Comparison of En Masse Versus Dual-Layer Suture Bridge Procedures for Delaminated Rotator Cuff Tears

Purpose: To compare clinical outcomes between 2 suturing procedures, conventional en masse suture bridging (EMSB) and dual-layer suture bridging (DLSB), for delaminated rotator cuff tears. Methods: From January 2011 through December 2015, 98 consecutive cases with delaminated rotator cuff tears were included in this study (52 with EMSB and 46 with DLSB). The mean age was 65.0 +/- 8.9 years (range, 38-85 years). The mean follow-up period was 28.0 +/- 6.3 months (range, 24-40 months). The cases included 78 medium tears (1-3 cm) and 20 large tears (3-5 cm). The University of California, Los Angeles (UCLA) rating scale, the Simple Shoulder Test (SST), a visual analog scale for pain, and active range of motion of the shoulder preoperatively and 2 years after surgery were evaluated. Postoperative magnetic resonance imaging was obtained at 12 months after surgery. Results: Both the EMSB and DLSB groups showed improved clinical outcomes. Postoperative UCLA and SST scores were higher in the DLSB group than in the EMSB group (UCLA score, 33.2 +/- 2.3 vs 32.0 +/- 3.3 [P =.027]; SST score, 10.0 +/- 1.0 vs 9.5 +/- 1.2 [P =.014]). Postoperative abduction and external rotation of the shoulder were greater in the DLSB group than in the EMSB group (abduction, 160.1 degrees +/- 9.1 degrees vs 154.8 degrees +/- 19.8 degrees [P =.030]; external rotation, 53.7 degrees +/- 8.5 degrees vs 46.1 degrees +/- 9.4 degrees [P =.023]). Postoperative magnetic resonance imaging showed a retear in 7 of 52 cases in the EMSB group and 3 of 46 cases in the DLSB group, with no significant difference between groups. Conclusions: The DLSB and EMSB procedures for delaminated rotator cuff tears improved clinical and radiographic outcomes, and the DLSB group achieved better postoperative range of motion of the shoulder than the EMSB group. The DLSB procedure is useful for repairing delaminated rotator cuff tears. Level of Evidence: Level III, retrospective, case-control, comparative study.