The relationship among strength and mobility measures and self-report outcome scores in persons after rotator cuff repair surgery: Impairment measures are not enough

2005 ◽  
Vol 14 (1) ◽  
pp. S95-S98 ◽  
Author(s):  
Toni S. Roddey ◽  
Karon F. Cook ◽  
Kimberly J. O’Malley ◽  
Gary M. Gartsman
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Self Report ◽  
Outcome Scores ◽  
The Relationship ◽  
Cuff Repair

The Relationship Between In-Vivo Glenohumeral Joint Motion and Joint Morphology in Rotator Cuff Repair Patients and Healthy Control Subjects

2011 ◽  
Author(s):  
Cathryn D. Peltz ◽  
Kristin Ciarelli ◽  
Jeffrey A. Haladik ◽  
Michael J. McDonald ◽  
Nicole Ramo ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
Rotator Cuff Tears ◽  
Joint Motion ◽  
Healthy Control ◽  
The Relationship ◽  
Cuff Repair

Rotator cuff tears are a common condition that adversely affect function and quality of life. Altered glenohumeral joint (GHJ) motion is believed to contribute to the development of rotator cuff tears. Previous research has demonstrated relationships between in-vivo joint motion and bony morphology (particularly in the knee [e.g., 1]), and similar relationships have been reported in cadaveric shoulder studies [2, 3]. However, the extent to which these relationships exist under in-vivo conditions or if these relationships are altered in shoulders with pathologic conditions is not known. Thus, the objective of this study was to assess the relationship between glenoid/humerus morphology and in-vivo GHJ motion in healthy control shoulders and rotator cuff repair patients. We hypothesized that a relationship exists between glenoid/humerus morphology and GHJ motion in healthy control shoulders, but that this relationship is altered in rotator cuff patients.

Ultrasound evaluation of postsurgical shoulder after rotator cuff repair: comparison of clinical results

2020 ◽  
pp. 028418512094849
Author(s):  
Haejung Kim ◽  
Hee Jin Park ◽  
So Yeon Lee ◽  
Ji Na Kim ◽  
Juhee Moon ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcome ◽  
Rotator Cuff Repair ◽  
Inverse Relationship ◽  
Fluid Collection ◽  
Supraspinatus Tendon ◽  
Tendon Thickness ◽  
Arthroscopic Rotator Cuff ◽  
The Relationship ◽  
Cuff Repair

Background The relationship between the imaging parameters on postoperative ultrasound (US) other than repaired tendon integrity with clinical outcome such as postoperative residual pain has not been well defined. Purpose To investigate whether the repaired tendon thickness and subdeltoid fluid collection after rotator cuff repair are correlated with early postoperative clinical outcome. Material and Methods This retrospective study included 54 patients who underwent repair of the arthroscopic rotator cuff either by suture-bridge or single-row technique and postoperative US. We assessed the relationship between the sonographic parameters, including repaired supraspinatus tendon thickness and subdeltoid fluid collection, with the clinical outcome represented by the Korean Shoulder Scoring system (KSS) score using correlation coefficients (R). Also, the subgroup analysis was done to assess the differences by surgical technique and patients’ age. Results There was a significant inverse relationship between the amount of subdeltoid fluid collection and degree of self-assessed pain improvement of the patients ( P < 0.05), although every KSS category showed statistically insignificant tendency of inverse relationship with the fluid thickness. However, there was no statistically significant relationship between the thickness of repaired supraspinatus tendon and KSS scores. In patients aged >60 years, a statistically significant inverse relationship between thickness of subdeltoid fluid collection and difference value of the KSS scores in category of function was observed with both interpreters ( P = 0.015 and P = 0.04, respectively). Conclusion Subdeltoid fluid collection measured on US after repair of the arthroscopic rotator cuff in the early postoperative period has significant association with the patients’ subjective clinical outcome.

Are Pulley Exercises Initiated 6 Weeks After Rotator Cuff Repair a Safe and Effective Rehabilitative Treatment?

