This retrospective case series of 123 shoulders evaluated whether suture bridge (transosseous-equivalent) rotator cuff repair — shown biomechanically superior in laboratory studies — actually delivers better tendon healing in vivo, using postoperative MRI to assess structural integrity and classify retear patterns.
When planning suture bridge repair, counsel patients over 60 with large tears or Goutallier grade ≥2 fatty infiltration that structural failure risk is substantial (~60% in the highest-risk group) — and that the dominant failure mode is medial cuff strangulation, not footprint pullout, which means meticulous attention to suture placement intervals and tension at the medial row is as important as footprint coverage.
This retrospective case series of 123 shoulders evaluated whether suture bridge (transosseous-equivalent) rotator cuff repair — shown biomechanically superior in laboratory studies — actually delivers better tendon healing in vivo, using postoperative MRI to assess structural integrity and classify retear patterns.
When planning suture bridge repair, counsel patients over 60 with large tears or Goutallier grade ≥2 fatty infiltration that structural failure risk is substantial (~60% in the highest-risk group) — and that the dominant failure mode is medial cuff strangulation, not footprint pullout, which means meticulous attention to suture placement intervals and tension at the medial row is as important as footprint coverage.