A comparative study of arthroscopic knotted and knotless single suture bridge technique in treatment of bursal-sided rotator cuff tear

HU Yangyang; WANG Zhanye; LU Yaojia; FEI Wenyong; YANG Yuxia; ZHANG Yucheng; GAO Rangshan

doi:10.7619/jcmp.20223149

Journal of Clinical Medicine in Practice > 2023 > 27(6): 44-50. > DOI: 10.7619/jcmp.20223149

HU Yangyang, WANG Zhanye, LU Yaojia, FEI Wenyong, YANG Yuxia, ZHANG Yucheng, GAO Rangshan. A comparative study of arthroscopic knotted and knotless single suture bridge technique in treatment of bursal-sided rotator cuff tear[J]. Journal of Clinical Medicine in Practice, 2023, 27(6): 44-50. DOI: 10.7619/jcmp.20223149

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A comparative study of arthroscopic knotted and knotless single suture bridge technique in treatment of bursal-sided rotator cuff tear

1.
Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu, 225001
2.
Department of Ultrasound, Northern Jiangsu People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001
3.
Department of Sports Medicine, Northern Jiangsu People's Hospital of Jiangsu Province, Yangzhou, Jiangsu, 225001
4.
Dalian Medical University, Dalian, Liaoning, 116044

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Received Date: October 19, 2022
Revised Date: October 28, 2022
Available Online: April 11, 2023

Graphical Abstract

Abstract

Abstract

Objective
To compare the clinical effect of arthroscopic knotted versus non-knotted single suture bridge technique in the treatment of rotator cuff bursae tear.
Methods
Ninety-four patients with rotator cuff bursal tear were selected. A total of 46 patients in knotted group received knotted single-wire bridge repair, and 48 patients in non-knotted group received non-knotted single suture bridge technique. The shoulder forward flexion, neutral external rotation, lateral internal rotation and Visual Analogue Scale (VAS) scores of the two groups were collected and compared before surgery, 3 weeks, 3 months, 6 months and the last follow-up. American Society for Shoulder-to-elbow Surgery (ASES) scores and Constant scores were obtained before surgery and at the last follow-up. At the last follow-up, the rotator cuff healing was evaluated by Barth ultrasound imaging typing.
Results
There were no significant differences in the shoulder range of forward flexion, neutral external rotation and lateral internal rotation between two groups at three weeks after operation (P>0.05); at three and six months after operation, the shoulder range of forward flexion and lateral internal rotation in the non-knotted group were significantly higher than that in the knotted group (P < 0.05). However, there was no significant difference in VAS score 3 weeks after operation (P>0.05); at 3 months, 6 months and the last follow-up, non-knotted group was better in VAS scores than the knotted group (P < 0.05). There was no significant difference in Constant score between the two groups at the last follow-up (P>0.05). The score of postoperative ASES in the non-knotted group was (96.87±5.09), which was significantly higher than (92.78±7.85) in the knotted group (P < 0.05). At the final follow-up, healing efficacy was better in the non-knotted group than knotted group in terms of Barth ultrasound classification (P < 0.05). There were 2 cases with retear in the knotted group, with the retear rate of 4.35%. In the non-knotted group, there was only 1 case with retear, with the retear rate of 2.08%. Three cases were type 2 retear, and the difference was not statistically significant (P>0.05).
Conclusion
Both knotless or knotted single suture bridge technique for bursal-sided rotator cuff tear can obtain significant results. However, knotless single suture bridge technique can obtain more obvious pain relief, better shoulder range of forward flexion and lateral internal rotation and functional recovery of shoulder joints, and better healing results under ultrasound imaging assessment.
- rotator cuff injury,
- bursal-side,
- knotless,
- knot,
- arthroscopy,
- single suture bridge,
- shoulder joints

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References (27)

References

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A comparative study of arthroscopic knotted and knotless single suture bridge technique in treatment of bursal-sided rotator cuff tear

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