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Repair Site Integrity After Arthroscopic Transosseous-Equivalent Suture-Bridge Rotator Cuff Repair

Joshua B. Frank, MD^,*, Neal S. ElAttrache, MD, Joshua S. Dines, MD, Allie Blackburn, MD, John Crues, MD and James E. Tibone, MD

From the Kerlan-Jobe Orthopaedic Clinic, Los Angeles, California, and RadNet Radiology, Los Angeles, California

^* Address correspondence to Joshua B. Frank, MD, Coastal Orthopaedics, 40 Cross Street, Suite 300, Norwalk, CT 06851 (e-mail: jbfmd{at}hotmail.com).

Background: Successful healing after arthroscopic rotator cuff repair remains a challenge. Earlier studies have shown a relatively high rate of failure. New surgical techniques may improve healing potential. The purpose of this study was to provide an objective evaluation of repair site integrity after arthroscopic transosseous-equivalent suture-bridge rotator cuff repair.

Hypothesis: Rotator cuff tears repaired using the transosseous-equivalent suture-bridge technique will show a higher intact rate on postoperative magnetic resonance imaging (MRI) evaluation.

Study Design: Case series; Level of evidence, 4.

Methods: The first 25 patients who underwent arthroscopic rotator cuff repair using the transosseous-equivalent suture-bridge technique underwent MRI evaluation of the postoperative shoulder. Minimum follow-up was 1 year. Demographic, clinical, and surgical factors, including tear size, were evaluated.

Results: Postoperative MRI demonstrated intact surgical repair sites in 22 of 25 patients (88%). Tears limited to the supraspinatus tendon were intact in 16 of 18 patients (89%). Tears of the supraspinatus involving part or all of the infraspinatus showed an 86% intact rate (6 of 7 patients). Of these tears, 3 were considered massive (complete 2-tendon or greater). These demonstrated an intact cuff on MRI.

Conclusions: The transosseous-equivalent suture-bridge technique demonstrates a high healing rate on imaging studies at 1 year. Of the first 25 patients repaired with the technique, 88% had an intact rotator cuff repair on MRI evaluation. This indicates excellent cuff healing, as judged by the intact repair sites, compared with most standard arthroscopic rotator cuff repair series. In this early report of the technique, a persistent tear could not be correlated with age or initial tear size; however, this may be due to the relatively small sample size.

Key Words: arthroscopic repair • rotator cuff • double-row • transosseous-equivalent