Skip to main content
SpringerLink
Log in

Einzelreihe, Doppelreihe oder transossäre Refixation

Biomechanische und klinische Daten

Single-row, double-row, or transosseous repair

Biomechanical and clinical data

  • Leitthema
  • Published:
Obere Extremität Aims and scope Submit manuscript

Zusammenfassung

Die arthroskopische Rotatorenmanschettennaht ist ein etabliertes Verfahren zur Behandlung von Rotatorenmanschettenrupturen. Die klinischen Ergebnisse sind unabhängig von der verwendeten Nahttechnik sehr gut. Eine kritische Analyse der Ergebnisse bezüglich der Sehnenintegrität zeigte in den frühen klinischen Serien insbesondere für große Rupturen hohe Rerupturraten. Neben biologischen Faktoren wie Patientenalter, Muskelatrophie und fettige Infiltration der Rotatorenmanschette wiesen experimentelle Studien biomechanische Defizite der Einzelreihentechniken nach. Die Doppelreihentechnik mit einer medialen und lateralen Reihe Fadenanker wurde als Verbesserung der Einzelreihentechnik entwickelt und zeigt sich in den meisten Studien biomechanisch dieser überlegen. Die klinische Ergebnisse lassen im kurzzeitigen Follow-up eine Tendenz zu besseren Einheilungsraten gegenüber der Einzelreihentechnik erkennen, ohne dass das klinische Ergebnis weiter verbessert werden konnte. Dass die als Alternative zur klassischen Doppelreihentechnik entwickelte „Suture-bridge-Technik“ dieselben biomechanischen Vorteile oder signifikant höhere Einheilungsraten verglichen mit der Einzelreihentechnik liefert, ist derzeit nicht eindeutig belegt.

Abstract

Arthroscopic rotator cuff repair is an established treatment option for rotator cuff tears. Clinical results are very good regardless of the repair technique. Critical analysis of repair integrity showed a high retear rate for larger tears especially in the earlier series. Apart from biological factors e.g., age, muscle atrophy, and fatty infiltration of the rotator cuff, studies have shown biomechanical deficiencies of single-row repair. Double-row repair with a medial and lateral row of suture anchors was developed as an improvement over single-row repair and showed superior biomechanical properties in most of the recent literature. Clinical results reveal a tendency towards better healing rates compared with single-row repair without further improvement of the clinical result. Transosseous-equivalent repair, which was developed as an alternative to the classic double-row repair, has not clearly shown the same biomechanical superiority or significantly higher healing rates compared to single-row repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Ahmad CS, Vorys GC, Covey A et al (2009) Rotator cuff repair fluid extravasation characteristics are influenced by repair technique. J Shoulder Elbow Surg 18:976–981

    Article  PubMed  Google Scholar 

  2. Anderson K, Boothby M, Aschenbrener D et al (2006) Outcome and structural integrity after arthroscopic rotator cuff repair using 2 rows of fixation: minimum 2-year follow-up. Am J Sports Med 34:1899–1905

    Article  PubMed  Google Scholar 

  3. Apreleva M, Ozbaydar M, Fitzgibbons PG et al (2002) Rotator cuff tears: the effect of the reconstruction method on three-dimensional repair site area. Arthroscopy 18:519–526

    Article  PubMed  Google Scholar 

  4. Aydin N, Kocaoglu B, Guven O (2010) Single-row versus double-row arthroscopic rotator cuff repair in small- to medium-sized tears. J Shoulder Elbow Surg 19:722–725

    Article  PubMed  Google Scholar 

  5. Barber FA, Herbert MA, Schroeder FA et al (2010) Biomechanical advantages of triple-loaded suture anchors compared with double-row rotator cuff repairs. Arthroscopy 26:316–323

    Article  PubMed  Google Scholar 

  6. Baums MH, Buchhorn GH, Spahn G et al (2008) Biomechanical characteristics of single-row repair in comparison to double-row repair with consideration of the suture configuration and suture material. Knee Surg Sports Traumatol Arthrosc 16:1052–1060

