Bony Path Assisted Suturing and Tendon-to-Tendon Suturing Technique for External Rotator Repair After Hip Arthroplasty: A Randomized-Controlled Trial

Abstract Objective To compare and verify the effectiveness of tendon-to-bone suture technique for the repair of external rotator injuries after hip arthroplasty. Methods This was a prospective, randomized, controlled study including 178 patients that were divided into two groups. Clinical outcomes, joint dislocation rates, and external rotation angles were compared between patients who underwent the tendon-to-bone suture technique (group I) and those who underwent the tendon-to-tendon suture technique (group II). Results There were no statistically significant differences between the two groups in terms of sex, age, operative side, body mass index, diagnosis, visual analog scale (VAS) score, operation time, blood loss, or incision length ( P > 0.05). The hip Harris scores of the two groups were significantly higher in group I than in group II at 1 and 3 months after surgery ( P < 0.05); however, the difference was not statistically significant at 6 months after surgery ( P > 0.05). The difference in postoperative VAS scores of the two groups was not statistically significant ( P > 0.05). The incidence of postoperative joint dislocation in group I was significantly lower than in group II ( P < 0.05). The external rotation angles of the two groups were higher in group I than in group II at 1, 3, and 6 months after surgery ( P < 0.05); however, after 12 months of rehabilitation, the external rotation angles were close to normal, and the difference between the two groups was not statistically significant ( P > 0.05). Conclusion Tendon-to-bone repair is superior to tendon-to-tendon repair. Crucially, this technique enhances therapeutic outcomes without increasing operative time, incision length, or blood loss.