Partial and complete repairs of massive rotator cuff tears maintain similar long-term improvements in clinical scores

2020 ◽  
Author(s):  
Marion Besnard ◽  
Benjamin Freychet ◽  
Julien Clechet ◽  
Gerjon Hannink ◽  
Mo Saffarini ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears ◽  
Clinical Scores

scholarly journals Complete and partial repair of massive rotator cuff tears provide sustainable long term improvement in clinical scores

2021 ◽  
Vol 9 (2_suppl) ◽  
pp. 2325967121S0000
Author(s):  
Marion Besnard ◽  
Benjamin Freychet ◽  
Julien Clechet ◽  
Yannick Carrillon ◽  
Arnaud Godenèche
Keyword(s):  
Rotator Cuff ◽  
Fatty Infiltration ◽  
Arthroscopic Repair ◽  
Rotator Cuff Tears ◽  
Long Term Results ◽  
Massive Rotator Cuff Tears ◽  
Clinical Scores ◽  
Goutallier Classification

Objectives: The aim was to report results of arthroscopic repair of 86 massive cuff tears and decided to assess whether or not clinical scores were maintained 5 years later. Methods: Of the initial series of 86 shoulders, 2 patients died, 16 were lost to follow-up and 4 had a repeat surgery. Therefore, it was possible to reevaluate 64 patients. Repairs were complete in 44 cases and partial in 20 cases. Seventeen shoulders were pseudoparalytic. Tears with fatty degeneration at stage 4 or higher according to the Goutallier classification were not eligible for repair. Preoperatively, the Constant Score (CS), shoulder strength, location of the tear, tendon retraction and degree of fatty infiltration were assessed. Patients were assessed at 8.1±0.6 years [7.1-9.3] using absolute and age- and sex-adjusted CS, the subjective shoulder value (SSV) and the simple shoulder test (SST). Results: The absolute CS was 80.0±11.7 at the first follow-up (at 2-5 years) and decreased to 76.7±10.2 at the last follow-up (at 7-10 years) (p<0.001). The adjusted CS was 99.7±15.9 at the first follow-up and remained at 98.8±15.9 at the last follow-up (ns.). In terms of the other criteria, strength decreased over time (p<0.001) but pain, SSV and SST remained the same. Partial repairs had less strength at the first and last follow-up (p<0.05). Pseudoparalytic shoulders had a lower absolute and adjusted CS at the last follow-up (p<0.05) but the improvement in CS was greater (p=0.014). Conclusion: Partial and complete arthroscopic repair provide good long-term results in patients with massive rotator cuff tears, regardless of the location of the tear, the degree of fat infiltration (I to III according to the Goutallier classification) and even in case of a pseudoparalytic shoulder.

scholarly journals Long-term outcome and structural integrity following open repair of massive rotator cuff tears

2012 ◽  
Vol 6 (1) ◽  
pp. 1 ◽  
Author(s):  
Christoph Bartl ◽  
Stefan Eichhorn ◽  
Pannos Kouloumentas ◽  
Konstantin Holzapfel ◽  
Andreas Imhoff ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Structural Integrity ◽  
Open Repair ◽  
Rotator Cuff Tears ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Massive Rotator Cuff Tears

Long-Term Outcomes of Massive Rotator Cuff Tear Repair: A Systematic Review

2021 ◽  
pp. 155633162110081
Author(s):  
Nihar S. Shah ◽  
Emil Suriel Peguero ◽  
Yuta Umeda ◽  
Zachary T. Crawford ◽  
Brian M Grawe
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Long Term Outcomes ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Massive Rotator Cuff Tears ◽  
Outcome Scores ◽  
Long Term Follow Up