    Article  PubMed  CAS  Google Scholar 

  7. Bishop J, Klepps S, Lo IK et al (2006) Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg 15:290–299

    Article  PubMed  Google Scholar 

  8. Boileau P, Brassart N, Watkinson DJ et al (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87:1229–1240

    Article  PubMed  Google Scholar 

  9. Burks RT, Crim J, Brown N et al (2009) A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med 37:674–682

    Article  PubMed  Google Scholar 

  10. Castagna A, Conti M, Markopoulos N et al (2008) Arthroscopic repair of rotator cuff tear with a modified Mason-Allen stitch: mid-term clinical and ultrasound outcomes. Knee Surg Sports Traumatol Arthrosc 16:497–503

    Article  PubMed  Google Scholar 

  11. Charousset C, Bellaiche L, Duranthon LD et al (2005) Accuracy of CT arthrography in the assessment of tears of the rotator cuff. J Bone Joint Surg Br 87:824–828

    PubMed  CAS  Google Scholar 

  12. Charousset C, Grimberg J, Duranthon LD et al (2007) Can a double-row anchorage technique improve tendon healing in arthroscopic rotator cuff repair? A prospective, nonrandomized, comparative study of double-row and single-row anchorage techniques with computed tomographic arthrography tendon healing assessment. Am J Sports Med 35:1247–1253

    Article  PubMed  Google Scholar 

  13. Cole BJ, Mccarty LP, Kang RW et al (2007) Arthroscopic rotator cuff repair: prospective functional outcome and repair integrity at minimum 2-year follow-up. J Shoulder Elbow Surg 16:579–585

    Article  PubMed  Google Scholar 

  14. Defranco MJ, Bershadsky B, Ciccone J et al (2007) Functional outcome of arthroscopic rotator cuff repairs: a correlation of anatomic and clinical results. J Shoulder Elbow Surg 16:759–765

    Article  PubMed  Google Scholar 

  15. El-Azab H, Buchmann S, Beitzel K et al (2010) Clinical and structural evaluation of arthroscopic double-row suture-bridge rotator cuff repair: early results of a novel technique. Knee Surg Sports Traumatol Arthrosc

  16. Flurin PH, Guillo S, Landreau P et al (2006) Arthroscopic repair of full-thickness tears of the rotator cuff. Chir Main 25S1:S60–S69

    Article  PubMed  Google Scholar 

  17. Franceschi F, Ruzzini L, Longo UG et al (2007) Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. Am J Sports Med 35:1254–1260

    Article  PubMed  Google Scholar 

  18. Frank JB, Elattrache NS, Dines JS et al (2008) Repair site integrity after arthroscopic transosseous-equivalent suture-bridge rotator cuff repair. Am J Sports Med 36:1496–1503

    Article  PubMed  Google Scholar 

  19. Galatz LM, Ball CM, Teefey SA et al (2004) The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 86-A:219–224

    Google Scholar 

  20. Gartsman GM, Brinker MR, Khan M (1998) Early effectiveness of arthroscopic repair for full-thickness tears of the rotator cuff: an outcome analysis. J Bone Joint Surg Am 80:33–40

    Article  PubMed  CAS  Google Scholar 

  21. Grasso A, Milano G, Salvatore M et al (2009) Single-row versus double-row arthroscopic rotator cuff repair: a prospective randomized clinical study. Arthroscopy 25:4–12

    Article  PubMed  Google Scholar 

  22. Harryman DT, Mack LA, Wang KY et al (1991) Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am 73:982–989

    PubMed  Google Scholar 

  23. Huijsmans PE, Pritchard MP, Berghs BM et al (2007) Arthroscopic rotator cuff repair with double-row fixation. J Bone Joint Surg Am 89:1248–1257

    Article  PubMed  Google Scholar 

  24. Klinger HM, Buchhorn GH, Heidrich G et al (2008) Biomechanical evaluation of rotator cuff repairs in a sheep model: suture anchors using arthroscopic Mason-Allen stitches compared with transosseous sutures using traditional modified Mason-Allen stitches. Clin Biomech (Bristol, Avon) 23:291–298

  25. Krishnan SG, Cyran LT (2010) MRI evaluation of arthroscopic transosseous (no-anchor) rotator cuff repair: repair integrity at one year. Presented at American Shoulder and Elbow Surgeons Annual Meeting. Scottsdale/AZ, 20–23 October 2010

  26. Lafosse L, Brozska R, Toussaint B et al (2007) The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg Am 89:1533–1541

