Clinical outcomes of arthroscopic suture-bridge repair for intratendinous rotator cuff tears converted to full-thickness tears

Background The aim of this study was to evaluate the clinical outcomes of arthroscopic rotator cuff repair (ARCR) in which intratendinous tears (ITTs) were converted to full-thickness tears and repaired via the suture-bridge technique. Methods Partial-thickness ITTs that were refractory for more than 6 months to conservative treatment were surgically treated using a radiofrequency device to convert the ITTs into full-thickness tears, which were subsequently repaired via the suture-bridge technique. The evaluation parameters included shoulder range of motion (forward elevation and external rotation), Japanese Orthopaedic Association (JOA) scores, Constant-Murley scores, University of California at Los Angeles (UCLA) scores, American Shoulder and Elbow Surgeons (ASES) scores, and retear rates (Sugaya classifications IV and V). Results Twenty-one patients (8 males, 13 females; mean age: 55.3 ± 14.7 years) out of 25 diagnosed with isolated ITT completed at least 12 months of follow-up after surgery. Significant improvements were observed in the shoulder range of motion (139.5 ± 31.4° preoperatively to 164.5 ± 12.8° postoperatively), external rotation (45.8 ± 15.1° to 54.1 ± 14.7°), and clinical scores including the JOA score (64.4 ± 15.0 to 91.9 ± 7.2), Constant-Murley score (49.1 ± 18.7 to 81.9 ± 16.6), UCLA score (18.1 ± 5.2 to 30.4 ± 6.1), and ASES score (46.9 ± 28.8 to 91.3 ± 9.8). No re-tears were observed (0%). Conclusions There is no consensus on the optimal surgical approach for ITT. This study demonstrated the favorable clinical outcomes of ARCR via the suture-bridge technique after conversion of ITT to full-thickness tears. Level of evidence Level Ⅳ, retrospective cohort study