Functional outcomes of arthroscopic rotator cuff repair: transosseous technique versus single-row with anchors

Authors

  • Julio Solis Kronthal Department of Joint Surgery Service; Hospital de Ortopedia Cruz Roja Mexicana; Yucatán, México
  • Ramon Esperón Hernández School of Medicine, University of Yucatán, Mexico
  • Felipe Martínez Escalante Department of Joint Surgery Service; Hospital de Ortopedia Cruz Roja Mexicana; Yucatán, México
  • Guillermo Bobadilla Lezcano Department of Joint Surgery Service; Hospital de Ortopedia Cruz Roja Mexicana; Yucatán, México
  • Felipe Cámara Arrigunaga Department of Joint Surgery Service; Hospital de Ortopedia Cruz Roja Mexicana; Yucatán, México

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251124

Keywords:

Arthroscopy, Functional outcomes, Rotator cuff, Single-row fixation, Transosseous fixation

Abstract

Background: Transosseous repair (TO) has declined in popularity since the introduction of suture anchors and arthroscopic methods in 1985. Nevertheless, failure rates remain significant, at 12% to 40% and the cost of these devices is considerable. Consequently, interest has revived in arthroscopic transosseous technique, the aim of this study was to evaluate whether anchorless transosseous arthroscopic fixation achieves similar or better functional outcomes than single-row fixation with anchors in patients with rotator cuff tears.

Methods: 60 shoulders with complete rotator cuff tears were evaluated, divided into two groups based on fixation technique: Group 1 (transosseous) and Group 2 (single row with anchors). All patients had a minimum 12-month follow-up, including clinical assessments (VAS, range of motion) and functional questionnaires (ASES, Constant scores).

Results: No significant differences were found in VAS scores at 6 months (t=0.244, p=0.404) and 12 months (t=0.220, p=0.413). Additionally, there was no superiority of either group in motion ranges at 12 months (forward flexion t=0.732, p=0.234; external rotation t=1.608, p=0.057; abduction t=0.583, p=0.281). Both groups reported high postoperative satisfaction, with no differences in ASES (t=0.153, p=0.439) and constant scores (t=0.572, p=0.285) at 12 months.

Conclusions: The transosseous repair technique is as effective as single-row anchor repair for rotator cuff repair, achieving similar clinical and functional outcomes.

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References

Flanagin BA, Garofalo R, Lo EY, Feher L, Castagna A, Qin H, et al. Midterm clinical outcomes following arthroscopic transosseous rotator cuff repair. Int J Shoulder Surg. 2016;10(1):3-9. DOI: https://doi.org/10.4103/0973-6042.174511

Beauchamp JÉ, Beauchamp M. Functional outcomes of arthroscopic transosseous rotator cuff repair using a 2-mm tape suture in a 137-patient cohort. JSES Int. 2021;5(6):1105-10. DOI: https://doi.org/10.1016/j.jseint.2021.06.001

Cole BJ, ElAttrache NS, Anbari A. Arthroscopic rotator cuff repairs: an anatomic and biomechanical rationale for different suture-anchor repair configurations. Arthroscopy. 2007;23(6):662-9. DOI: https://doi.org/10.1016/j.arthro.2007.02.018

Chhabra A, Goradia VK, Francke EI, Baer GS, Monahan T, Kline AJ, et al. In vitro analysis of rotator cuff repairs: a comparison of arthroscopically inserted tacks or anchors with open transosseous repairs. Arthroscopy. 2005;21(3):323-7. DOI: https://doi.org/10.1016/j.arthro.2004.11.018

Cobaleda Aristizabal, A., Barber, F. Rotator cuff repair: technical considerations influencing optimum anchor choice in rotator cuff repair. Annals of Joint, North America. 2020. DOI: https://doi.org/10.21037/aoj-20-32

Salata MJ, Sherman SL, Lin EC, Sershon RA, Gupta A, Shewman E, et al. Biomechanical evaluation of transosseous rotator cuff repair: do anchors really matter? Am J Sports Med. 2013;41(2):283-90. DOI: https://doi.org/10.1177/0363546512469092

Castagna A, Garofalo R, Conti M, Khair Y, Gumina S, De Giorgi S. Arthroscopic transosseous versus suture anchor repair: clinical outcomes in patients with bilateral rotator cuff tears. J Biol Regul Homeost Agents. 2020;34(3):51-7.

Benson EC, MacDermid JC, Drosdowech DS, Athwal GS. The incidence of early metallic suture anchor pullout after arthroscopic rotator cuff repair. Arthroscopy. 2010;26(3):310-5. DOI: https://doi.org/10.1016/j.arthro.2009.08.015

Li X, Xiao Y, Shu H, Sun X, Nie M. Risk Factors and Corresponding Management for Suture Anchor Pullout during Arthroscopic Rotator Cuff Repair. J Clin Med. 2022;11(22):6870. DOI: https://doi.org/10.3390/jcm11226870

Randelli P, Stoppani CA, Zaolino C, Menon A, Randelli F, Cabitza P. Advantages of Arthroscopic Rotator Cuff Repair with a Transosseous Suture Technique: A Prospective Randomized Controlled Trial. Am J Sports Med. 2017;45(9):2000-9. DOI: https://doi.org/10.1177/0363546517695789

Plachel F, Traweger A, Vasvary I, Schanda JE, Resch H, Moroder P. Long-term results after arthroscopic transosseous rotator cuff repair. J Shoulder Elbow Surg. 2019;28(4):706-14. DOI: https://doi.org/10.1016/j.jse.2018.09.003