    Article  PubMed  Google Scholar 

  27. Leek BT, Robertson C, Mahar A et al (2010) Comparison of mechanical stability in double-row rotator cuff repairs between a knotless transtendon construct versus the addition of medial knots. Arthroscopy 26:S127–S133

    Article  PubMed  Google Scholar 

  28. Liem D, Lichtenberg S, Magosch P et al (2007) Magnetic resonance imaging of arthroscopic supraspinatus tendon repair. J Bone Joint Surg Am 89:1770–1776

    Article  PubMed  Google Scholar 

  29. Lo IKY, Burkhart SS (2003) Double-row arthroscopic rotator cuff repair: re-establishing the footprint of the rotator cuff. Arthroscopy 19:1035–1042

    Article  PubMed  Google Scholar 

  30. Lorbach O, Bachelier F, Vees J et al (2008) Cyclic loading of rotator cuff reconstructions: single-row repair with modified suture configurations versus double-row repair. Am J Sports Med 36:1504–1510

    Article  PubMed  Google Scholar 

  31. Ma CB, Macgillivray JD, Clabeaux J et al (2004) Biomechanical evaluation of arthroscopic rotator cuff stitches. J Bone Joint Surg Am 86-A:1211–1216

    Google Scholar 

  32. Matis N, Tauber M, Auffarth A, Resch H (2010) Technik und erste Ergebnisse der transossären arthroskopische Stabilisierung von PASTA-Läsionen. Präsentiert auf dem 27. AGA-Kongress, Wien, Österreich, 9–11. September 2010

  33. Mazzocca AD, Millett PJ, Guanche CA et al (2005) Arthroscopic single-row versus double-row suture anchor rotator cuff repair. Am J Sports Med 33:1861–1868

    Article  PubMed  Google Scholar 

  34. Nelson CO, Sileo MJ, Grossman MG et al (2008) Single-row modified Mason-Allen versus double-row arthroscopic rotator cuff repair: a biomechanical and surface area comparison. Arthroscopy 24:941–948

    Article  PubMed  Google Scholar 

  35. Oh JH, Kim SH, Ji HM et al (2009) Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy 25:30–39

    Article  PubMed  Google Scholar 

  36. Park JY, Lhee SH, Choi JH et al (2008) Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears. Am J Sports Med 36:1310–1316

    Article  PubMed  Google Scholar 

  37. Park MC, Elattrache NS, Ahmad CS et al (2006) Transosseous-equivalent rotator cuff repair technique. Arthroscopy 22:e1361–e1365

    Google Scholar 

  38. Pennington WT, Gibbons DJ, Bartz BA et al (2010) Comparative analysis of single-row versus double-row repair of rotator cuff tears. Arthroscopy 26:1419–1426

    Article  PubMed  Google Scholar 

  39. Stollsteimer GT, Savoie FH 3rd (1998) Arthroscopic rotator cuff repair: current indications, limitations, techniques, and results. Instr Course Lect 47:59–65

    PubMed  CAS  Google Scholar 

  40. Sugaya H, Maeda K, Matsuki K et al (2005) Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy 21:1307–1316

    Article  PubMed  Google Scholar 

  41. Tauro JC (1998) Arthroscopic rotator cuff repair: analysis of technique and results at 2- and 3-year follow-up. Arthroscopy 14:45–51

    Article  PubMed  CAS  Google Scholar 

  42. Voigt C, Bosse C, Vosshenrich R et al (2010) Arthroscopic supraspinatus tendon repair with suture-bridging technique: functional outcome and magnetic resonance imaging. Am J Sports Med 38:983–991

    Article  PubMed  Google Scholar 

Download references

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Klinik und Poliklinik für Allgemeine Orthopädie und Tumororthopädie, Universitätsklinikum Münster, Albert-Schweitzer-Str. 33, 48149, Münster, Deutschland

    D. Liem, C. Schmidt, T. Vogler & N. Dedy

Authors
  1. D. Liem
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Schmidt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. T. Vogler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Dedy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Liem.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liem, D., Schmidt, C., Vogler, T. et al. Einzelreihe, Doppelreihe oder transossäre Refixation. Obere Extremität 6, 11–18 (2011). https://doi.org/10.1007/s11678-011-0102-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11678-011-0102-8

Schlüsselwörter

Keywords

Search

Navigation