Cutting-through at the Greater Tuberosity

Study Overview
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Brief Summary
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The investigators evaluated the correlation between cutting-through at the greater tuberosity (GT) just medial to the lateral knotless anchor in arthroscopic suture-bridge rotator cuff repair and the bone mineral density (BMD) of the lumbar spine, hip and GT of the proximal humerus and to evaluate factors and clinical outcomes related to cutting-through at the GT.

Detailed Description
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Seventy-eight patients who underwent arthroscopic suture-bridge rotator cuff repair and who had undergone dual energy X-ray absorptiometry (DEXA) scans before surgery were included. Patients were divided into two groups: patients who had cutting-through (46, group I) and patients who did not (32, group II). Clinical and radiological data including demographics, BMDs, fatty infiltration of rotator cuff muscles, tear size, tear involvement, VAS pain score, and ASES score were analyzed.

Official Title
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The Correlation Between the Bone Mineral Density of the Proximal Humerus and Cutting-through at the Greater Tuberosity in Arthroscopic Suture-bridge Rotator Cuff Repair

Conditions
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Rotator Cuff Tears

Intervention / Treatment
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* Procedure: Arthroscopic suture-bridge rotator cuff repair


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary arthroscopic repair for a symptomatic full-thickness rotator cuff tear identified by preoperative MRI Dual energy X-ray absorptiometry (DEXA) to evaluate the BMD of the lumbar spine and hip, as a standardized measurement, and the GT of the affected proximal humerus Follow up for a minimum of 2 years after the primary surgery. Exclusion Criteria: Primary arthroscopic repair due to partial-thickness rotator cuff tear or an isolated subscapularis tear Primary suture-bridge repair with 3 or more lateral-knotless anchors Previous history of fractures or surgeries on the affected shoulder Shoulder instability Glenohumeral osteoarthritis Neurologic or systemic disease diseases influencing the shoulder joint 7 History of infection of the shoulder joint

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with cutting-through<br>Patients who had cutting-through during the lateral knotless anchor fixation. | Procedure: Arthroscopic suture-bridge rotator cuff repair<br>* Arthroscopic suture-bridge repair is a widely used and universal surgical method for symptomatic rotator cuff tear patients. It is arthroscopic surgery to reattach ruptured rotator cuff tendons to the original insertion (greater tuberosity) using medial and lateral row anchors.<br>|
| Patients without cutting-through<br>Patients who didn't have cutting-through during the lateral knotless anchor fixation. | Procedure: Arthroscopic suture-bridge rotator cuff repair<br>* Arthroscopic suture-bridge repair is a widely used and universal surgical method for symptomatic rotator cuff tear patients. It is arthroscopic surgery to reattach ruptured rotator cuff tendons to the original insertion (greater tuberosity) using medial and lateral row anchors.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The occurrence of cutting-through | The occurrence of cortical breakage of the GT just medial to the lateral knotless anchor hole due to the tension of the sutures from the medial anchor | During the surgery | 
| Visual Analog Scale (VAS) Pain Score | The VAS pain score was based on a scale from 0 to 10, where 0 indicated no pain and 10 indicated severe pain | 2 years after surgery | 
| American Shoulder and Elbow Surgeons (ASES) score | American Shoulder and Elbow Surgeons score for estimating shoulder function was based on a score from 0 to 100, where 0 indicated poor outcome and 100 indicated excellent outcome. | 2 years after surgery | 
| Greater tuberosity bone mineral density | GT BMD was measured using the predefined region of interest (ROI). Dividing the humeral head into three columns of even width, we defined a 1x1-cm2-sized square in the center of the lateral column as ROI. | preoperatively | 
| Lumbar spine bone mineral density | Measured by using standard techniques according to the manufacturer and the International Society for Clinical Densitometry guidelines. | preoperatively | 
| Hip bone mineral density | Measured by using standard techniques according to the manufacturer and the International Society for Clinical Densitometry guidelines. | preoperatively | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rotator cuff tear, cutting-through, Bone mineral density, suture-bridge repair