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Arthroscopic treatment of rotator cuff tears. Single versus double bridge technique
ESSKA Academy. Makridis K. May 9, 2018; 209923; P22-576
Mr. Konstantinos Makridis
Mr. Konstantinos Makridis
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Abstract
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Objectives: To compare the outcome and results of the arthroscopic treatment of rotator cuff tears with the use of single and double bridge techniques.

Methods: From 2010 - 2012, 110 patients diagnosed with rotator cuff tears were operated. There were 51 women (46%) and 59 men (54%). According to Patte classification, 39 tears type I (36%), 51 tears type II (46%) and 20 tears type III (18%) were recorded. According to Goutallier classification, 26 tendons had no fatty degeneration (24%), 41 tendons had a grade I fatty degeneration (37%), 26 tendons had a grade II fatty degeneration (24%), 8 tendons had a grade III fatty degeneration (7%) and 9 tendons had a grade IV fatty degeneration (8%). Clinical evaluation was performed with the use of ASES and Constant scores, while the SF-12 questionnaire was used to evaluate the quality of life.
Data were recorded and statistically analyzed with the use of Student t-test for paired samples. Significance levels were set at P < 0.05 with confidence intervals at 95%.

Results: Median follow-up was 15 months (range 12-24). The mean preoperative ASES score was 43 (SD: 5.4) and the mean postoperative score was 88 (SD: 7.6), p=0.0001. The mean preoperative Constant score was 33.9 (SD: 9.8) and the mean postoperative score was 77 (SD: 13), p=0.0001. The mean preoperative SF-12 score was 54.5 (SD: 8.1) whereas the mean postoperative SF-12 score was 60 (SD: 7.5), p=0.54. The patients with type I and II ruptures (Patte classification) showed better functional scores during the first 6 postoperative months, however there were no differences in relation with type III ruptures at the final follow-up. The use of double bridge technique showed better functional results in the patients with type III and IV ruptures (Goutallier classification).

Conclusions: Both single and double bridge techniques can provide a successful functional outcome in the treatment of rotator cuff tears. The evaluation of the extent of the rupture and the fatty degeneration of the tendons is crucial to determine the surgical technique to be used. Patients with type I and II ruptures (Patte classification) may have a faster recovery, while the tendons with high fatty degeneration can be better treated with the use of double bridge technique.

Keywords:
rotator cuff, tears, single bridge, double bridge
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