• Clinics in Shoulder and Elbow
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• v.9 no.1
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• pp.89-95
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• 2006

Purpose: Arthroscopic repair of rotator cuff tears are many techniques that have been developed to improve the initial postoperative strength of the repair. There was a doubt that current arthroscopic cuff repairs using a single row of suture anchors reproduce insufficient area of the anatomic cuff insertion, and concerns about failure of fixation often lead surgeons to limit early motion. Newer technique of double-row repair in arthroscopic treatment may provide initial stronger fixation and more contact with bone at the repair site than single-row repair did. We studied the comparison between clinical outcomes of arthroscopic single- and double-row repair in cuff tears at 1year postoperatively. Materials and methods: We retrospectively analyzed 40 shoulders with single-row repair and 38 shoulders with double-row repair of full-thickness rotator cuff tears between May 2002 and October 2004. Out of total 78 shoulders, 42 (54%) were male patients and 36 (46%) were female patients and the mean age at surgery was 56 years. All patients were diagnosed by physical examination and MRI. At 1year' follow-up after operation, we evaluated with the ASES and the Constant scoring system, and measured muscle power of abduction, internal and external rotation of the affected shoulder then compared with each other. Results: Mean ASES scores and Constant scores in double-row repair group improved more than single-row repair group significantly at 1year postoperatively. Muscle power of abduction and internal rotation, especially abduction power, improved more significantly in double-row repair group than in single-row repair. Conclusion: Arthroscopic double-row repair for the full thickness rotator cuff tear may be a superior technique, which showed better clinical outcomes and restoration of muscle power compared with single-row repair at relatively short period of postoperative follow-up. Restoration of footprint close to normal anatomy by double-row repair seems to play an important role in the recovery of muscle strength.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.111-111
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• 2007

• Clinics in Shoulder and Elbow
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• v.18 no.4
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• pp.197-205
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• 2015

Background: The purpose of this study was to evaluate the postoperative magnetic resonance imaging (MRI) results of minimal-tying (one medial-row tie among 4 medial-row sutures) on the medial-row in double-row suture-bridge configuration ($2{\times}2$ anchor with $4{\times}4$ suture stands). Methods: From 2011 March to 2012 July, 79 patients underwent arthroscopic rotator cuff repair using $2{\times}2$ anchor double-row configuration. The mean age was 61.3 years (range, 31-81 years). Two double-loaded suture anchors were used for medial-row. Four medial-row stitches were made with only one medial-row knot-tying (the most anterior suture). Lateral-row was secured using the conventional suture-bridge anchor technique; all 4 strands were used for each anchor. Repair integrity was evaluated with MRI at mean 6.2 months postoperatively. Retear and the pattern of retear, change of fatty infiltration, and muscle atrophy of supraspinatus were evaluated using pre- and postoperative MRI. Results: Repaired tendon integrity was 38 for type I, 30 for type II, 6 for type III, 4 for type IV, and 1 for type V, according to Sugaya classification. Considering type IV/V as retear, the rate was 6.3% (5 out of 79 patients). Medial cuff failure was observed in 4 patients. Fatty atrophy of supraspinatus was significantly improved postoperatively according to Goutallier grading (p=0.01). The level of muscle atrophy of supraspinatus was not changed significantly after surgery. Conclusions: Minimal tying technique with suture configuration of four-by-four strand double-row suture-bridge yielded a lower retear rate (6.3%) in medium to large rotator cuff tears.

• Clinics in Shoulder and Elbow
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• v.11 no.2
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• pp.82-89
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• 2008

Ideal rotator cuff repair is to maintain high fixation strength and minimize gap formation for optimizing the environment of biologic healing of tendon to bone. Among the current repair techniques, the suture bridge technique is superior to single- or double-row repair in ultimate load to failure, gap formation, restoring anatomical footprint and achieving pressurized contact area. The suture bridge technique also minimizes gap formation and has rotational and torsional resistances allowing early rehabilitation. However, despite superior biomechanical characteristics of the suture bridge technique, there is no evidence that these mechanical advantages result in better clinical outcomes. Furthermore, there is no difference in failure rates between the double-row repair and suture bridge techniques. An appropriate repair technique should be determined based on tear size and pattern and tendon quality.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2005.03a
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• pp.18-18
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• 2005

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.36-36
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• 2006

• 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.

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2007.03a
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• pp.129-135
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• 2007

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.31-31
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• 2006

• The Academic Congress of Korean Shoulder and Elbow Society
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• 2006.03a
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• pp.32-32
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• 2006