Li L, Bokshan SL, Ready LV, Owens BD. The primary cost drivers of arthroscopic rotator cuff repair surgery: a cost-minimization analysis of 40,618 cases. J Shoulder Elbow Surg. 2019;28(10):1977-82. DOI: https://doi.org/10.1016/j.jse.2019.03.004

Tocci SL, Tashjian RZ, Leventhal E, Spenciner DB, Green A, Fleming BC. Biomechanical comparison of single-row arthroscopic rotator cuff repair technique versus transosseous repair technique. J Shoulder Elbow Surg. 2008;17(5):808-14. DOI: https://doi.org/10.1016/j.jse.2008.02.016

Yang G, Li S, Jiang C, Zhang H, Lu Y. The role of bone marrow stimulation in rotator cuff repair: a systematic review and meta-analysis. J Exp Orthop. 2023;10(1):27. DOI: https://doi.org/10.1186/s40634-023-00589-w

Zhang L, Zhu Y, Xu T, Fu W. Bone marrow stimulation in arthroscopic rotator cuff repair is a cost-effective and straightforward technique to reduce retear rates: A systematic review and meta-analysis. Front Surg. 2023;10:1047483. DOI: https://doi.org/10.3389/fsurg.2023.1047483

Kawamata J, Suenaga N, Oizumi N. Relationship between hematoma-like tissue on the footprint and structural outcome of arthroscopic rotator cuff repair with a transosseous technique. JSES Int. 2023;7(2):324-30. DOI: https://doi.org/10.1016/j.jseint.2022.12.019

Srikumaran U, Huish EG Jr, Shi BY, Hannan CV, Ali I, Kilcoyne KG. Anchorless arthroscopic transosseous and anchored arthroscopic transosseous equivalent rotator cuff repair show no differences in structural integrity or patient-reported outcomes in a matched cohort. Clin Orthop Relat Res. 2020;478(6):1295-303.

Hasler A, Beeler S, Götschi T, Catanzaro S, Jost B, Gerber C. No difference in long-term outcome between open and arthroscopic rotator cuff repair: a prospective, randomized study. JSES Int. 2020;4(4):818-25. DOI: https://doi.org/10.1016/j.jseint.2020.08.005

Black EM, Lin A, Srikumaran U, Jain N, Freehill MT. Arthroscopic transosseous rotator cuff repair: technical note, outcomes and complications. Orthopedics. 2015;38(5):352-8. DOI: https://doi.org/10.3928/01477447-20150504-50

Seidl AJ, Lombardi NJ, Lazarus MD, Black EM, Maltenfort MG, Pepe MD, et al. Arthroscopic Transosseous and Transosseous-Equivalent Rotator Cuff Repair: An Analysis of Cost, Operative Time and Clinical Outcomes. Am J Orthop (Belle Mead NJ). 2016;45(7):415-20.

Fırat A, Aydın M, Tecimel O, Öçgüder A, Sanisoğlu Y, Uğurlu M. Comparison of the clinical and radiological outcomes of arthroscopic transosseous and transosseous-equivalent double-row rotator cuff repair techniques. Acta Orthop Traumatol Turc. 2020;54(2):178-85. DOI: https://doi.org/10.5152/j.aott.2020.02.37

Srikumaran U, Huish EG Jr, Shi BY, Hannan CV, Ali I, Kilcoyne KG. Anchorless Arthroscopic Transosseous and Anchored Arthroscopic Transosseous Equivalent Rotator Cuff Repair Show No Differences in Structural Integrity or Patient-reported Outcomes in a Matched Cohort. Clin Orthop Relat Res. 2020;478(6):1295-303. DOI: https://doi.org/10.1097/CORR.0000000000001151

Liu XN, Yang CJ, Lee GW, Kim SH, Yoon YH, Noh KC. Functional and Radiographic Outcomes After Arthroscopic Transosseous Suture Repair of Medium Sized Rotator Cuff Tears. Arthroscopy. 2018;34(1):50-7. DOI: https://doi.org/10.1016/j.arthro.2017.07.035

Binder H, Buxbaumer P, Steinitz A, Waibl B, Sonnenschein M, Hackl M, et al. Arthroscopic Anchorless Transosseous Rotator Cuff Repair Produces Equivalent Clinical Outcomes and Imaging Results as a Standard Suture Bridge Technique with Anchors. Arthrosc Sports Med Rehabil. 2022;4(6):2025-34. DOI: https://doi.org/10.1016/j.asmr.2022.09.002

Garofalo R, Calbi R, Castagna A, Cesari E, Budeyri A, Krishnan SG. Is there a difference in clinical outcomes and repair integrity between arthroscopic single-row versus transosseous (anchorless) fixation? A retrospective comparative study. J Orthop Sci. 2018;23(5):770-6. DOI: https://doi.org/10.1016/j.jos.2018.05.011

De Giorgi S, Ottaviani G, Bianchi FP, Delmedico M, Suma M, Moretti B. Single-row versus transosseous technique in the arthroscopic treatment of rotator cuff tears: a meta-analysis. Eur J Orthop Surg Traumatol. 2024;34(1):31-8. DOI: https://doi.org/10.1007/s00590-023-03657-0

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Published

2025-04-25

How to Cite

Kronthal, J. S., Esperón Hernández, R., Martínez Escalante, F., Bobadilla Lezcano, G., & Cámara Arrigunaga, F. (2025). Functional outcomes of arthroscopic rotator cuff repair: transosseous technique versus single-row with anchors. International Journal of Research in Orthopaedics, 11(3), 491–497. https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20251124

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Original Research Articles