A Comparative Study Of Arthroscopic Treatment Of Bursal-Sided Rotator Cuff Tear With Knotted And Knotless Single Suture Bridge Technique

PurposeTo compare the clinical prognosis of knotted and knotless single suture bridge technique with the same number of anchors in treatment of bursal-sided rotator cuff tear under arthroscopy,and to provide clinical basis for clinical treatment of bursal-sided rotator cuff tear.Method94 patients with bursal-sided rotator cuff tear were selected from the Department of Sports Medicine,Northern Jiangsu People’s Hospital of Jiangsu Province from June 2018 to June 2021,46 patients repaired with knotted single suture bridge technique(knotted group)and 48 patients with knotless single suture bridge technique(knotless group).The data of shoulder range of motion of flexion,neutral external rotation,lateral internal rotation and VAS was collected before operation,three weeks,three months,six months after operation and at the last follow-up.At the same time,ASES score and Constant score were collected before operation and at the last follow-up.The above data were compared between the two groups.At the last follow-up,rotator cuff healing was evaluated by Barth ultrasonic classification.Result1、There were no significant differences in the shoulder range of motion of flexion,neutral external rotation and lateral internal rotation between two groups at three weeks after operation(P>0.05);at three and six months after operation,the shoulder range of motion of flexion and lateral internal rotation in the knotless group were significantly higher than that in knotted group(P<0.05).However,there were no significant differences in the shoulder range of motion of neutral external rotation(P>0.05);meanwhile,at the last follow-up,the shoulder range of motion of lateral internal rotation in the knotless group was still better than that of the knotted group.2、In addition,no significant difference was acquired in VAS between two groups at three weeks after operation.However,three and six months after operation and at the last follow-up,the knotless group in VAS were superior to the knotted group(P<0.05).3、There was no significant difference in Constant score between two groups at the last follow-up,but the ASES score in the knotless group[(96.87±5.09)points]was better than that in the knotted group[(92.78±7.85)points].4、At the final follow-up,healing was better in the knotless group in terms of Barth ultrasound classification(P<0.05).There were 2 cases with retear in the knotted group,and the retear rate was 4.35%.In the knotless group,there was only 1 case with retear,with the retear rate 2.08%.All 3 cases were type 2 retear.The difference with retear was not statistically significant(P>0.05).Conclusion1、Both knotless or knotted single suture bridge technique for bursal-sided rotator cuff tear can get significant results.2、Knotless single suture bridge technique can obtain more obvious pain relief in the early stage.3、Knotless single suture bridge technique can obtain better range of motion of flexion and lateral internal rotation in the early stage.4、Knotless single suture bridge technique can obtain better functional recovery and healing effect.