2016 ◽  
Vol 44 (7) ◽  
pp. 1844-1851 ◽  
Author(s):  
Keith M. Baumgarten ◽  
Roy Osborn ◽  
Will E. Schweinle ◽  
Matthew J. Zens ◽  
Elizabeth A. Helsper
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Adhesive Capsulitis ◽  
Rehabilitation Program ◽  
Activity Level ◽  
Outcome Scores ◽  
Cuff Repair ◽  
Shoulder Score ◽  
Over Time

Background: There are few level 1 or 2 evidence studies that examine rehabilitation after rotator cuff repair. Pulleys have been used in postoperative shoulder rehabilitation with the intention of improving range of motion and developing strength. There is a concern that the use of pulleys in rehabilitation of rotator cuff repairs may contribute to excessive scapular motion (scapular substitution) and potentially inferior outcomes. Hypothesis: Rotator cuff repair patients treated with pulley exercises would have increased scapular substitution and inferior patient-determined outcome scores, range of motion, and strength compared with patients treated with an alternative rehabilitation program without pulleys. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 27 patients who underwent rotator cuff repair were randomized to a rehabilitation group that used pulleys initiated 6 weeks postoperatively, and 26 patients followed a rehabilitation protocol without pulleys. Inclusion criteria were patients undergoing arthroscopic rotator cuff repair. Exclusion criteria were large to massive rotator cuff tears, revision rotator cuff repair, glenohumeral osteoarthritis, adhesive capsulitis, and a symptomatic contralateral shoulder. Outcomes of intervention were patient-determined outcome scores (Western Ontario Rotator Cuff Index [WORC], American Shoulder and Elbow Surgeons [ASES] Shoulder Score, Single Assessment Numeric Evaluation [SANE], Shoulder Activity Level, and Simple Shoulder Test [SST]), range of motion, scapular substitution, and strength. Outcomes were determined at 6, 12, 18, 26, and 52 weeks. A power analysis determined that 22 patients were needed per group to have a power of 0.80, α = 0.05, and effect size of f = 0.5. Results: Both groups had statistically significant improvements in WORC, ASES Shoulder Score, SST, and SANE scores over time after rotator cuff repair ( P < .0001). There were no differences between the interventions for WORC ( P = .18), ASES Shoulder Score ( P = .73), SANE ( P = .5), Shoulder Activity Level ( P = .39), or SST ( P = .36). Both interventions demonstrated improvements in shoulder flexion ( P = .002), abduction ( P = .0001), external rotation ( P = .02), strength ( P ≤ .0002), and scapular substitution ( P ≤ .07) over time after rotator cuff repair. However, there was no difference in range of motion ( P ≥ .26), strength ( P ≥ .20), or scapular substitution ( P ≥ .17) between interventions. Conclusion: A rotator cuff repair rehabilitation program that uses pulleys does not result in inferior outcomes, as determined by patient-determined outcome scores, measurements of scapular substitution, range of motion, and scaption strength. Registration: ClinicalTrials.gov NCT01819909

The Effect of Preexisting and Shoulder-Specific Depression and Anxiety on Patient-Reported Outcomes After Arthroscopic Rotator Cuff Repair

2019 ◽  
Vol 47 (13) ◽  
pp. 3073-3079 ◽  
Author(s):  
Brian C. Lau ◽  
Melissa Scribani ◽  
Jocelyn Wittstein
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Depression And Anxiety ◽  
Patient Reported ◽  
Outcome Scores ◽  
History Of ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
History Of Depression

Background: Few studies have considered the potential effect of depression or anxiety on outcomes after rotator cuff repair. Purpose: To evaluate the effect of a preexisting diagnosis of depression or anxiety, as well as the feeling of depression and anxiety directly related to the shoulder, on the American Shoulder and Elbow Surgeons (ASES) score. Study Design: Cohort study; Level of evidence, 3. Methods: This study is a retrospective review of prospectively collected data on patients who underwent arthroscopic rotator cuff repair and were evaluated by the ASES score preoperatively and at a minimum 12 months postoperatively as part of the senior author’s shoulder registry. Preexisting diagnoses of depression and/or anxiety were recorded, and questions from the Western Ontario Rotator Cuff Index directed at feelings of depression or anxiety related to the shoulder were also evaluated. The Wilcoxon rank sum test was used to compare ASES scores between patients with and without anxiety and/or depression. Spearman correlation was used to correlate questions on depression and anxiety with ASES scores. Results: A total of 187 patients (63 females, 124 males; mean age, 58.6 years, SD, 8.7 years) undergoing arthroscopic rotator cuff repair were evaluated with a mean follow-up of 47.5 months (SD, 17.4 months; range, 12-77 months). Fifty-three patients (mean age, 60 years; SD, 8.6 years) had preexisting diagnoses of depression and/or anxiety and 134 patients (mean age, 58.1 years; SD, 8.7 years) did not. Patients with depression and/or anxiety had significantly lower preoperative and postoperative ASES scores (60.7 vs 67.8, P = .014; and 74.6 vs 87.1, P = .008, respectively). The change in ASES scores from preoperative to postoperative, however, was not significantly different (18.0 vs 14.9). A higher score of depression or anxiety related to the shoulder had a negative correlation with the preoperative ( r = −0.76, P < .0001; and r = −0.732, P < .0001, respectively) and postoperative ( r = −0.31, P = .0001; and r = −0.31, P = .0003, respectively) ASES scores, but a positive correlation ( r = 0.50, P < .0001; and r = 0.43, P < .0001, respectively) with the change in ASES scores. Conclusion: Patients with a history of depression and/or anxiety have lower outcome scores preoperatively and postoperatively; however, they should expect the same amount of relief from arthroscopic rotator cuff repair as those without a history of depression or anxiety. Stronger feelings of depression or anxiety directly related to the shoulder correlated with lower preoperative and postoperative outcome scores, but a greater amount of improvement from surgery. The results from this study suggest that a preexisting diagnosis of depression or anxiety, as well as feelings of depression or anxiety directly related to the shoulder, should be considered during the management of patients with rotator cuff tears.