Background: With an increase in the treatment options available for massive rotator cuff tears, understanding the long-term outcomes of the chosen modality is important. Questions/Purpose: The purpose of this study was to systematically review the available literature on repair of massive rotator cuff repairs and learn the longevity of outcomes, the failure rate, outcomes after failure, and any contributing factors to poor outcomes or failure. Methods: We conducted a systematic review of the MEDLINE, Cochrane, and Embase databases to find studies that investigated the long-term results of repair of massive rotator cuff repairs. Studies were excluded if they did not stratify results of massive tears, provide a definition for a massive rotator cuff tear, or report isolate patients with long-term follow-up. Results: Six studies met the inclusion criteria, for a total of 472 shoulders; average patient age was 57.6 years. Follow-up ranged from 119 to 240 months. Outcome scores improved significantly following repair and were maintained throughout follow-up. The repair failure rate across studies was 39.2%. Patients who suffered retear had significantly worse outcome scores than patients with intact tendons at long-term follow-up. Conclusions: The existing literature on long-term follow-up after massive rotator cuff repair is scarce and not of high level of evidence. This review found repair of massive rotator cuff tears leads to long-term maintained improvements in outcome measures. Failure of repair is quite common, but results following failure are superior to preoperative outcomes.

Deltoid flap reconstruction for massive rotator cuff tears: Mid- and long-term functional and structural results

2010 ◽  
Vol 19 (3) ◽  
pp. 439-445 ◽  
Author(s):  
Michael C. Glanzmann ◽  
Jörg Goldhahn ◽  
Matthias Flury ◽  
Hans-Kaspar Schwyzer ◽  
Beat R. Simmen
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Flap Reconstruction ◽  
Deltoid Flap ◽  
Massive Rotator Cuff Tears

Long-term outcome of tuberoplasty for irreparable massive rotator cuff tears: is tuberoplasty really applicable?

2016 ◽  
Vol 25 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Jung Gwan Park ◽  
Nam Su Cho ◽  
Jong Hoon Song ◽  
Jong Hun Baek ◽  
Yong Girl Rhee
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Massive Rotator Cuff Tears

scholarly journals Tendon Repair Leads to better Long-Term Clinical Outcome than Debridement in Massive Rotator Cuff Tears

2017 ◽  
Vol 11 (1) ◽  
pp. 546-553 ◽  
Author(s):  
Matthias Alexander König ◽  
Volker Alexander Braunstein
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcome ◽  
Tendon Repair ◽  
Shoulder Function ◽  
Rotator Cuff Tears ◽  
Short Term ◽  
Massive Rotator Cuff Tears ◽  
Massive Tears

Introduction: Massive tears in the rotator cuff are debilitating pathologies normally associated with loss of function and pain. Tendon reconstruction is seen as the standard treatment in order to preserve shoulder function and to inhibit cuff associated osteoarthritis. However, the effect on longer-term shoulder function and patient satisfaction is unknown. Material and Methods: 165 consecutive patients with massive tears were included. 57 debridement (mean age 61.9±8.7 years (range 43-77)) and 108 reconstruction (mean age 57.5±8.9 years (range 45-74)) cases could be followed up 2-4 (short-term), 5-6 (mid-term) and 8-10 (long-term) years after surgery. Evaluation was performed with the Constant, a modified ASES and the DASH score. Statistical analysis was done using Sigma-Stat Version 3.5 with a p-value<0.05 indicating statistical significant differences. Results: All three scoring systems showed no significant differences in the short-term follow-up for the two groups (mean values: Constant debridement/repair: 70±11.9/66±13.6; ASES debridement/repair: 22.3±3.3/ 23.3±3.3; DASH debridement/repair: 22.3±11.0/ 24.3±10.1). In the mid-term (Constant debridement/repair: 51±2.9/68.3±5.2; ASES debridement/repair: 20.3±1.3/24.3±1.7; DASH debridement/repair: 31.0±6.5/20.3±5.4) and long-term follow-up (Constant debridement/repair: 42.3±3.8 /60.7±2.6, ASES debridement/repair: 17.3±0.5/21.7±0.5, DASH debridement/repair: 41.3±6.2/25.0±1.4), rotator cuff reconstruction revealed better objective results and better patients’ satisfaction. Conclusion: Rotator cuff tendon repair leads to better long-term clinical outcome and subjective satisfaction compared to debridement. Tendon reconstruction should be considered as a treatment for patients suffering from massive rotator cuff tears, thus preserving shoulder function and by that means delay indication for reverse arthroplasty.

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