| Background:Rotator cuff tears are a common cause of shoulder joint pain and dysfunction.In the population,the prevalence of rotator cuff injuries ranges from 5% to 40%,with a significant increase in the prevalence in patients aged 60 years.The basic principles of arthroscopic repair of rotator cuff tears in rotator cuff injuries are to achieve firm tissue fixation and to prevent postoperative retear of the rotator cuff.At present,there are many methods for the treatment of rotator cuff tears under arthroscopy,but the best method is still controversial,in order to further reduce rivet implantation,reduce medical costs,shorten operation time,early return to normal life,and improve patient satisfaction.Therefore,we propose a modified load-sharing repair technique as a new approach to treat rotator cuff tears.In this retrospective study,we analyzed the clinical results of the new modified load-sharing repair and suture bridge repair technique for the treatment of full-thickness rotator cuff tears under arthroscopy to verify the effectiveness of this procedure and to gradually promote it in the clinic.However,no comparative clinical studies have been performed.Methods:A retrospective case-control study was conducted to analyze 70 patients with medium-large degree full-thickness rotator cuff tear admitted to Qian foshan Hospital of Shandong University from december 2019 to july 2021,including 40 males and 30 females,aged 35～77 years [(57.9±9.4) years].There were 20 patients on the left side and 50 patients on the right side,with the body mass index (BMI) of 18.17～36.98 kg/m2 [(25.27±3.81)kg/m2],and pain duration of2～12months [(5.40±2.43) months].A total of 36 patients were repaired with a new modified load-sharing technique and 34 patients with suture bridge technique.Comparison was made between the two groups in aspects of range of motion of shoulder flexion,forward flexion、abduction and external rotation,visual analog scale(VAS),University of California Los Angeles (UCLA) should function score,Constant shoulder function score。To compare and analyse postoperative outcomes,operative time,intraoperative bleeding,length of hospital stay,time to return to active activity and rotator cuff retears.The occurrence of postoperative complications was observed.Objective:To compare the clinical outcome of new modified load-sharing and suture bridge technique in treatment of rotator cuff tear under shoulder arthroscopy,validates the effectiveness of this procedure and gradually promotes it in clinical practice.Results:All patients were followed up for 6 to 17 months [(13.50±2.19) months].At the end of the follow-up,the patients in both groups had significantly better shoulder forward flexion,abduction and external rotation mobility and VAS pain visual analogue scores,UCLA shoulder function scores and Constant-Murley scores than before surgery (p<0.01).Patients in the modified load-sharing group had significantly better outcomes than the suture-bridge group in terms of time to return to active activity,operative time,intraoperative bleeding and number of anchors (P<0.01).The retear rate in the reduced-tension group was (5.6%) lower than the retear rate in the suture-bridge group (17.7%),but there was no significant significance in the Sugaya grading of the two groups (P>0.05).There were no postoperative complications such as non-healing of the wound,infection or persistent swelling in either group.Conclusions:There was no significant difference in functional post-operative shoulder outcomes or retear rates between patients who underwent repair with the new modified load-sharing technique and those who underwent repair with the sutured bridge technique.However,shortened the operative time and allowed the patient to return to active activity earlier.Therefore,the new modified load-sharing technique can be considered an effective treatment for patients with medium to large-sized full-thickness rotator cuff tears. |
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