# Clinico-Radiological Outcomes of Arthroscopic Rotator Cuff Repair With a Single-Row Construct Supplemented With Bone Marrow Vents

## TL;DR

This study shows that adding bone marrow vents to a single-row rotator cuff repair improves healing and function in patients with large tears.

## Contribution

The study introduces bone marrow vents as an augmentation to single-row rotator cuff repair to enhance biological healing.

## Key findings

- 20 out of 21 patients showed MRI-confirmed tendon healing after six months.
- ASES scores significantly improved in all patients post-surgery.
- Only one patient developed adhesive capsulitis, which resolved with conservative treatment.

## Abstract

Introduction: Full-thickness rotator cuff tears are common in aging populations and pose healing challenges and significant re-tear rates due to a variety of factors, especially in large or massive tears. Arthroscopic single-row repair construct, though simpler and cost-effective, has biomechanical limitations. Adding bone marrow vents may improve biological healing via the release of certain growth factors through those vents. This study evaluates the outcomes of this combined approach and factors influencing tendon recovery.

Methods: This prospective study involved 22 patients with full-thickness rotator cuff tears that were confirmed on magnetic resonance imaging (MRI) scans and were unresponsive to conservative treatment modalities. Patients underwent arthroscopic single-row repair along with vents created over the greater tuberosity adjacent and lateral to the anatomical footprint using a micro-fracture awl. Outcomes of 21 patients were assessed using the American Shoulder and Elbow Surgeons (ASES) scores at three months and six months compared with the preoperative score. A follow-up MRI at six months was done to evaluate clinical and radiological healing. One patient was lost to follow-up.

Results: A total of 21 patients were available for follow-up, and a repeat MRI was then performed after a minimum duration of six months. All patients showed significant clinical improvement in the ASES scores. MRI confirmed tendon healing in 20 (95.2%) cases. No demographic or lifestyle factors significantly affected the outcomes. One (4.7%) case developed adhesive capsulitis in the postoperative period that resolved conservatively with medications and physiotherapy, indicating an overall positive result.

Discussion: Our study shows that arthroscopic single-row rotator cuff repair augmented with bone marrow vents offers enhanced outcomes for medium to large rotator cuff tears. Single-row repair has been considered an inferior construct as compared to double-row repair, but augmenting the single row with bone marrow vents has proven to show decreased re-tear rates in multiple studies. While trends suggest younger age and traumatic etiology may favor healing, a statistically significant correlation was limited by the small sample size and a shorter duration of follow-up.

Conclusion: Single-row repair of the rotator cuff with bone marrow vents enhances the biological healing effectively. Significant functional improvement indicated with improved ASES score and high tendon healing rates on a follow-up MRI support its use as a reliable and cost-effective technique to gain desirable outcomes in patients. Larger studies are needed to confirm the role of clinical factors that influence long-term outcomes, but our findings have proved to be promising and clinically relevant.