# Predictors of outcomes following double-row rotator cuff repair: an assessment of all-suture or solid medial row anchor utilization at a single high-volume institution

## TL;DR

This study examines factors affecting outcomes after rotator cuff surgery using all-suture or solid anchors, finding that longer follow-up and tear size or male sex influence results.

## Contribution

The study identifies specific predictors of clinical outcomes following rotator cuff repair using all-suture or solid anchors, which had not been well established previously.

## Key findings

- Longer follow-up time was associated with better patient-reported outcomes in both all-suture and solid anchor groups.
- Male sex predicted better outcomes in the all-suture group, while smaller tear size predicted better outcomes in the solid anchor group.

## Abstract

Use of all-suture soft anchors in arthroscopic rotator cuff repair (RCR) has been shown to provide both biomechanical and functional advantages. However, predictors of clinical outcomes following RCR using all-suture anchors have not been well established. This study aimed to examine predictors of clinical outcomes following double-row suture bridge RCR using either all-suture or solid medial row anchors.

We retrospectively identified patients at our institution who underwent arthroscopic RCR. Patients were eligible for inclusion if they underwent primary arthroscopic RCR using a double-row suture-bridge technique with either all-suture or solid medial row anchors, were between the ages of 18 and 85, and were at least 2 years postoperative. We collected demographic, clinical, and intraoperative data via electronic health record review. Patient-reported outcomes were evaluated at follow-up using the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment and visual analog scale (VAS). Proportions meeting Patient Acceptable Symptomatic State (PASS) thresholds for each were calculated. Within either anchor group, we used univariable linear and logistic regression to examine predictors of scores and meeting PASS thresholds at follow-up, respectively.

In total, 352 patients completed follow-up (mean age = 60.3 ± 10.0 years; 61% male; mean follow-up time = 3.0 ± 0.8 years). Within the all-suture anchor group (n = 280), male sex (P = .04) and longer follow-up time (P < .01) were associated with improved ASES scores, higher odds of meeting the PASS cutoff for the ASES (P < .01), improved VAS scores (P = .01), and higher odds of meeting the PASS cutoff for the VAS (P = .02). Within the solid anchor group (n = 72), large tears were associated with worse ASES scores (P < .01), lower odds of meeting the PASS cutoff for the ASES (P = .02), and worse VAS scores (P < .01. Longer follow-up time was associated with higher odds of meeting the PASS cutoff for the VAS (P = .04).

Following arthroscopic double-row suture-bridge RCR, longer follow-up time was associated with better patient-reported outcomes (PROs) in both anchor type groups. However, smaller tear size was associated with better PROs only within the solid anchor group, whereas male sex was associated with better PROs only within the all-suture anchor group.