Arthroscopic Knotless Double-Row Transosseous Equivalent Repair Is a Viable Option for Treatment of Large and Massive Rotator Cuff Tears

Abstract

Purpose

To determine the clinical outcomes of large and massive rotator cuff tears treated with a knotless double-row transosseus equivalent repair. It is hypothesized that there would be statistically significant improvement in pain, range of motion, and function over time.

Methods

Patients who had an arthroscopic rotator cuff repair (Current Procedural Terminology code 29827) performed by a single surgeon at a community-based hospital were reviewed over a 32-month period. Patients were included if their tear measured more than 3 cm in the coronal and sagittal planes based on preoperative magnetic resonance imaging and if they had a repair using a knotless transosseous equivalent technique with suture tape. Minimum follow-up was 2 years. Clinical evaluation was performed using shoulder functionality tests, Constant score, and University of California, Los Angeles score. Postoperative ultrasonography was performed and reviewed by a musculoskeletal radiologist. Data were compared preoperatively versus postoperatively using the Wilcoxon rank test.

Results

Thirty-two patients met inclusion criteria with an average age of 64.4 ± 8.7 years. The average tear size on coronal magnetic resonance imaging T2 imaging was 4.0 ± 0.7 cm and on sagittal imaging was 4.2 ± 1.8 cm. The average follow-up was 2.5 ± 1.1 years. At the 2-year follow-up the average pain had improved from 7.3 to 0.8 (P < .001), the UCLA score improved from 11.6 to 31.2 (P < .001) and the Constant score improved from 38.3 to 78.7 (P < .001). At the final follow-up, the mean shoulder scaption strength was 16.1 lbs. on both the nonoperative shoulder and postoperative shoulder (P = .95). Of the 14 patients available for postoperative ultrasound, 12 showed sonographic healing (86%), 1 partial tear, and 1 full-thickness tear.

Conclusions

The arthroscopic double-row transosseus equivalent repair is a viable option for repairing large and massive rotator cuff tears with significant improvement in pain, active range of motion, functional outcomes and a high rate of radiographic healing.

Level of Evidence

Level IV, retrospective case series.