Impact of Diaphyseal Cortical Thickness on Functional Outcomes After Arthroscopic Rotator Cuff Repair

2019 ◽  
Vol 35 (9) ◽  
pp. 2565-2570
Author(s):  
Merrill Lee ◽  
Jerry Chen ◽  
Hao Ying ◽  
Denny Lie
Keyword(s):  
Rotator Cuff ◽  
Cortical Thickness ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

scholarly journals Clinical and Radiologic Outcomes of Combined Use of Biocomposite and PEEK Suture Anchors during Arthroscopic Rotator Cuff Repair: A Prospective Observational Study

2020 ◽  
Vol 9 (8) ◽  
pp. 2545
Author(s):  
Jae-Hoo Lee ◽  
Yong-Beom Lee
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Fluid Collection ◽  
Cyst Formation ◽  
Arthroscopic Rotator Cuff Repair ◽  
Suture Anchors ◽  
Shoulder Range Of Motion ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

The aim of the current study was to evaluate the functional and radiologic outcomes of biocompatible non-absorbable PEEK (polyetheretherketone) and biocomposite (poly-L-lactic acid/poly(lactic-co-glycolic acid) 70% + β-tricalcium phosphate) anchors, especially in terms of perianchor cyst formation during the first six months postoperatively. We prospectively analysed 29 patients who underwent arthroscopic rotator cuff repair between March and May 2019. Both PEEK and biocomposite suture anchors were used as lateral anchors in one body. Clinical outcomes were assessed using the shoulder range of motion (ROM), visual analogue scale (VAS) for pain and satisfactory score, American Shoulder and Elbow Surgeons (ASES) score, and Simple Shoulder Test (SST). All these were obtained in patients preoperatively at 3 and 6 months after surgery. The imaging evaluation included perianchor cyst formation, anchor absorption, repaired cuff integrity, and retear pattern. All functional outcomes significantly improved over time. The biocomposite anchor had a statistically significant tendency to form higher grades of fluid collection at 3 months after surgery. However, the perianchor cyst reduced by the sixth postoperative month. Six months postoperatively, the functional outcomes were improved after rotator cuff repair and similar degrees of perianchor cyst formation were observed, regardless of the suture anchor material used.

scholarly journals Comparing the Predictors of Functional Outcomes After Arthroscopic Rotator Cuff Repair Modified Frailty Index, Clinical Frailty Scale, and Charlson Comorbidity Index

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110050
Author(s):  
Vikaesh Moorthy ◽  
Merrill Lee ◽  
Benjamin Fu Hong Ang ◽  
Jerry Yongqiang Chen ◽  
Denny Tjiauw Tjoen Lie
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Frailty Index ◽  
Arthroscopic Rotator Cuff Repair ◽  
Clinical Frailty Scale ◽  
Comorbidity Index ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Shoulder Score

Background: The incidence of rotator cuff tears increases with age, and operative management is usually required in patients with persistent symptoms. Although several studies have analyzed the effect of age and comorbidities on outcomes after rotator cuff repair, no study has specifically examined the consequence of frailty. Purpose: To determine the best frailty/comorbidity index for predicting functional outcomes after arthroscopic rotator cuff repair. Study Design: Cohort study; Level of evidence, 3. Methods: The authors conducted a retrospective cohort study of 340 consecutive patients who underwent unilateral arthroscopic rotator cuff repair at a tertiary hospital between April 2016 and April 2018. All patients had undergone arthroscopic double-row rotator cuff repair with subacromial decompression by a single fellowship-trained shoulder surgeon. Patient frailty was measured using the Modified Frailty Index (MFI), Clinical Frailty Scale (CFS), and Charlson Comorbidity Index (CCI), calculated through retrospective chart review based on case notes made just before surgery; patient age and sex were also noted preoperatively. Functional outcomes using the Oxford Shoulder Score (OSS), Constant Shoulder Score (CSS), University of California Los Angeles (UCLA) Shoulder Score, and visual analog scale for pain were measured preoperatively and at 3, 6, 12, and 24 months postoperatively. Results: The MFI was a consistent significant predictor in all functional outcome scores up to 24 months postoperatively ( P < .05), unlike the CFS and CCI. Sex was also a significant predictor of postoperative OSS, CSS, and UCLA Shoulder Score, with male sex being associated with better functional outcomes. Patients with higher MFI scores had slower functional improvement postoperatively, but they eventually attained functional outcome scores comparable with those of their counterparts with lower MFI scores at 24 months postoperatively. Conclusion: The MFI was found to be a better tool for predicting postoperative function than was the CFS or CCI in patients undergoing arthroscopic rotator cuff repair. The study findings suggest that a multidimensional assessment of frailty (including both functional status and comorbidities) is important in determining functional outcomes after arthroscopic rotator cuff repair.

