Efficacy of bone marrow stimulation for arthroscopic knotless suture bridge rotator cuff repair: a prospective randomized controlled trial.
Bone marrow stimulation
knotless suture bridge technique
musculotendinous junction
retear
rotator cuff
rotator cuff repair
Journal
Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499
Informations de publication
Date de publication:
May 2023
May 2023
Historique:
received:
14
09
2022
revised:
23
12
2022
accepted:
06
01
2023
medline:
21
4
2023
pubmed:
17
2
2023
entrez:
16
2
2023
Statut:
ppublish
Résumé
The purpose of this study was to investigate the efficacy of bone marrow stimulation (BMS) on the repair integrity of the rotator cuff insertion treated with arthroscopic knotless suture bridge (K-SB) rotator cuff repair. We hypothesized that BMS during K-SB repair can improve the healing of the rotator cuff insertion. Sixty patients who underwent arthroscopic K-SB repair of full-thickness rotator cuff tears were randomly allocated to 2 treatment groups. Patients in the BMS group underwent K-SB repair augmented with BMS at the footprint. Patients in the control group underwent K-SB repair without BMS. Cuff integrity and retear patterns were evaluated by postoperative magnetic resonance imaging. The clinical outcomes included the Japanese Orthopaedic Association score, University of California at Los Angeles score, Constant-Murley score, and Simple Shoulder Test. Clinical and radiological evaluations were completed in 60 patients at 6 months postoperatively, in 58 patients at 1 year postoperatively, and in 50 patients at 2 years postoperatively. Both treatment groups showed significant improvements in the clinical outcome from baseline to the 2-year follow-up, but no significant differences were found between the 2 groups. At 6 months postoperatively, the retear rate at the tendon insertion was 0.0% (0 of 30) in the BMS group and 3.3% (1 of 30) in the control group (P = .313). The retear rate at the musculotendinous junction was 26.7% (8 of 30) in the BMS group and 13.3% (4 of 30) in the control group (P = .197). All retears in the BMS group occurred at the musculotendinous junction, and the tendon insertion was preserved. There was no significant difference in the overall retear rate or retear patterns between the 2 treatment groups during the study period. No significant differences were detected in the structural integrity or retear patterns regardless of the use of BMS. The efficacy of BMS for arthroscopic K-SB rotator cuff repair was not proven in this randomized controlled trial.
Sections du résumé
BACKGROUND
BACKGROUND
The purpose of this study was to investigate the efficacy of bone marrow stimulation (BMS) on the repair integrity of the rotator cuff insertion treated with arthroscopic knotless suture bridge (K-SB) rotator cuff repair. We hypothesized that BMS during K-SB repair can improve the healing of the rotator cuff insertion.
METHODS
METHODS
Sixty patients who underwent arthroscopic K-SB repair of full-thickness rotator cuff tears were randomly allocated to 2 treatment groups. Patients in the BMS group underwent K-SB repair augmented with BMS at the footprint. Patients in the control group underwent K-SB repair without BMS. Cuff integrity and retear patterns were evaluated by postoperative magnetic resonance imaging. The clinical outcomes included the Japanese Orthopaedic Association score, University of California at Los Angeles score, Constant-Murley score, and Simple Shoulder Test.
RESULTS
RESULTS
Clinical and radiological evaluations were completed in 60 patients at 6 months postoperatively, in 58 patients at 1 year postoperatively, and in 50 patients at 2 years postoperatively. Both treatment groups showed significant improvements in the clinical outcome from baseline to the 2-year follow-up, but no significant differences were found between the 2 groups. At 6 months postoperatively, the retear rate at the tendon insertion was 0.0% (0 of 30) in the BMS group and 3.3% (1 of 30) in the control group (P = .313). The retear rate at the musculotendinous junction was 26.7% (8 of 30) in the BMS group and 13.3% (4 of 30) in the control group (P = .197). All retears in the BMS group occurred at the musculotendinous junction, and the tendon insertion was preserved. There was no significant difference in the overall retear rate or retear patterns between the 2 treatment groups during the study period.
CONCLUSIONS
CONCLUSIONS
No significant differences were detected in the structural integrity or retear patterns regardless of the use of BMS. The efficacy of BMS for arthroscopic K-SB rotator cuff repair was not proven in this randomized controlled trial.
Identifiants
pubmed: 36796716
pii: S1058-2746(23)00080-0
doi: 10.1016/j.jse.2023.01.016
pii:
doi:
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
909-916Informations de copyright
Copyright © 2023 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.