Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
권호 표지
DOI QR코드

DOI QR Code

Arthroscopic Rotator Cuff Repair by Single Row Technique

회전근 개 파열에 대한 관절경적 봉합술 중 일열 봉합술의 유용성

  • Yum, Jae-Kwang (Department of Orthopaedic Surgery, Sanggye Paik Hospital, Inje University)
  • 염재광 (인제대학교 의과대학 상계백병원 정형외과학교실)
  • Published : 2008.12.15
Download PDF
⟨ Previous Next ⟩

Abstract

The goal of rotator cuff repairs is to achieve high initial fixation strength, minimize gap formation, maintain mechanical stability under cyclic loading and optimize the biology of the tendon-bone interface until the cuff heals biologically to the bone. Single row repairs are least successful in restoring the footprint of the rotator cuff and are most susceptible to gap formation. Double row repairs have an improved load to failure and minimal gap formation. Transosseous equivalent repairs (suture bridge technique) have the highest ultimate load and resistance to shear and rotational forces and the lowest gap formation. Even though the superior advantages of double row and transosseous equivalent repairs, those techniques take longer surgical time and are more expensive than single row repairs. Therefore single row repairs can be useful in bursal side partial thickness or small size full thickess rotator cuff tear.

회전근 개 파열에 대한 봉합 수술의 목적은 봉합 초기에 고정력을 높이고 건-골 사이의 간격 형성을 최소화 하며 반복적인 부하에 기계적인 안정성을 유지시키고 회전근 개의 끝이 뼈에 부착되어 치유될 때까지 건-골 사이의 치유 환경을 최적화시키는 것이다. 일열 봉합은 원래의 회전근 개 부착부에 건을 완전히 부착시키는 면적이 제일 적고 간격 형성에 취약하다. 이열 봉합은 고정 실패를 방지하는 힘이 일열 봉합보다는 우수하고 간격 형성도 더 적으며 교량형 봉합은 최대 인장력이 가장 크며 전단력 및 회전력에 강하고 간격 형성도 제일 적다. 이러한 것을 볼 때 이열 봉합 및 교량형 봉합이 일열 봉합보다 우수한 점이 많지만 수술 시간이 좀 더 오래 걸리고 삽입하는 나사못의 개수도 많아 수술료가 비싸다는 단점도 가지고 있다. 따라서 일열 봉합도 회전근 개의 점액 낭측 부분층 파열이나 작은 완전 파열에 쓰여질 수 있는 아직은 유용한 방법으로 사료된다.

