of the retear was divided into the medial and lateral areas by the site, which was 1 cm medial to the anchor insertion. We investigated the incidence rate and the location of the retear, in terms of the age, sex, initial tear size and the suture method. Also, we compared the functional score of the retear group and the non-retear group, after an average of 13.9 months follow-up. Results: There were 38 of the 109 patients that showed the rotator cuff retear. Of these patients, 25 were male patients, and 13 were female patients. Of the 38 patients with the rotator cuff retear, 21 patients were included in the <3 cm retear group, and 17 were included in the ${\geqq}3$ cm retear group. At the end of the follow up period, all 109 patients showed a statistical significant improvement in the shoulder functional score. Conclusion: According to the follow up of the MRI scan, which was taken after the rotator cuff repair, the retear rate reached 34.9 %, and there were no significant differences on the age and the suture method. More rotator cuff retear occurred in male patients, and the initial tear size was positively correlated with the incidence rate of the rotator cuff retear. Also, the retear was more frequently observed at the medial side. That is because when the suture was performed, excessive tension was loaded on the medial side of the suture site.