Graft Augmentation Versus Bridging for Large to Massive Rotator Cuff Tears: A Systematic Review

2017 ◽  
Vol 33 (3) ◽  
pp. 673-680 ◽  
Author(s):  
Yohei Ono ◽  
Diego Alejandro Dávalos Herrera ◽  
Jarret M. Woodmass ◽  
Richard S. Boorman ◽  
Gail M. Thornton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears

scholarly journals Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877773 ◽  
Author(s):  
Muzammil Memon ◽  
Jeffrey Kay ◽  
Emily Quick ◽  
Nicole Simunovic ◽  
Andrew Duong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Clinical Findings ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Massive Rotator Cuff Tears

Background: Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has shown promising results with good outcomes in patients with massive rotator cuff tears (MRCTs), as reported by individual studies. However, to the best of the authors’ knowledge, no systematic review has been performed to assess the collective outcomes of these individual studies. Purpose/Hypothesis: The primary purpose of this study was to assess patient outcomes after arthroscopic-assisted LDTT for the management of MRCTs. The secondary objectives were to report on the management of MRCTs, including diagnostic investigations, surgical decision making, and arthroscopic techniques, as well as to evaluate the quality of evidence of the existing literature. It was hypothesized that nearly all patients were satisfied with arthroscopic-assisted LDTT and that they experienced improvements in pain symptoms, function, and strength after the procedure, with an overall complication rate of less than 10%. Study Design: Systematic review; Level of evidence, 4. Methods: The databases MEDLINE, Embase, and PubMed were searched from database inception (1946) until August 18, 2017, with titles, abstracts, and full-text articles screened independently by 2 reviewers. Inclusion criteria were English-language studies investigating arthroscopic-assisted LDTT for the management of MRCTs on patients of all ages. Conference papers, book chapters, review articles, and technical reports were excluded. The quality of the included studies was categorized by level of evidence and the Methodological Index for Non-Randomized Studies (MINORS) checklist. Results: In total, 8 studies (7 case series [median MINORS score, 7 of 16] and 1 prospective comparative study [median MINORS score, 14 of 24]) were identified; the studies included 258 patients (258 shoulders) with MRCTs treated with LDTT using arthroscopic-assisted techniques. The decision to pursue surgery was based on both clinical findings and investigations in 5 studies, investigations only in 2 studies, and clinical findings only in 1 study. Overall, 88% of patients were satisfied with the results of surgery and experienced significant improvement in their symptoms, including shoulder pain, strength, range of motion, and overall function, over a mean follow-up period of 34.3 months. Overall, there was a low rate of complications (7%) associated with the procedure. Conclusion: Arthroscopic-assisted LDTT for MRCTs provides patients with marked improvement in shoulder pain, strength, and function, and the procedure is associated with a low risk of complication. Further high-quality comparative studies are warranted to validate these findings in comparison with other operative techniques.

Outcome Comparison of Graft Bridging and Superior Capsule Reconstruction for Large to Massive Rotator Cuff Tears: A Systematic Review

2019 ◽  
Vol 48 (11) ◽  
pp. 2828-2838
Author(s):  
Jinrong Lin ◽  
Yaying Sun ◽  
Qingyan Chen ◽  
Shaohua Liu ◽  
Zheci Ding ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Healing Rate ◽  
Visual Analog Scale Score ◽  
Rotator Cuff Tears ◽  
Analog Scale ◽  
Massive Rotator Cuff Tears ◽  
Constant Murley Score ◽  
The Mean

Background: Graft bridging (GB) and superior capsule reconstruction (SCR) were developed to treat large to massive rotator cuff tears (RCTs); however, the outcome differences between GB and SCR remain unclear. Purpose: To systematically review and compare the outcomes of GB and SCR for large to massive RCT. Study Design: Systematic review. Methods: A systematic review was performed via a comprehensive search of PubMed, Embase, and the Cochrane Library. Studies of GB or SCR were included according to the inclusion and exclusion criteria. The primary outcome was Constant-Murley score at the final follow-up. Secondary outcomes included the American Shoulder and Elbow Surgeons score, visual analog scale score for pain, active shoulder range of motion, and graft healing rate. Complication rate was the safety outcome measure. Outcomes were summarized into group SCR and group GB, and the results were compared statistically ( P < .05). Results: A total of 23 studies were included in this review: 238 repairs from the 5 studies in group SCR and 593 repairs from the 18 studies in group GB. For group SCR and group GB, the mean age was 61.6 and 63.3 years, and the mean follow-up was 18.0 and 40.1 months, respectively. Overall, both procedures demonstrated improvement of clinical outcomes. When compared with group SCR, group GB had significantly higher mean differences of the Constant-Murley score (41.9 vs 19.8), American Shoulder and Elbow Surgeons score (39.3 vs 33.8), visual analog scale score for pain (4.4 vs 3.4), and active external rotation at side (15.3 vs 9.3). No statistically significant difference was detected in the mean difference of active forward flexion, internal rotation, abduction, and graft healing rate between the groups. The complication rates were 0.84% (2 of 238) in group SCR and 0.67% (4 of 593) in group GB. Conclusion: In general, GB showed significantly better clinical and functional outcomes postoperatively than SCR, with a similar complication rate. The available fair-quality evidence suggested that GB might be a better choice for large to massive RCT. More high-quality randomized controlled studies are required to further evaluate the relative benefits of the 2 procedures.

