Massive rotator cuff injury is often accompanied with decrease of rotator cuff muscle strength, acromion impingement syndrome, tendon retraction and even muscle atrophy with fatty infiltration, which can cause suprascapular nerve paralysis, shoulder instability, humeral head dislocation and other dysfunctions. The manifestations were posterolateral shoulder pain, radiating pain behind the neck and in the arm, and weakness of shoulder abduction and external rotation. It is a potentially devastating disease. Massive rotator cuff injury is often combined with the injury of biceps tendon of long head. Massive rotator cuff injury usually refers to the injury which is > 5 cm or which involves more than 2 tendons. In Europe, the injury of more than 2 tendons is defined as massive rotator cuff injury, while in North America, the diameter of rotator cuff injury > 5 cm is defined as massive rotator cuff injury.

To investigate the effect of arthroscopic double row suture bridge technique on shoulder function recovery, pain and prognosis in patients with huge rotator cuff injury.

From June 2018 to June 2020, 100 patients with massive rotator cuff injury in our hospital were equally divided into single suture group and double suture group with andomized digital table according to different treatment methods. The patients in the single suture group was treated with single-row suture technique under shoulder arthroscopy, and the patients in the double suture group was treated with double-row suture bridge technique under shoulder arthroscopy. American shoulder and elbow surgery score (ASES) , the University of California at Los Angeles shoulder score (UCLA) and visual analogue scale (VAS) scores and the range of motion of flexion and external rotation of the affected shoulder were compared before and 3 months after operation. The postoperative complications and rotator cuff retear were compared between the two groups after 12 months of follow-up.

The postoperative ASES scores and UCLA scores in both single suture group and double suture group were significantly higher than those before operation, and the postoperative ASES scores and UCLA scores in the double suture group were significantly higher than those in the single suture group (P<0.01) . The VAS scores of both single suture group and double suture group were lower after operations, and the decrease degree of VAS scores in the double suture group was larger than those in the single row group (P<0.01) . The ranges of motion of flexion and external rotation in both single suture group and double suture group were significantly higher than those before operation, and the ranges of motion of flexion and external rotation in the double suture group were significantly higher than those in single suture group (P<0.01) . After 12 months of follow-up, there were no postoperative complications such as vascular, nerve injury or incision infection in both groups. The incidence of rotator cuff retear in the double suture group was 6.00%, which was significantly lower than that in the single suture group (20.00%) (x²=4.332, P=0.037) .

Compared with single-row suture technique, arthroscopic double-row suture bridge technique can effectively improve shoulder function and pain of patients with massive rotator cuff injury, and reduce the occurrence of postoperative rotator cuff retear, which has sound security.