Original article
Arthroscopic Side-to-Side Rotator Cuff Repair

https://doi.org/10.1016/j.arthro.2005.03.014Get rights and content

Purpose: To study the results of arthroscopic repair of full-thickness rotator cuff tears using a side-to-side suture technique without fixation to bone. Type of Study: Case series study of the long-term results of patients who underwent purely arthroscopic rotator cuff repair with a side-to-side suturing technique. Methods: A retrospective review was performed of patients who underwent arthroscopic repair of full-thickness rotator cuff defects. Patients with full-thickness rotator cuff tears repaired in a side-to-side fashion without anchoring the repair to bone were selected. Patients were evaluated using a modified UCLA shoulder scoring system. The data collected were analyzed to determine the outcome in patients with a 4- to 10-year follow-up. Results: A total of 105 arthroscopic rotator cuff repairs were performed in 104 patients between February 1990 and February 1996. Forty-two patients had a full-thickness tear of the rotator cuff that was repaired using a purely side-to-side suturing technique. The mean UCLA score of all patients in this group was 33; 23 patients reported excellent results, 18 good results, and 1 poor result according to the UCLA scoring system. Conclusions: In this series, 98% of patients qualified as a good to excellent result according to the UCLA shoulder score. This study shows that patients with a full-thickness defect of the rotator cuff tendon with anatomy amenable to side-to-side closure may be effectively treated with a purely arthroscopic repair using only a side-to-side suturing technique with excellent long-term clinical results. Level of Evidence: Level IV.

Section snippets

Methods

The results of 105 consecutive arthroscopic rotator cuff repairs in 104 patients performed by the senior author (E.M.W.) over a 6-year period between February 1990 and February 1996 were evaluated. Initially, a retrospective clinical chart review was performed for each case. Nine patients were lost to follow-up, leaving 96 shoulders in 95 patients available for evaluation with an average follow-up of 73 months (range, 48 to 120 months). Forty-two of these patients who underwent repair of a

Results

Ninety-eight percent of patients had good and excellent postoperative scores with 23 excellent (55%), 18 good (43%), and 1 poor result (2%). The average UCLA score was 33. Forty-one of the 42 patients (98%) rated their surgery as being successful and were satisfied with the repair. One patient rated his surgery as unsuccessful.

The UCLA shoulder scoring system evaluated for strength, pain, and function (Table 1). The mean response in all patients grading their strength was 4.6 (range 2–5), mean

Discussion

Rotator cuff tears are often attritional in nature and the defect present often involves more than just an avulsion of the musculotendinous cuff from the greater tuberosity of the humerus. Burkhart9 has eloquently described a broad classification scheme to which rotator cuff tears can be classified: crescent-shaped or U-shaped tears. He describes the crescent-shaped tear as a disruption of the tendinous insertion from the greater tuberosity of the humerus without a large element of retraction.

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