Is the Shoestring Bridge Technique an Effective Option to Treat Massive Rotator Cuff Tears?

Objective: Numerous surgical strategies have been proposed to treat non-arthritic irreparable massive rotator cuff tears and the comparative efficacy of these treatments remains unclear. The purpose of our study is to clarify the role of this type of repair. Methods: We report the medium-term clinical outcomes of a retrospective study that includes 21 patients submitted to an arthroscopic side-to-side repair technique in the configuration of a shoestring using one single suture anchored to the tendon footprint, for large and retracted posterosuperior rotator cuff tears. Results: All the range of motion measurements have significantly improved after surgery, except external rotation. A mean Constant score of 68.8 was obtained (SD 15.46). Both functional scores (QuickDASH and ASES) have improved significantly (QuickDASH Z = -3.877, p = .001; ASES Z = -4.016, p = .001). The absence of symptomatic improvement was defined as failure and a rate of 20.8% was found. Conclusions: According to our findings, this technique can offer good results in terms of range of motion and functional scores. It should be seen as an effective option for large and retracted posterosuperior rotator cuff tears in which an anatomic primary repair cannot be achieved. Other advantages are its low potential for complications, low cost and not compromising future treatment options that may be required in case of failure.