Abstract
Objectives:
All-suture anchors are a recent addition that serve as an alternative to conventional suture anchors utilized for arthroscopic rotator cuff repair (RCR). We hypothesize that there will be no difference in functional outcomes or complication rates in patients who underwent arthroscopic rotator cuff repair with all-suture medial row anchors compared to traditional suture anchors during a transosseous equivalent repair. The study design for this investigation is a level III retrospective case-control study.
Methods:
Patients undergoing primary arthroscopic RCR from January 1st, 2017, to August 31st, 2021 were eligible for inclusion. Operative notes were reviewed to determine tear size, type of anchors utilized, and concomitant pathology diagnosed and treated. Patients were separated into 2 groups based on which suture anchor was used (all-suture versus traditional (screw in anchors)). Patient medical records were examined to determine postoperative range of motion (ROM) and strength. Patient reported outcome (PRO) measures such as American Shoulder and Elbow Surgeons (ASES) score, Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, Simple Shoulder Test (SST), and Visual Analogue Pain Scale (VAS) were gathered.
Results:
In total, 252 patients were ultimately included for final analysis. 118 patients (46.8%) underwent aRCR with all-suture anchors while 134 (53.2%) patients had aRCR with traditional suture anchors. Size of tear was significantly larger in the all-suture cohort (18.21 ± 12.9 mm) than the traditional anchor cohort (13.93 ± 6.1 mm) (p=0.037). The number of sutures used (8.26 ± 4.3 vs. 5.0 ± 2.1) as well as number of anchors used (2.97 ± 1.4 vs. 2.6 ± 1.3) were significantly greater in the all-suture cohort than the traditional anchor cohort (p<0.001 and p=0.018, respectively). No other demographic or operative information was significantly different between groups (p>0.05). Abduction was found to be greater in the all-suture cohort (176.2° ± 14.8 vs. 168° ± 18.6, p<0.001). No other ROM parameter was significantly different between groups (p>0.05). The all-suture cohort also demonstrated greater proportions of postoperative strength in the 4+/5 and 5/5 categories when compared to traditional anchor patients (p=0.015). All-suture patients reported lower (better) VAS Pain scores postoperatively (1.2 ± 1.1 vs. 2.8 ± 2.1, p<0.001). ASES, DASH, and SST scores did not differ between cohorts (p>0.05)
Conclusions:
Patients who undergo arthroscopic rotator cuff repair using all-suture medial row anchors have increased abduction and strength postoperatively, as well as lower pain scores compared to traditional suture anchors during a transosseous equivalent repair.
