Open AccessFootprint preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1‐year follow‐up. A randomized controlled trial
Author(s) -
Ruiz Ibán Miguel Angel,
Sanchez Alepuz Eduardo,
Diaz Heredia Jorge,
Hachem Abdulilah,
Ezagüi Bentolila Leon,
Calvo Angel,
Verdú Carlos,
Rus Aznar Ignacio,
Soler Romagosa Francesc
Publication year - 2021
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-020-06073-7
Subject(s) - medicine , randomized controlled trial , surgery , tears , rotator cuff , footprint , paleontology , biology
Purpose To evaluate if adding nanofractures to the footprint of a supraspinatus tear repair would have any effect in the outcomes at one‐year follow‐up. Methods Multicentric, triple‐blinded, randomized trial with 12‐months follow‐up. Subjects with isolated symptomatic reparable supraspinatus tears smaller than 3 cm and without grade 4 fatty infiltration were included. These were randomized to two groups: In the Control group an arthroscopic supraspinatus repair was performed; in the Nanofracture group the footprint was additionally prepared with nanofractures (1 mm wide, 9 mm deep microfractures). Clinical evaluation was done with Constant score, EQ‐5D‐3L, and Brief Pain Inventory. The primary outcome was the retear rate in MRI at 12‐months follow‐up. Secondary outcomes were: characteristics of the retear (at the footprint or at the musculotendinous junction) and clinical outcomes. Results Seventy‐one subjects were randomized. Two were lost to follow‐up, leaving 69 participants available for assessment at 12‐months follow‐up (33 in the Control group and 36 in the Nanofracture Group). The Nanofracture group had lower retear rates than the Control group (7/36 [19.4%] vs 14/33 [42.4%], differences significant, p = 0.038). Retear rates at the musculotendinous junction were similar but the Nanofracture group had better tendon healing rates to the bone (34/36 [94.4%] vs. 24/33 [66.71%], p = 0.014). Clinically both groups had significant improvements, but no differences were found between groups. Conclusion Adding nanofractures at the footprint during an isolated supraspinatus repair lowers in half the retear rate at 12‐months follow‐up. This is due to improved healing at the footprint. Level of evidence Level I.