Objective To compare the clinical effect of arthroscopic knotted versus non-knotted single suture bridge technique in the treatment of rotator cuff bursae tear.
Methods Ninety-four patients with rotator cuff bursal tear were selected. A total of 46 patients in knotted group received knotted single-wire bridge repair, and 48 patients in non-knotted group received non-knotted single suture bridge technique. The shoulder forward flexion, neutral external rotation, lateral internal rotation and Visual Analogue Scale (VAS) scores of the two groups were collected and compared before surgery, 3 weeks, 3 months, 6 months and the last follow-up. American Society for Shoulder-to-elbow Surgery (ASES) scores and Constant scores were obtained before surgery and at the last follow-up. At the last follow-up, the rotator cuff healing was evaluated by Barth ultrasound imaging typing.
Results There were no significant differences in the shoulder range of forward 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 forward flexion and lateral internal rotation in the non-knotted group were significantly higher than that in the knotted group (P < 0.05). However, there was no significant difference in VAS score 3 weeks after operation (P>0.05); at 3 months, 6 months and the last follow-up, non-knotted group was better in VAS scores than the knotted group (P < 0.05). There was no significant difference in Constant score between the two groups at the last follow-up (P>0.05). The score of postoperative ASES in the non-knotted group was (96.87±5.09), which was significantly higher than (92.78±7.85) in the knotted group (P < 0.05). At the final follow-up, healing efficacy was better in the non-knotted group than knotted group in terms of Barth ultrasound classification (P < 0.05). There were 2 cases with retear in the knotted group, with the retear rate of 4.35%. In the non-knotted group, there was only 1 case with retear, with the retear rate of 2.08%. Three cases were type 2 retear, and the difference was not statistically significant (P>0.05).
Conclusion Both knotless or knotted single suture bridge technique for bursal-sided rotator cuff tear can obtain significant results. However, knotless single suture bridge technique can obtain more obvious pain relief, better shoulder range of forward flexion and lateral internal rotation and functional recovery of shoulder joints, and better healing results under ultrasound imaging assessment.
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