{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T12:17:57Z","timestamp":1776860277477,"version":"3.51.2"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,8,21]],"date-time":"2021-08-21T00:00:00Z","timestamp":1629504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,8,21]],"date-time":"2021-08-21T00:00:00Z","timestamp":1629504000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,8,21]],"date-time":"2021-08-21T00:00:00Z","timestamp":1629504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The optimal technique for arthroscopic rotator cuff repair is still controversial. The aim of this study was to compare modified arthroscopic double\u2010pulley suture\u2010bridge (DPSB) technique with medial knot tying to those without tying, considering clinical and radiological outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 292 patients with large full\u2010thickness rotator cuff tears treated with modified DPSB technique. The patients were divided into 158 cases with medial knot tying (knot\u2010tying group) and 134 without tying (knotless group). At follow\u2010up, clinical outcome was assessed by the Constant score, American Shoulder and Elbow Surgeons (ASES) score, and Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score. The assessment of tendon healing was performed with magnetic resonance imaging (MRI) at a minimum of 12\u00a0months postoperatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The Constant score, ASES score and UCLA score in the knot\u2010tying and knotless groups all improved significantly from before surgery to 12\u00a0months postoperatively (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05, respectively). No significant differences were observed between groups for each phase evaluated (n.s.). Tendon healing was categorised according to Sugaya\u2019s classification. The retearing rate was 27\/158 (17.0%) in the knot\u2010tying group and 20\/134 (14.9%) in the knotless group, with no statistically significant difference between groups (n.s.). Additionally, the retear was classified using the Cho\u2019s classification. When comparing the retear rates of different types independently, no statistically significant differences were found between groups (n.s.).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The knotless modified DPSB technique showed comparable short\u2010term functional outcomes to those of the knot tying method in large full\u2010thickness rotator cuff tears. Additionally, no significant differences in repair integrity were observed between the two methods. Both techniques can be considered effective treatments for patients with large\u2010sized full\u2010thickness rotator cuff tears.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06708-3","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T23:31:22Z","timestamp":1629502282000},"page":"3997-4003","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Modified double\u2010pulley suture\u2010bridge techniques with or without medial knot tying show comparable clinical and radiological outcomes in arthroscopic rotator cuff repair"],"prefix":"10.1002","volume":"29","author":[{"given":"Xinxian","family":"Xu","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> The Sports Medicine Department The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University Wenzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haixiao","family":"Liu","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> The Sports Medicine Department The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University Wenzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyun","family":"Pan","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> The Sports Medicine Department The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University Wenzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huachen","family":"Yu","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> The Osteopathy Department The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University Wenzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6192-4114","authenticated-orcid":false,"given":"Yuezheng","family":"Hu","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> The Sports Medicine Department The Second Affiliated Hospital and Yuying Children\u2019s Hospital of Wenzhou Medical University Wenzhou Zhejiang Province China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,21]]},"reference":[{"issue":"675","key":"e_1_2_12_2_2","first-page":"e1","article-title":"The double\u2010pulley technique for double\u2010row rotator cuff repair","volume":"23","author":"Arrigoni P","year":"2007","journal-title":"Arthroscopy"},{"key":"e_1_2_12_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00590\u2010018\u20102306\u20108"},{"key":"e_1_2_12_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102401\u20107"},{"key":"e_1_2_12_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2019.01.013"},{"key":"e_1_2_12_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546509350081"},{"key":"e_1_2_12_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.12.012"},{"key":"e_1_2_12_8_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623\u2010198466040\u201000011"},{"key":"e_1_2_12_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2019.02.028"},{"key":"e_1_2_12_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967119842881"},{"key":"e_1_2_12_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102474\u20108\u2010123"},{"key":"e_1_2_12_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2018.08.027"},{"key":"e_1_2_12_13_2","first-page":"78","article-title":"Fatty muscle degeneration in cuff ruptures. 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