Dataset Information

Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears.

ABSTRACT: Delamination is a commonly observed finding at the time of rotator cuff repair, but few studies have described the surgical techniques used for delaminated rotator cuff tears (RCTs) or their clinical outcomes. We developed a technique using a combination of a double row and an additional row, which we call lamina-specific double-row fixation, for large delaminated RCTs. The lamina-specific double-row technique is performed using an additional row (lamina-specific lateral row) of suture anchors placed between the typical medial and lateral rows of suture anchors. The technique is performed as follows: (1) medial-row sutures are passed through the inferior (articular-side) and superior (bursal-side) layers in a mattress fashion; (2) lamina-specific lateral-row simple sutures are passed through the inferior layer; and (3) lateral-row simple sutures are passed through the superior layer. We believe that this technique offers the following advantages: (1) creation of a larger area of contact between the inferior layer and the footprint, (2) higher initial fixation strength of the articular-side components of the repaired rotator cuff tendon, and (3) an adaptation between the superficial and inferior layers. This technique represents an alternative option in the operative treatment of large delaminated RCTs.

SUBMITTER: Mori D

PROVIDER: S-EPMC4314549 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears.

Mori Daisuke D Funakoshi Noboru N Yamashita Fumiharu F

Arthroscopy techniques 20141110 6

Delamination is a commonly observed finding at the time of rotator cuff repair, but few studies have described the surgical techniques used for delaminated rotator cuff tears (RCTs) or their clinical outcomes. We developed a technique using a combination of a double row and an additional row, which we call lamina-specific double-row fixation, for large delaminated RCTs. The lamina-specific double-row technique is performed using an additional row (lamina-specific lateral row) of suture anchors p ...[more]

PMID: 25685671

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Project description:BACKGROUND: The single-row and double-row fixation techniques have been widely used for rotator cuff tears. However, whether the double-row technique produces superior clinical or anatomic outcomes is still considered controversial. This study aims to use meta-analysis to compare the clinical and anatomical outcomes between the two techniques. METHODS: The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before November 1, 2012. Studies clearly reporting a comparison of the single-row and double-row techniques were selected. The Constant, ASES, and UCLA scale systems and the rotator cuff integrity rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model. RESULTS: Eight studies were included in this meta-analysis. The weighted mean differences of the ASES (-0.84; P?=?0.04; I(2)?=?0%) and UCLA (-0.75; P?=?0.007; I(2)?=?0%) scales were significantly low in the single-row group for full-thickness rotator cuff tears. For tear sizes smaller than 3 cm, no significant difference was found between the groups no matter in Constant (P?=?0.95; I(2)?=?0%), ASES (P?=?0.77; I(2)?=?0%), or UCLA (P?=?0.24; I(2)?=?13%) scales. For tear sizes larger than 3 cm, the ASES (-1.95; P?=?0.001; I(2)?=?49%) and UCLA (-1.17; P?=?0.006; I(2)?=?0%) scales were markedly lower in the single-row group. The integrity of the rotator cuff (0.81; P?=?0.0004; I(2)?=?10%) was greater and the partial thickness retear rate (1.93; P?=?0.007; I(2)?=?10%) was less in the double-row group. Full-thickness retears showed no difference between the groups (P?=?0.15; I(2)?=?0%). CONCLUSION: The meta-analysis suggests that the double-row fixation technique increases post-operative rotator cuff integrity and improves the clinical outcomes, especially for full-thickness rotator cuff tears larger than 3 cm. For tear sizes smaller than 3 cm, there was no difference in the clinical outcomes between the two techniques. LEVEL OF EVIDENCE: Level I.

Dataset Information

Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears.

Publications

Arthroscopic lamina-specific double-row fixation for large delaminated rotator cuff tears.

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