Arthroscopic rotator cuff repair using a triple-loaded suture anchor and a modified Mason-Allen technique (Alex stitch)

One of the most discussed point about arthroscopic full-thickness rotator cuff (RTC) repair is the strength of tendon-stitch interface. In the period between November 2003 and September 2004, in a series of 29 patients with primary isolated supraspinatus tear measuring > 2 cm a reconstruction using one titanium anchor and a modified Mason-Allen (MMA) stitch was done. These patients were prospectively collected in this study and then retrospectively evaluated. There were 21 men and 8 women with a mean age of 59.3 years. Patients were examined pre-operatively by a single sport medicine doctor, very experienced on shoulder pathology problem. Constant score, University of California at Los Angeles (UCLA) scale and Simple Shoulder Test (SST) were administered. After a minimum follow-up of 24 months patients were revaluated clinically by the same independent examiner. At the same time patients underwent an ultrasound shoulder examination to evaluate rotator cuff integrity. Clinically there was a significant improvement of Constant score, SST score and UCLA scale at followup. Twenty-five patients (86.2%) were satisfied, whether the other four patients (13.8%) stated that they would decline procedure. Recurrent rotator cuff tear was found in 11 patients (38%), who were all older than 60. All the patients but one with a pre-operative MRI grade III tendon tissue fatty infiltration, had a cuff re-tear. Arthroscopic supraspinatus tendon repair with one single anchor and MMA stitch is a reliable technique leading to a re-tear of 38% that is comparable with results reported in literature.