Arthroscopic Treatment of Rotator Cuff Tears

Rotator cuff tears are the primary cause of shoulder pain and functional impairment, accounting for 50% to 85% of shoulder disorders. With the acceleration of population aging in China and the increasing demand for sports brought about by the improvement of economic standards, rotator cuff tears have gradually become a significant social health problem that cannot be ignored. Currently, arthroscopic rotator cuff repair is the standard treatment for rotator cuff tears. However, studies have shown that the average re-tear rate after rotator cuff repair surgery is 26.6%, which can be as high as 95% for massive rotator cuff tears. Therefore, how to prevent the occurrence of re-tears after arthroscopic rotator cuff repair and improve surgical outcomes has become a hot spot for research in the field of shoulder arthroscopy. Based on previous clinical experience, our team developed an M-shaped suture technique for arthroscopic rotator cuff repair. Clinical observations have shown that the re-tear rate at one-year post-surgery is 8%, which is significantly lower than what has been reported in the literature. However, there is currently a lack of comparative studies on the efficacy of this technique versus traditional single-row and double-row suture techniques. Moreover, the current research evidence on the prognostic factors affecting rotator cuff repair surgery is conflicting, and there is still a lack of high-quality cohort studies to screen for risk factors for poor prognosis. This project aims to establish a high-quality ambispective cohort for minimally invasive arthroscopic surgery for rotator cuff tears, to compare the clinical efficacy of the M-shaped suture technique with traditional techniques, and to identify risk factors related to the prognosis after rotator cuff repair surgery. This will provide high-quality, real-world evidence to optimize the new suture technique and develop a clinical prediction model for re-tears after rotator cuff suture repair. In the long term, the project will conduct embedded intervention studies to address modifiable risk factors (including lifestyle interventions and optimization of rehabilitation protocols) and verify whether these interventions can enhance prognostic outcomes, so as to better develop a more scientific and rational management and treatment plan for patients with rotator cuff tears. We aim to address the challenge of low tendon-bone healing rates and high re-tear rates in rotator cuff repair surgery, and provide reliable, effective, and cost-effective treatment options for patients.