Does dynamically tensioning suture alter outcomes after rotator cuff repair?

Abstract

Background: Dynamically tensioning suture is now available as an alternative to traditional static tendon-repair sutures. The purpose of this study was to compare rotator cuff repair (RCR) patient-reported outcomes (PRO) between repairs performed using dynamic and static suture.

Methods: A retrospective review was performed for patients who underwent rotator cuff repair by a single surgeon at an academic institution between 2016 and 2022. Patients who underwent RCR with either dynamically tensioning suture or traditional static suture were included. Intraoperative variables included tear width, tear retraction, number of anchors used in repair, repair construct, and Goutallier grades for supraspinatus, infraspinatus, teres minor and subscapularis evaluated on preoperative MRI. Patient Reported Outcomes (PRO) collected preoperatively and at a minimum of two-years postoperatively included the American Shoulder and Elbow Surgeons (ASES) score, Visual analogue scale (VAS) pain score, and the Subjective Shoulder Value (SSV) score. We used both univariable and multivariable regression models, where the multivariable models estimated the dynamic suture effect controlling for a set of predictors selected a priori.

Results: A total of 424 patients (441 shoulders) were included, with 2-year outcomes available for 78% (344/441). Patients were divided into dynamic (47.1%) and static (52.9%) tensioning suture groups. There were no significant preoperative differences in demographics, preoperative PROs, or intraoperative findings between the groups, except for acromial undersurface characteristics (p < 0.001). Postoperatively, there were no significant differences between the groups in ASES, VAS, or SSV scores. Multivariable regression analysis revealed preoperative ASES was independently associated with postoperative ASES, and preoperative VAS and tear size were independently associated with postoperative VAS. There were no differences in postoperative outcomes between the dynamic and static groups.

Conclusion: Patient-reported outcomes did not differ significantly between the dynamic tensioning and static tensioning sutures in arthroscopic rotator cuff repair.