Study: Modified DPSB techniques with or without medial knot
The aim of this study was to compare modified arthroscopic double-pulley suture-bridge (DPSB) technique with medial knot tying to those without tying, considering clinical and radiological outcomes.

This study included 292 patients with large full-thickness rotator cuff tears treated with modified DPSB technique. The patients were divided into 158 cases with medial knot tying (knot-tying group) and 134 without tying (knotless group). At follow-up, 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 Constant score, ASES score and UCLA score in the knot-tying and knotless groups all improved significantly from before surgery to 12 months postoperatively.

--No significant differences were observed between groups for each phase evaluated (n.s.). Tendon healing was categorised according to Sugaya’s classification.

--The retearing rate was 27/158 in the knot-tying group and 20/134 in the knotless group, with no statistically significant difference between groups (n.s.). Additionally, the retear was classified using the Cho’s classification.

--When comparing the retear rates of different types independently, no statistically significant differences were found between groups.

In particular, the knotless modified DPSB technique showed comparable short-term functional outcomes to those of the knot tying method in large full-thickness rotator cuff tears. Both techniques can be considered effective treatments for patients with large-sized full-thickness rotator cuff tears.