Keywords

References

  1. Ahmad CS, Stewart AM, Izquierdo R, Bigliani LU: Tendon-bone interface motion in transosseous suture and suture anchor rotator cuff repair techniques. Am J Sports Med, 33: 1667-1671, 2005. https://doi.org/10.1177/0363546505278252
  2. Apreleva M, Ozbaydar M, Fitzgibbons PG, Warner JP: Rotator cuff tears: The effect of reconstruction method on three-dimensional repair site area. Arthroscopy, 18: 519-526, 2002. https://doi.org/10.1053/jars.2002.32930
  3. Bicknell RT, Harwood C, Ferreira L: Cyclic loading of rotator cuff repairs: An in vitro biomechanical comparison of bioabsorbable tacks with transosseous sutures. Arthroscopy, 21: 875-880, 2005. https://doi.org/10.1016/j.arthro.2005.03.009
  4. Brady PC, Arrigoni P, Burkhart SS: Evaluation of residual rotator cuff defects after in vivo single- versus double-row rotator cuff repairs. Arthroscopy, 22: 1070-1075, 2006. https://doi.org/10.1016/j.arthro.2006.05.007
  5. Buess E, Steuber KU, Waibl B: Open versus arthroscopic rotator cuff repair: A comparative view of 96 cases. Arthroscopy, 21: 597-604, 2005. https://doi.org/10.1016/j.arthro.2005.01.002
  6. Chhabra A, Goradia VK, Francke EI: In vitro analysis of rotator cuff repairs: A comparison of arthroscopically inserted tacks or anchors with open transosseous repairs. Arthroscopy, 21: 323-327, 2005. https://doi.org/10.1016/j.arthro.2004.11.018
  7. Cicak N, Klobucar H, Bicanic G, Trsek D: Arthroscopic transosseous suture anchor technique for rotator cuff repairs. Arthroscopy, 22: 565.e1-565.e6, 2006. https://doi.org/10.1016/j.arthro.2005.07.029
  8. Cole BJ, Alford JW, Hayden K, Pylawka T, Lewis PB: Arthroscopic rotator cuff repair: Prospective evaluation at minimum 2-year follow-up. J Shoulder Elbow Surg, 16: e22, 2007.
  9. Cole BJ, ElAttrache NS, Anrabi A: Arthroscopic Rotator Cuff reapirs: An anatomic and biochemical rationale for different suture-anchor repair configurations. Arthroscopy, 23: 662-669, 2007. https://doi.org/10.1016/j.arthro.2007.02.018
  10. Cummins CA, Appleyard RC, Strickland S, Haen P, Chen S, Murrell GAC: Rotator cuff repair: An exvivo analysis of suture anchor repair techniques on initial load to failure. Arthroscopy, 21: 1236-1241, 2005. https://doi.org/10.1016/j.arthro.2005.06.022
  11. Cummins CA, Murrell GAC: Mode of failure for rotator cuff repair with suture anchors identified at revision surgery. J Shoulder Elbow Surg, 12: 128-133, 2003. https://doi.org/10.1067/mse.2003.21
  12. Curtis AS, Burbank KM, Tierney JJ, Scheller AD, Curran AR: The insertional footprint of the rotator cuff: An anatomic study. Arthroscopy, 22: 603-609, 2006. https://doi.org/10.1016/j.arthro.2006.04.001
  13. Fealy S, Rodeo SA, MacGillivray JD, Nixon AJ, Adler RS, Warren RF: Biomechanical evaluation of the relation between number of suture anchors and strength of the bone-tendon interface in a goat rotator cuff model. Arthroscopy, 22: 595-602, 2006. https://doi.org/10.1016/j.arthro.2006.03.008
  14. Galatz LM, Ball CM, Teeley SA, Middleton WD, Yamaguchi K: The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am, 86: 219-224, 2004.
  15. Gazielly DF, Gleyze P, Montagnon C: Functional and anatomical results after rotator cuff repair. Clin Orthop Relat Res, 304: 43-53, 1994.
  16. Harryman DT 2nd, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA 3rd: Repairs of the rotator cuff: Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am, 73: 982-989, 1991.
  17. Ide J, Maeda S, Takagi K: A comparison of arthroscopic and open rotator cuff repair. Arthroscopy, 21: 1090-1098, 2005. https://doi.org/10.1016/j.arthro.2005.05.010
  18. James Davidson JF, Burkhart SS, Richards DP, Campbell SE: Use of preoperative magnetic resonance imaging to predict rotator cuff tear pattern and method of repair. Arthroscopy, 21: 1428.e1-1428.e10, 2005. https://doi.org/10.1016/j.arthro.2005.09.015
  19. Kim DH, ElAttrache NS, Tibone JE: Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med, 34: 407-414, 2006.
