| Objective The purpose of this retrospective study was to analysis and evaluate functional outcome of arthroscopic rotator cuff repair using a suture bridge technique for rotator cuff tears.Methods In the first part of the study, the data of 39 patients of Grade III bursal-side partial-thickness rotator cuff tears was retrospectively analyzed from March 2010 to October 2012, who were treated by arthroscopic repair using a suture bridge technique. They were disposed with or without preserving the normal articular respectively(Group A, Group B). In the second part of the study included 70 patients with full-thickness rotator cuff tears repaired by arthroscopic repair using a suture bridge technique, from March 2010 to April 2013. According to the preoperative shoulder passive range of motion, they were divided into 2 groups: stiffness group(Group C) and non-stiffness group(Group D). In Group C, they received manipulation under anesthesia, and then 1-stage arthroscopic adhesion release and rotator cuff repair were performed. Arthroscopic repair rotator cuff repair were done in Group D. Before operation and at the last follow-up, the visual analog scale(VAS) was used to assess the pain, American shoulder and elbow surgeons scores(ASES), the Constant shoulder score(CSS), University of California at Los Angeles scores(UCLA) and Simple shoulder test(SST) were used to evaluate and analyze the overall outcomes of all patients.Results In the first part, 39 patients got followed up with an average of 32.4 months(range, 24-52 months). The VAS was respectively improved from(6.1±2.1) in Group A and(6.5±1.5) in Group B before operation to(0.8±0.4) and(1.2±1.2) respectively at the latest follow up; ASES increased from(45.8±13.7) and(41.4±12.3) preoperatively to(93.3±3.0) and(90.5±7.3)respectively at the latest follow up; CSS increased from(43.1±13.8) and(39.1±8.6) preoperatively to(81.6±5.0) and(81.5±7.4) respectively at the last follow-up; UCLA improved from(15.0±4.0) and(14.2±3.6) preoperatively to(32.2±2.4) and(31.6±2.1) respectively at the latest follow up; SST increased from(4.8±1.4) and(4.7±1.0) preoperatively to(9.1±0.9) and(9.1±1.3) respectively at the last follow-up. There were significant differences between pre-operation and the last follow-up in the same group(p<0.05), but no significant differences between groups at the latest follow up(p>0.05). In Group A, 6 cases were excellent, good in 13 and fair in 2, the excellent and good rate was 90.5%; excellent in 4, good in 13 and fair in 1,the fine rate was 94.4% in Group B. In the second part, All the 70 patients were followed up with an average of 24.6 months(range, 15-46 months). The VAS was respectively improved from(7.3±1.5) in Group C and 6.2±2.1 in Group D before operation to(0.7±1.0) in Group C and(0.8±0.8) in Group D at the latest follow up; ASES increased from(27.7±10.0) in Group C and(48.0±17.6) in Group D preoperatively to(92.7±7.5) and(91.9±5.7) respectively at the latest follow up; UCLA improved from(10.8±2.9) in Group C and(16.9±3.9) in Group D preoperatively to(33.1±3.0) and(33.3±1.9) respectively at the latest follow up; SST increased from(3.6±1.1) in Group C and(5.9±1.5) in Group D preoperatively to(9.4±1.2) and(9.5±1.1) respectively at the last follow-up. There were significant differences between pre-operation and the last follow-up within the same group(P<0.05), but no significant differences between groups at the latest follow up(P>0.05). 14 cases were excellent, good in 7 and fair in 2, the excellent and good rate was 91.3% in Group C; excellent in 25, good in 20 and fair in 2,the fine rate was 95.7% in Group D.Conclusion In the first part, arthroscopic suture bridge technique combined with or without preserving the articular tissue for treatment of Grade III bursal-side partial-thickness rotator cuff tears achieved satisfactory outcomes in selected patients, the excellent and good rate is more than 90.0%. The clinical outcomes of Group A in this study were statistically the same as Group B. In the second part, arthroscopic rotator cuff repair using a suture bridge technique for full-thickness rotator cuff tears with shoulder stiffness achieved satisfactory results in selected patients, the excellent and good rate is more than 90%. The clinical outcomes of the stiffness group in this study were statistically the same as those in the non-stiffness group. |
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