Rotator cuff injury is the most common shoulder joint disease in clinical practice, accounting for 50%-85% of shoulder diseases. With the increase in age, the risk of disease gradually increases, and the prevalence rate can reach 31% in people aged 60-69, while it is expected to reach 65% in people over 80. It is characterized by discontinuity of rotator cuff tendons (supraspinatus, infraspinatus, teres minor, and subscapularis), mainly manifested by shoulder joint pain and limited active activity. Arthroscopic suture repair of torn rotator cuff has become the gold standard for treating rotator cuff injury. Depending on the severity and size of the rotator cuff tear, the suture methods are also diversified, including the single-row anchor repair technique, double-row anchor repair technique, and suture bridge repair technique. A double-row suture anchor or suture bridge technique is usually used for medium to large rotator cuff tears. Although many factors affect the healing of the rotator cuff, most current studies believe that double-row suture anchor and suture bridge techniques have the same curative effect, and there is no significant difference between them in the rotator cuff healing score and retear rate. No matter what suture method is used, the purpose is to maximize the contact area between the rotator cuff and the footprint area to achieve as much anatomical healing of the repaired rotator cuff as possible. How to increase the contact area between tendon and bone and promote tendon-bone healing with fewer anchors to cover more of the footprint area has become the research direction of many scholars. Suture bridge technology is currently recognized as the first choice for treating medium to large-size rotator cuff tears. Biomechanical studies show that the suture bridge technique has advantages in repairing the rotator cuff, which can improve the compression contact area and average pressure between the tendon and fixed site, achieve strong fixation, and even distribution of suture tension, resulting in better healing effect of the rotator cuff. However, it also has disadvantages, such as many anchors used, high cost, complex and challenging operation, and relatively long operation time. The traditional internal and external technique can achieve rotator cuff repair by using one medial anchor and one lateral anchor, but it also has a defect that easily forms an "ear-like" deformity at the edge of the tendon. In order to prevent this defect, more medial and lateral anchors are usually implanted. As a result, the tendon-bone contact area in the footprint area is reduced, and the rotator cuff surface has too many linear knots, resulting in suture cutting of the tendon and other shortcomings. We propose an improved suture method, miming the "overlap" technique of increasing the coverage area of embroidery thread in "Sichuan embroidery" to optimize the contact area between the rotator cuff stop and the footprint area. This method is based on the conventional medial and lateral single anchor nail fixation row. After the medial row of the anchor suture line is drawn out, the cross Knot is imitative of the "V-Y knot" (shaped like V-Y), and then the lateral row is fixed. This method can prevent the formation of ear-like deformity at the tendon edge after rotator cuff repair and maximize the benefit, requiring only one internal and one external anchor.

To retrospectively compare the efficacy of two suture methods, the V-Y knot and the suture bridge technique, in repairing medium-sized (1-3 cm) rotator cuff tears.

A total of 60 patients underwent shoulder arthroscopic surgery to repair medium-size rotator cuff injury in our department from June 2019 to June 2022 and were effectively followed up and divided into two groups according to different suture methods. Group 1 was sutured with V-Y junction (30 cases), including 14 males and 16 females, with an average age of (58.60±4.61) years. Group 2 was sutured with suture bridge technique (30 cases), including 15 males and 15 females, with an average age of (58.37±4.60) years. After surgery, the patient was protected by an abduction bag for six weeks, passive shoulder movement was performed within six weeks, and active shoulder lifting exercise began after six weeks. Perioperative indexes of the two groups were compared. Shoulder joint motion, UCLA, ASES, Constant-Murley, and VAS scores were performed before surgery and at the last follow-up to compare the efficacy.

All patients were followed up for 12 to 24 months, with a mean of (16.05±3.34) months. There were no severe complications such as infection and nerve injury; all patients had Grade A wound healing. The operative time of the V-Y junction group was significantly less than that of the suture bridge group, and the difference was statistically significant (P<0.05). There were no significant differences in intraoperative blood loss, incision size, length of hospital stays, preoperative shoulder motion, and scores between the two groups (P>0.05). At the last follow-up, there were no statistically significant differences in shoulder joint motion, VAS score, UCLA score, Constant-Murley score, ASES score, and follow-up time between the two groups (P>0.05). At the last follow-up, the two groups' shoulder joint motion and scores were better than those before surgery (P<0.05) .

Arthroscopic V-Y knot suture is a reliable suture method for repairing medium-sized rotator cuff tears, which can achieve clinical efficacy comparable to the suture bridge technique and requires fewer anchors and shorter operation time.