  20. Lee S, Mahar A, Bynum K, Pedowitz R: Biomechanical comparison of bioabsorbable sutureless screw anchor versus suture anchor fixation for rotator cuff repair. Arthroscopy, 21: 43-47, 2005. https://doi.org/10.1016/j.arthro.2004.09.020
  21. Ma CB, Cumerford L, Wilson J, Puttlitz CM: Biomechanical evaluation of arthroscopic rotator cuff repairs: Double-row compared to single-row fixation. J Bone Joint Surg Am, 88: 403-410, 2006. https://doi.org/10.2106/JBJS.D.02887
  22. Mazzocca AD, Millett PJ, Guanche CA, Santangelo SA, Arciero RA: Arthroscopic single-row versus double-row suture anchor rotator cuff repair. Am J Sports Med, 33:1861-1868, 2005. https://doi.org/10.1177/0363546505279575
  23. McBirnie JM, Miniaci A, Miniaci SL: Arthroscopic repair of full-thickness rotator cuff tears using bioabsorbable tacks. Arthroscopy, 21: 1421-1427, 2005. https://doi.org/10.1016/j.arthro.2005.09.017
  24. Meier SW, Meier JD: The effect of double-row fixation on initial repair strength in rotator cuff repair: A biomechanical study. Arthroscopy, 22: 1168-1173, 2006. https://doi.org/10.1016/j.arthro.2006.07.004
  25. Nho SJ, Yadav H, Pensak M, Dodson CC, Good CR, MacGillivray JD: Biomechanical fixation in arthroscopic rotator cuff repair. Arthroscopy, 23: 94-102, 2007. https://doi.org/10.1016/j.arthro.2006.10.010
  26. Park MC, Cadet ER, Levine WN, Bigliani LU, Ahmad CS: Tendon-to-bone pressure distributions at a repaired rotator cuff footprint using transosseous suture and suture anchor fixation techniques. Am J Sports Med, 33: 1154-1159, 2005. https://doi.org/10.1177/0363546504273053
  27. Rebuzzi E, Coletti N, Schiavetti S, Giusto F: Arthroscopic rotator cuff repair in patients older than 60 years. Arthroscopy, 21: 48-54, 2005. https://doi.org/10.1016/j.arthro.2004.09.019
  28. Ruotolo C, Fow JE, Nottage WM: The supraspinatus footprint: An anatomic study of the supraspinatus insertion. Arthroscopy, 20: 246-249, 2004. https://doi.org/10.1016/j.arthro.2004.01.002
  29. Sano H, Yamashita T, Wakabayashi I, Itoi E: Stress distribution after rotator cuff repair: Suture anchors vs. transosseous suture fixation, Presented at the American Academy of Orthopaedic Surgeons, Chicago, IL, March 22-26, 2006.
  30. Sauerbrey AM, Getz CL, Piancastelli M, Iannotti JP, Ramsey ML, Williams GR Jr: Arthroscopic versus mini-open rotator cuff repair: A comparison of clinical outcome. Arthroscopy, 21: 1415-1420, 2005. https://doi.org/10.1016/j.arthro.2005.09.008
  31. Siskosky MJ, ElAttrache NS, Chu E, Tibone JE, Lee TQ: Biomechanical evaluation of the "transosseous equivalent" rotator cuff repair technique using the PushLock for lateral fixation compared to the doublerow technique, Presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons, San Diego, CA, February 14-18, 2007.
  32. Sugaya H, Maeda K, Matsuki K, Moriishi J: Functional and structural outcome after arthroscopic fullthickness rotator cuff repair: Single-row versus dual row fixation. Arthroscopy, 21: 1307-1316, 2005. https://doi.org/10.1016/j.arthro.2005.08.011
  33. Verma NN, Dunn W, Adler RS: All-arthroscopic versus mini-open rotator cuff repair: A retrospective review with minimum 2-year follow-up. Arthroscopy, 22: 587-594, 2006. https://doi.org/10.1016/j.arthro.2006.01.019
  34. Warner JJP, Tetreault P, Lehtinen J, Zurakowski D: Arthroscopic versus mini-open rotator cuff repair: A cohort comparison study. Arthroscopy, 21: 328-332, 2005. https://doi.org/10.1016/j.arthro.2004.11.006
  35. White CD, Bunker TD, Hooper RM: The strength of suture configurations in arthroscopic rotator cuff repair. Arthroscopy, 22: 837-841, 2006. https://doi.org/10.1016/j.arthro.2006.04.093
  36. Wolf EM, Pennington WT, Agrawal V: Arthroscopic side-to-side rotator cuff repair. Arthroscopy, 21: 881-887, 2005. https://doi.org/10.1016/j.arthro.2005.03.014
  37. Wolff AB, Magit DP, Miller SR, Wyman J, Sethi PM: Arthroscopic fixation of bursal-sided rotator cuff tears. Arthroscopy, 22: 1247.e1-1247.e4, 2006. https://doi.org/10.1016/j.arthro.2006.05.026