Arthroscopic anatomic complete versus non-anatomic repair of massive rotator cuff tears: a systematic review of comparative trials

2020 ◽  
Vol 104 (2) ◽  
pp. 145-154
Author(s):  
M.-A. Malahias ◽  
D. Chytas ◽  
L. Kostretzis ◽  
I. Gkiatas ◽  
S. Kokkineli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Anatomic Repair ◽  
Massive Rotator Cuff Tears ◽  
Comparative Trials

scholarly journals Arthroscopic partial repair for massive rotator cuff tears: does it work? A systematic review

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Michael-Alexander Malahias ◽  
Lazaros Kostretzis ◽  
Efstathios Chronopoulos ◽  
Emmanouil Brilakis ◽  
Grigorios Avramidis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Partial Repair ◽  
Massive Rotator Cuff Tears

Arthroscopic and open repair of massive rotator cuff tears have similar results: a systematic review

2017 ◽  
Vol 2 (4) ◽  
pp. 178-185 ◽  
Author(s):  
Nuno Sevivas ◽  
Nuno Ferreira ◽  
Renato Andrade ◽  
Pedro Moreira ◽  
Nuno Sousa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Open Repair ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears

Superior Capsule Reconstruction for Irreparable Massive Rotator Cuff Tears: Does It Make Sense? A Systematic Review of Early Clinical Evidence

2020 ◽  
Vol 48 (13) ◽  
pp. 3365-3375 ◽  
Author(s):  
Burak Altintas ◽  
Michael Scheidt ◽  
Victor Kremser ◽  
Robert Boykin ◽  
Sanjeev Bhatia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Clinical Evidence ◽  
External Rotation ◽  
Rotator Cuff Tears ◽  
Current Evidence ◽  
Massive Rotator Cuff Tears ◽  
Superior Capsule Reconstruction

Background: Treatment of irreparable massive rotator cuff tears (MRCTs) in patients without advanced glenohumeral osteoarthritis remains a challenge. Arthroscopic superior capsule reconstruction (SCR) represents a newer method for treatment with increasing popularity and acceptance. Purpose: To analyze the clinical evidence surrounding SCR and determine the current clinical outcomes postoperatively. Study Design: Systematic review. Methods: A systematic review of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Electronic databases of PubMed, MEDLINE, Cochrane, and Google Scholar were used for the literature search. The study quality was evaluated according to the Modified Coleman Methodology Score. Studies in English evaluating SCR outcomes were included. Results: Seven studies were reviewed, including 352 patients (358 shoulders) treated with arthroscopic SCR with the mean duration of follow-up ranging from 15 to 48 months (range, 12-88 months). Fourteen patients were lost to follow-up, leaving 338 patients (344 shoulders) with clinical outcome data. Graft types included dermal allografts (n = 3 studies), fascia lata autografts (n = 3), or both (n = 1). Most commonly, a double-row technique was utilized for humeral graft fixation. The most common complication included graft tears in 13% of patients, resulting in 15 SCR revisions and 7 reverse shoulder arthroplasties. Postoperatively, improvements in visual analog scale (2.5 to 5.9), American Shoulder and Elbow Surgeons (20 to 56), Japanese Orthopaedic Association (38.0), Subjective Shoulder Value (37.0 to 41.3), and Constant (11.6 to 47.4) scores were observed. Three studies reported respective satisfaction rates of 72.9%, 85.7% and 90%. Increases in external rotation, internal rotation, and abduction with improved strength in external rotation were observed postoperatively. Improvement of pseudoparalysis was also observed in 3 studies. One study reported return to sports in 100% of patients (2 competitively, 24 recreationally) with no adverse outcomes. Conclusion: SCR showed good to excellent short-term clinical outcomes with adequate pain relief and functional improvement. The current evidence suggests that the procedure is an alternative for symptomatic patients with irreparable MRCT; however, the included studies were fair to poor in quality, and there were some notable complications. Long-term follow-up will determine the longevity and ultimate role of this new method in the treatment of irreparable MRCT.

Arthroscopic Repair for Chronic Massive Rotator Cuff Tears: A Systematic Review

2015 ◽  
Vol 31 (12) ◽  
pp. 2472-2480 ◽  
Author(s):  
Patrick Henry ◽  
David Wasserstein ◽  
Sam Park ◽  
Tim Dwyer ◽  
Jaskarndip Chahal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Arthroscopic Repair ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears
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