2015 ISAKOS Biennial Congress ePoster #2425

Limitations of Arthroscopic Modified Tension Band Suture Technique in Full Thickness Rotator Cuff Tear

Jeong-Woo Kim, MD, Iksan KOREA, REPUBLIC OF
Seok Hyun Kweon, MD, Iksan, Chunbuk KOREA, REPUBLIC OF
Tae Kyun Kim, MD, PhD, Seongnamsi, Gyeonggido KOREA, REPUBLIC OF
Kyu Hwan Bae, MD, Iksan KOREA, REPUBLIC OF

Orthopedic department, Iksan, KOREA

FDA Status Not Applicable

Summary: the function was significantly improved compared to pre-operative function and shows lesion was restored structurally normal at 74% after arthroscopic modified tension band suture technique. if it was more than large lesion before surgery, functional improvement was significantly low and re-rupture rate was significantly high. Therefore, this technique is inappropriated to above large size.

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Abstract:

The goal of this study was to analyze clinical and radiological results after performing arthroscopic modified tension band suture technique among various arthroscopic suture techinques in full thickness rotator cuff tear.

Among 54 patients undergone arthroscopic modified tension band suture technique between from June 2011 to March 2013 in our hospital, 47 patients who were followed up for at least 1 year was targeted. There were 29 male and 18 female patients, the mean age of the patients was 59.9 years (range 46 - 75 years). The mean follow-up was 16.7 months (range 14 – 23 months). The sizes of lesions based on the DeOrio and Cofield classification were 6 cases of small tear, 25 cases of medium tear and 16 cases of more than large tear. The fatty degeneration degree estimated by global fatty degeneration index were 9 cases of 0 level, 21 cases of 1 level, 11 cases of 2 level and 6 cases of 3 levels. For evaluating functional assessment, we measured VAS score, range of motions, ASES score and Constant score pre-operatively, at post-operative 6 months and post-operative 12 months. Radiologic evaluation was evaluated by measuring consistency of suture sites to perform MRI before surgery and 6 months after surgery.

Following the results of functional assessment performed at post-operative 3 months, 6 months and 12 months, it showed significant improvement in comparison with pre-operative findings.(p<0.05) However, if pre-operative size was large or more, clinical improvement was significantly low. (p <0.05). Re-rupture of suture site were 6.5% (2 cases) below the medium tear and 62.5% (10 cases) above large tear. The re-rupture rate was significantly high at the cases of large or massive size (p<0.05) and at the cases more than 3 degree of fatty degeneration (p<0.05) assessed by the MRIs performed at postoperative 6 months.

This study shows that the function was significantly improved compared to pre-operative function and shows lesion was restored structurally normal at 74% after arthroscopic modified tension band suture technique in full thickness rotator cuff tear. However, if it was more than large lesion before surgery, functional improvement was significantly low and re-rupture rate was significantly high. Therefore, this technique is inappropriated to above large size of rotator cuff tear.