Our Summary

This study examined two different surgical techniques used to repair torn rotator cuffs in the shoulder - a “knotted suture bridge” method and a “knotless suture tape bridge” method. The researchers looked at 272 shoulders from 256 patients who had full-thickness tears in a specific shoulder tendon and had received one of these two treatments. They specifically looked at which treatment had the most failures, defined as either the tear re-opening (confirmed by an MRI) or needing another surgery. They also measured several other outcomes, including shoulder strength, range of motion, and patient-reported measures of pain and functionality.

Of the 272 shoulders, 127 met the criteria for the study. They found that there wasn’t a significant difference between the two methods in terms of how often they failed, nor was there a difference in the other measures of success. The study concluded that both methods are good options for repairing this kind of shoulder injury. This study is considered Level III evidence, which means it’s a moderately high level of proof of the methods’ effectiveness.

FAQs

  1. What were the two surgical techniques examined in the study for repairing torn rotator cuffs?
  2. How were the success and failure of the surgical techniques measured in the study?
  3. Did the study find a significant difference in effectiveness between the “knotted suture bridge” method and the “knotless suture tape bridge” method?

Doctor’s Tip

One helpful tip a doctor might give a patient about rotator cuff repair is to follow a structured rehabilitation program after surgery. This program will typically include exercises to improve range of motion, strengthen the shoulder muscles, and gradually progress towards full function. Compliance with the rehabilitation program is crucial for optimal recovery and to prevent re-injury. It’s important to work closely with a physical therapist and follow their guidance to ensure a successful outcome.

Suitable For

Patients who are typically recommended for rotator cuff repair are those with full-thickness tears in the shoulder tendon that are causing significant pain, weakness, and limited range of motion in the shoulder. These tears may be the result of acute injury or degenerative changes over time. Patients who have not responded well to conservative treatments such as physical therapy, corticosteroid injections, and rest may be candidates for surgical repair of the rotator cuff. Surgery may also be recommended for younger patients or those with active lifestyles who want to regain full function in their shoulder.

Timeline

Before the rotator cuff repair surgery, a patient typically experiences shoulder pain, weakness, and limited range of motion. They may have tried non-surgical treatments such as physical therapy or cortisone injections without success. The patient will undergo a thorough evaluation by a specialist, which may include imaging tests like an MRI to determine the extent of the tear.

After the surgery, the patient will go through a recovery process that typically includes physical therapy to regain strength and range of motion in the shoulder. The patient will also need to follow specific instructions from their surgeon regarding post-operative care and exercises. Over time, the patient should experience a reduction in pain and improvement in shoulder function as the rotator cuff heals and strengthens.

Overall, the timeline of a patient’s experience before and after rotator cuff repair can vary depending on the individual and the specific details of their injury and treatment plan. However, with proper care and rehabilitation, many patients are able to regain full function of their shoulder and return to their normal activities.

What to Ask Your Doctor

Some questions a patient should ask their doctor about rotator cuff repair include:

  1. What are the risks and potential complications associated with rotator cuff repair surgery?
  2. How long is the recovery process after rotator cuff repair surgery?
  3. Will I need physical therapy after surgery, and if so, for how long?
  4. What kind of pain management options will be available to me during the recovery period?
  5. How soon after surgery can I expect to return to normal activities or sports?
  6. What kind of follow-up appointments will I need after surgery?
  7. Are there any specific rehabilitation exercises or precautions I should take to prevent re-injury?
  8. What are the success rates of the different surgical techniques for rotator cuff repair, and which one do you recommend for my specific injury?
  9. What kind of long-term outcomes can I expect after rotator cuff repair surgery?
  10. Are there any lifestyle changes or modifications I should make to help promote healing and prevent future injuries to my shoulder?

Reference

Authors: Fox MA, Hughes JD, Drain NP, Wagala N, Patel N, Nazzal E, Popchak A, Sabsevari S, Lesniak BP, Lin A. Journal: Knee Surg Sports Traumatol Arthrosc. 2023 May;31(5):1919-1924. doi: 10.1007/s00167-022-07121-0. Epub 2022 Aug 23. PMID: 35996032