[Mid-Term Clinical Results after Open Rotator Cuff Reconstruction in Double-Row Technique with Titanium Anchor...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• The efficacy of double-row rotator cuff repair remains debated, with concerns about higher costs despite potential biomechanical advantages.
• Previous studies show no significant clinical outcome differences between single-row and double-row fixation methods.
• Mid-term clinical outcomes of open double-row rotator cuff repair using titanium anchor screws are evaluated.

Purpose of the Study:

• To assess the mid-term clinical results and re-tear rates of an open double-row rotator cuff repair technique.
• To compare the cost-effectiveness of titanium anchor screw fixation versus arthroscopic techniques.
• To identify factors influencing clinical outcomes and re-tear rates in rotator cuff repair.

Main Methods:

• A cohort of 237 patients undergoing open double-row rotator cuff repair with titanium screws in 2007 was retrospectively analyzed.
• Subjective Shoulder Value (SSG), Constant-Murley Score (CS), Simple Shoulder Test (SST), and Gerber's shoulder value were used for clinical evaluation at multiple follow-up points.
• Ultrasound imaging assessed rotator cuff integrity, calculating absolute and relative re-tear rates. Patient demographics, rupture size, and surgeon experience were considered.

Main Results:

• Significant improvements were observed in SSG (51 to 83 points), CS (mean 80 points), SST (mean 11 points), and Gerber's shoulder value (28.1% to 84.5%).
• The absolute re-tear rate was 7.6%, with a relative re-tear rate of 17.6%. Primary repairs showed better CS and lower re-tear rates.
• Rupture size significantly impacted re-tear rates and scores. Male patients demonstrated better strength and outcomes than females. Costs were substantially lower than arthroscopic suture bridge techniques (€330 vs. €600-€1000).

Conclusions:

• Open double-row rotator cuff repair with titanium screws is a safe and cost-effective procedure.
• This technique achieves comparable clinical results to other open and arthroscopic methods.
• The low re-tear rate and favorable cost profile support its consideration in clinical practice.