A Prospective Randomized Study Comparing the Interference Screw and Suture Anchor Techniques for Biceps Tenodesis

2016 ◽  
Vol 45 (2) ◽  
pp. 440-448 ◽  
Author(s):  
Ji Soon Park ◽  
Sae Hoon Kim ◽  
Ho Jin Jung ◽  
Ye Hyun Lee ◽  
Joo Han Oh
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Suture Anchor ◽  
Interference Screw ◽  
Arthroscopic Rotator Cuff Repair ◽  
Biceps Tenodesis ◽  
Work Level ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Several methods are used to perform biceps tenodesis in patients with superior labrum-biceps complex (SLBC) lesions accompanied by a rotator cuff tear. However, limited clinical data are available regarding the best technique in terms of clinical and anatomic outcomes. Purpose: To compare the clinical and anatomic outcomes of the interference screw (IS) and suture anchor (SA) fixation techniques for biceps tenodesis performed along with arthroscopic rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 2. Methods: A total of 80 patients who underwent arthroscopic rotator cuff repair with SLBC lesions were prospectively enrolled and randomly divided according to the tenodesis method: the IS and SA groups. Functional outcomes were evaluated with the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), Constant score, Korean Shoulder Score (KSS), and long head of the biceps (LHB) score at least 2 years after surgery. The anatomic status of tenodesis was estimated using magnetic resonance imaging or ultrasonography, and the anatomic failure of tenodesis was determined when the biceps tendon was not traced in the intertubercular groove directly from the insertion site of the IS or SA. Results: Thirty-three patients in the IS group and 34 in the SA group were monitored for more than 2 years. All postoperative functional scores improved significantly compared with the preoperative scores (all P < .001) and were not significantly different between the groups, including the LHB score (all P > .05). Nine anatomic failures of tenodesis were observed: 7 in the IS group and 2 in the SA group ( P = .083). In a multivariate analysis using logistic regression, IS fixation ( P = .003) and a higher (ie, more physically demanding) work level ( P = .022) were factors associated with the anatomic failure of tenodesis significantly. In patients with tenodesis failure, the LHB score ( P = .049) and the degree of Popeye deformity by the patient and examiner ( P = .004 and .018, respectively) were statistically different compared with patients with intact tenodeses. Conclusion: Care must be taken while performing biceps tenodesis in patients with a higher work level; IS fixation appears to pose a higher risk in terms of the anatomic failure of tenodesis than SA fixation, although functional outcomes were not different.

scholarly journals An assessment of the functional outcomes of patients undergoing early exercise physiotherapy following arthroscopic rotator cuff repair using the double-row suture bridge technique

2020 ◽  
Vol 7 (1) ◽  
pp. 66
Author(s):  
Nixon K. Dias ◽  
Rakesh Sera
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Arthroscopic Rotator Cuff Repair ◽  
Double Row ◽  
Early Exercise ◽  
Suture Bridge ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Suture Bridge Technique

<ol><li><p><strong>Background:</strong> The methods of repairing rotator cuff tear are single-row technique, traditional double-row technique and suture-bridge technique. Studies have shown that the arthroscopic suture-bridge technique improved the pressurized contact area between the tendon and footprint. Controversy exists regarding the influence of early versus delayed motion on stiffness and healing rate after cuff repair. Early motion rehabilitation increases range of motion after cuff repair, although risk of re-tear is higher compared to immobilization. This study evaluated the functional outcomes in patients who underwent arthroscopic rotator cuff repair using the suture-bridge technique followed by an early exercise physiotherapy regime.</p><p><strong>Methods:</strong> The study was a prospective and retrospective analysis of patients treated arthroscopically for rotator cuff tears in Hosmat hospital, Bangalore. 30 patients who had only a supraspinatus/infraspinatus tear were included in the study. The functional outcome was assessed by two scoring systems, UCLA and ASES scores. Post operatively, patients were immobilized for 3 weeks only. They were followed up at 3 weeks, 6 weeks, 12 weeks and at 6 months.</p><p><strong>Results:</strong> Our study had 20 patients reporting a good outcome, whereas 9 patients had a fair outcome. Only 1 patient reported a poor outcome. The mean ASES scores improved from 20.43 to 77.87 whereas the UCLA score improved from 10.03 to 27.93. None had re-tears.</p><strong>Conclusions:</strong> The arthroscopic suture-bridge technique resulted in acceptable patient satisfaction and functional outcome as 67% of our patients had a “good” outcome. Early ROM exercise accelerated recovery from postoperative stiffness for patients after arthroscopic rotator cuff repair. </li></ol>

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