Arthroscopic Repair of Medium to Large Rotator Cuff Tears with a Triple-Loaded Medially Based Single-Row Technique Augmented with Marrow Vents.

Purpose The primary purpose of this study was to evaluate the repair integrity on MRI, and secondarily, clinical outcomes, of medium to large (2cm to 4cm) rotator cuff tears treated using an arthroscopic triple-loaded medially based single-row repair technique augmented laterally with bone marrow vents. Methods This is a retrospective outcomes study of patients with full-thickness medium to large (2- to 4-cm) rotator cuff tears repaired by four surgeons at a single institution over a two-year period with a minimum of 24 months follow-up. A single-row repair with tension-minimizing medially based triple-loaded anchors and laterally placed bone-marrow vents was used. Patients completed a satisfaction and pain survey, the Western Ontario Rotator Cuff (WORC) index questionnaire, and a SF-36 version-2 survey to evaluate clinical outcomes. Magnetic resonance imaging (MRI) was obtained at a minimum of 24 months follow-up to assess repair integrity. Results 64 males and 27 females with a mean age of 59.7 (range 34-82) were included. The mean tear size was 2.6 cm in anterior-posterior dimension, treated with a mean of 2.2 anchors. 83 of 91 shoulders (91%) reported being completely satisfied with their result. The median WORC score was 95.2% of normal, with a significant difference found between those with an intact repair and those with a full-thickness recurrent defect (median 95.9% vs. 73.8%, (p = 0.003)). Post-operative MRI obtained at a median of 32 months (range 24-48 months) demonstrated an intact repair in 84 of 91 shoulders (92%), with failure defined as a full-thickness defect of the tendon. Conclusions Arthroscopic repair of medium to large rotator cuff tears using triple-loaded medially based single-row repair augmented with marrow vents resulted in a 92% healing rate by MRI and excellent patient-reported outcomes.