To explore the clinical efficacy of arthroscopic lateral suture combined with knot free suture bridge technique in the treatment of large L-shaped rotator cuff tears.

A total of 78 patients with large L-shaped rotator cuff tears who underwent arthroscopic treatment in the Affiliated Hospital of Xuzhou Medical University from September 2017 to September 2022 were included, including patients with a tear size of 3-5 cm and a tear shape of "L" or anti "L", excluding patients with other injuries (such as glenolabial injury and nerve injury). Among them, 40 patients were treated with single row technique (single row group), and 38 patients were treated with lateral suture combined with knotless suture bridge technique (suture bridge group). The shoulder range of motion, visual analogue score (VAS), Constant score, University of California at Los Angeles Shoulder Scores (UCLA), American Shoulder and Elbow Surgeons (ASES) were compared with t test between the two groups before operation and at the last follow-up. Sugaya classification standard was used to evaluate the rotator cuff healing, and chi square test was used to compare the retear rate of the two groups.

All the patients were followed up for more than one year, with an average follow-up of (18.2±5.0) months. There was no statistically significant difference in general information between the two groups (both P>0 05). There was no statistically significant difference in shoulder joint range of motion, VAS, Constant, UCLA, and ASES scores between the two groups before surgery (both P>0 05). At the last follow-up, the shoulder flexion, abduction, and lateral rotation range of motion in the suture bridge group were better than those in the single row group (t=3.268, 2.623, 3.395, all P<0.05). The VAS, Constant, UCLA, and ASES scores of the suture bridge group were better than those of the single row group (t=2.862, 2.773, 4.235, 3.848, all P<0.05). There were nine cases of retearing in the single row group, with a retearing rate of 22.5% (9/40), and one cases of retearing in the suture bridge group, with a retearing rate of 2.6%（1/38）. The difference in retearing rates between the two groups was statistically significant（χ²=5.220, P=0.022).

Arthroscopic repair of large L-shaped rotator cuff tears using lateral suture combined with knot free suture bridge technique has better clinical efficacy than single row repair, lower postoperative rate of rotator cuff retear, and is a recommended surgical method.