Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results

Background: The purpose of this study is to evaluate the tendon healing rate in large and massive tears using magnetic resonance imaging (MRI) based on the Sugaya classification and to present the functional outcomes (American Shoulder and Elbow Surgeons, University of California, Los Angeles, and v...

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Main Authors: Raul Meyer Kautsky, MD, Benno Ejnisman, MD, PhD, Juarez Leite Junior, MD, Eduardo Antônio de Figueiredo, MD, PhD, Ricardo Azeredo Costa, MD, Jair Simmer Filho, MSc, MD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:JSES International
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666638325000787
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author Raul Meyer Kautsky, MD
Benno Ejnisman, MD, PhD
Juarez Leite Junior, MD
Eduardo Antônio de Figueiredo, MD, PhD
Ricardo Azeredo Costa, MD
Jair Simmer Filho, MSc, MD
author_facet Raul Meyer Kautsky, MD
Benno Ejnisman, MD, PhD
Juarez Leite Junior, MD
Eduardo Antônio de Figueiredo, MD, PhD
Ricardo Azeredo Costa, MD
Jair Simmer Filho, MSc, MD
author_sort Raul Meyer Kautsky, MD
collection DOAJ
description Background: The purpose of this study is to evaluate the tendon healing rate in large and massive tears using magnetic resonance imaging (MRI) based on the Sugaya classification and to present the functional outcomes (American Shoulder and Elbow Surgeons, University of California, Los Angeles, and visual analog scale scores) in patients who underwent the Load-Sharing Rip-Stop (LSRS) suture technique. These patients often present with retracted lesions, limited mobility, poor-quality tissues prone to tearing, medial tears, and/or insufficient bone quality (osteopenia or osteoporosis). Methods: Retrospective evaluation of patients aged > 55 years who underwent arthroscopic rotator cuff repair due to retracted tears (that after appropriate releases, it was not possible to cover more than 50% of the tendon footprint on the greater tuberosity upon rotator cuff traction), operated between 2014 and 2022, using the LSRS technique, and who underwent a minimum follow-up of 1 year, including postoperative MRI assessment. Results: Eighteen shoulders were included in the study and all of them performed a postoperative MRI; 1 patient experienced tendon rerupture on follow-up MRI, corresponding to a 5.56% failure rate. In the functional analysis, 16 shoulders (88.89%) scored above 80 on the American Shoulder and Elbow Surgeons score and had satisfactory results on the University of California, Los Angeles score (rated as excellent and good). Conclusion: In an average follow-up of 28 months, the LSRS suture technique demonstrated satisfactory functional outcomes and a good healing rate in patients with retracted and low-mobility rotator cuff injuries. These findings reinforce the idea that the LSRS technique can be a valuable option in managing these challenging cases.
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spelling doaj-art-ca659d89ebfe4c0384fe8c79231710eb2025-08-20T03:17:03ZengElsevierJSES International2666-63832025-07-01941145115310.1016/j.jseint.2025.02.020Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging resultsRaul Meyer Kautsky, MD0Benno Ejnisman, MD, PhD1Juarez Leite Junior, MD2Eduardo Antônio de Figueiredo, MD, PhD3Ricardo Azeredo Costa, MD4Jair Simmer Filho, MSc, MD5Hospital Santa Rita–Vitória, Brazil; Corresponding author: Raul Meyer Kautsky, MD, Hospital Santa Rita - Vitória/ES, Rua Carlos Eduardo Monteiro de Lemos, n° 262, 2° andar, sala 209 – Shopping Jardins, Jardim da Penha, Vitória, ES, Brazil 29060-120.Universidade Federal de São Paulo (Unifesp), São Paulo, SP, BrazilUnimed Diagnóstico, Multiscan e Santi Vitória, BrazilUniversidade Federal de São Paulo (Unifesp), São Paulo, SP, BrazilHospital Santa Rita - Vitória/ES and Hospital Estadual Dr. Jayme Santos Neves–Vitória, BrazilHospital Santa Rita - Vitória/ES and Hospital Estadual Dr. Jayme Santos Neves–Vitória, BrazilBackground: The purpose of this study is to evaluate the tendon healing rate in large and massive tears using magnetic resonance imaging (MRI) based on the Sugaya classification and to present the functional outcomes (American Shoulder and Elbow Surgeons, University of California, Los Angeles, and visual analog scale scores) in patients who underwent the Load-Sharing Rip-Stop (LSRS) suture technique. These patients often present with retracted lesions, limited mobility, poor-quality tissues prone to tearing, medial tears, and/or insufficient bone quality (osteopenia or osteoporosis). Methods: Retrospective evaluation of patients aged > 55 years who underwent arthroscopic rotator cuff repair due to retracted tears (that after appropriate releases, it was not possible to cover more than 50% of the tendon footprint on the greater tuberosity upon rotator cuff traction), operated between 2014 and 2022, using the LSRS technique, and who underwent a minimum follow-up of 1 year, including postoperative MRI assessment. Results: Eighteen shoulders were included in the study and all of them performed a postoperative MRI; 1 patient experienced tendon rerupture on follow-up MRI, corresponding to a 5.56% failure rate. In the functional analysis, 16 shoulders (88.89%) scored above 80 on the American Shoulder and Elbow Surgeons score and had satisfactory results on the University of California, Los Angeles score (rated as excellent and good). Conclusion: In an average follow-up of 28 months, the LSRS suture technique demonstrated satisfactory functional outcomes and a good healing rate in patients with retracted and low-mobility rotator cuff injuries. These findings reinforce the idea that the LSRS technique can be a valuable option in managing these challenging cases.http://www.sciencedirect.com/science/article/pii/S2666638325000787Shoulder jointArthroscopyRotator cuff injuriesShoulder injuriesDouble-row suture bridgeArthroscopic rotator cuff repair
spellingShingle Raul Meyer Kautsky, MD
Benno Ejnisman, MD, PhD
Juarez Leite Junior, MD
Eduardo Antônio de Figueiredo, MD, PhD
Ricardo Azeredo Costa, MD
Jair Simmer Filho, MSc, MD
Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results
JSES International
Shoulder joint
Arthroscopy
Rotator cuff injuries
Shoulder injuries
Double-row suture bridge
Arthroscopic rotator cuff repair
title Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results
title_full Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results
title_fullStr Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results
title_full_unstemmed Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results
title_short Magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load-sharing rip-stop construct: encouraging results
title_sort magnetic resonance evaluation of rotator cuff healing after surgical repair of large and massive lesions using the load sharing rip stop construct encouraging results
topic Shoulder joint
Arthroscopy
Rotator cuff injuries
Shoulder injuries
Double-row suture bridge
Arthroscopic rotator cuff repair
url http://www.sciencedirect.com/science/article/pii/S2666638325000787
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