Comparison of clinical outcome and repair integrity after arthroscopic suture-bridge and triple-row rotator cuff repairs of Fosbury flop tears.

Abstract

The Fosbury flop tear (FFT) has recently been described as a rotator cuff tear that has flipped upon itself and adhered medially. FFT is known to have a high retear rate after arthroscopic rotator cuff repair. The cause of the high postoperative retear rate after arthroscopic rotator cuff repair is believed to be due to the inability to achieve anatomical reduction because of difficulties in reducing the torn tendon stump. Arthroscopic rotator cuff repairs using the triple-row technique may allow better anatomical reduction of the cuff tear when compared with the suture-bridge technique. We compared the clinical outcomes and cuff integrity of the triple-row and suture-bridge techniques in arthroscopic rotator cuff repair for FFT. Patients with small-to-medium sized cuff tears of the supraspinatus tendon alone who were diagnosed with FFT, underwent arthroscopic rotator cuff repair, and had 2 or more years of follow-up were included. A total of 34 shoulders underwent the triple-row technique and 22 shoulders underwent the suture-bridge technique. The following were compared between the two techniques: patient background, operation time, number of anchors used during the operation, Japanese Orthopedic Association (JOA) score, active range of motion, and retear rate. No significant difference in patient background was found between the two techniques. Although active range of motion was significantly improved compared with preoperative scores, no significant difference was observed between techniques. The triple-row technique demonstrated a significantly higher 24-month postoperative JOA score, significantly shorter surgery time, significantly lower retear rate, and significantly larger number of anchors used during the operation. The triple-row technique was an effective method compared with the suture-bridge technique in cases with FFT.