HUANG Peiguan , WANG Xiaoxu , WANG Bei , TAN Guanghua , HONG Liang , WANG Fang , ZENG Zhi , LEI Saiyun , QIU Mingjun , YAN Huyong , HE Chunrong
  • Department of Joint Surgery, the Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang Hunan, 421001, P. R. China;
WANG Xiaoxu, Email: wxx1024@163.com
Arthroscopy; double-pulley suture bridge; medium-sized supraspinatus tendon tear; early effectiveness
10.7507/1002-1892.202501065
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Objective  To describe a novel arthroscopic technique of modified tri-anchor double- pulley suture-bridge in repairing medium-sized supraspinatus tendon tears and evaluate the early effectiveness. Methods  Between June 2021 and January 2024, 26 patients with medium-sized supraspinatus tendon tears who underwent arthroscopic modified tri-anchor double- pulley suture-bridge repair and met the selective criteria were included. There were 11 males and 15 females with an average age of 61.4 years (range, 43-74 years). Five patients had a significant history of trauma, while the remaining 21 patients had no apparent cause. The time from symptom onset to hospitalization was 3-25 months (mean, 7.9 months). The effectiveness was evaluated during follow-up, including the scores of University of California at Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES), visual analog scale (VAS), the range of forward flexion, abduction, external rotation, and internal rotation, and patient’s satisfaction. Either MRI or ultrasound examination were used to evaluate structural integrity of the tendon. Results  The operation time was 65-110 minutes (mean, 81.8 minutes). All patients were followed up 12-43 months (mean, 23.0 months). At 3 and 12 months after operation, the shoulder range of flexion, abduction, external and internal rotation, and the scores of VAS, UCLA and ASES significantly improved compared with those before operation (P<0.05). The improvement was further observed at 12 months compared to 3 months (P<0.05). At last follow-up, 13 patients were very satisfied with the effectiveness and 11 patients were satisfied. During follow-up, 15 patients underwent imaging examination and imaging reexamination showed that the re-tear rate of tendon was 6.6%(1/15). The remaining 11 patients refused imaging examination. Complications included partial anchor withdrawal in 1 case, shoulder stiffness in 5 cases, and mild pain in shoulder joint in 2 cases in physical activity or heavy physical activity. Conclusion  Arthroscopic modified tri-anchor double-pulley suture-bridge technique is a novel surgical technique that uses double-loaded suture anchors as medial- and lateral-row anchors. In repairing medium-sized supraspinatus tendon tears, 6 sets of double-pulley suture-bridges can be created from one medial-row anchor; knotless medial-row can reduce re-tear rate of the tendon; good early effectiveness was obtained.

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