The relationship of preoperative factors to patient-reported outcome in rotator cuff repair: a systematic review

2016 ◽  
Vol 21 (3-6) ◽  
pp. 138-150 ◽  
Author(s):  
Jason D. Woollard ◽  
James E. Bost ◽  
Sara R. Piva ◽  
G. Kelley Fitzgerald ◽  
Mark W. Rodosky ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Patient Reported Outcome ◽  
Patient Reported ◽  
Relationship Of ◽  
The Relationship ◽  
Cuff Repair ◽  
Preoperative Factors

The Relationship of Staged, Bilateral Arthroscopic Primary Rotator Cuff Repair Timing and Postoperative Complications

2021 ◽  
pp. 036354652110151
Author(s):  
Jourdan M. Cancienne ◽  
Patrick J. Denard ◽  
Grant E. Garrigues ◽  
Brian C. Werner
Keyword(s):  
Emergency Department ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Emergency Department Visits ◽  
Single Stage ◽  
Medical Complications ◽  
Control Group ◽  
Complication Rates ◽  
The Relationship ◽  
Cuff Repair

Background: Although previous studies have reported acceptable clinical outcomes after simultaneous, single-stage bilateral and staged bilateral rotator cuff repair (RCR), few studies have been adequately powered to compare postoperative complication rates at various time intervals between procedures. Purpose: To examine the relationship between the timing of bilateral arthroscopic RCR and complications. Study Design: Descriptive epidemiology study. Methods: Patients from the Medicare data set within the PearlDiver database who underwent bilateral RCR between 2005 and 2014 were identified. These patients were then stratified by time between surgeries into cohorts: (1) single stage, (2) <3 months, (3) 3 to 6 months, (4) 6 to 9 months, (5) 9 months to 1 year, and (6) 1 to 2 years. Surgical and medical complications of these cohorts were compared with those of a control cohort of patients who underwent bilateral RCR >2 years apart using a regression analysis. Results: A total of 11,079 patients who underwent bilateral RCR were identified. Patients who underwent single-stage bilateral arthroscopic RCR experienced higher rates of revision RCR (odds ratio [OR], 2.1; P < .0001), reverse total shoulder arthroplasty (RTSA) (OR, 2.47; P < .0001), and postoperative infection (OR, 2.18; P = .007) in addition to higher rates of venous thromboembolism (VTE) (OR, 1.78; P = .031) and emergency department visits (OR, 1.51; P = .002) compared with the control group. Patients who underwent bilateral RCR with a <3-month interval had higher rates of revision surgery (OR, 1.56; P = .003), RTSA (OR, 1.89; P = .002), and lysis of adhesions (OR, 2.31; P < .0001) in addition to increased rates of VTE (OR, 1.92; P = .015) and emergency department visits (OR, 1.62; P < .0001) compared with the control group. There were no differences in any surgical or medical complications when surgeries were staged by ≥3 months compared with controls. Conclusion: Patients with Medicare undergoing single-stage and staged bilateral RCR who had the second repair within 3 months had significantly higher rates of multiple medical and surgical complications compared with patients waiting >2 years between procedures.

scholarly journals Bilateral single-staged arthroscopic rotator cuff repair is comparable to staged procedures: a retrospective follow up study of 2 years

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Chen Wang ◽  
Pu Yang ◽  
Dongfang Zhang ◽  
In-Ho Jeon ◽  
Tengbo Yu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Rotator Cuff Repair ◽  
Single Stage ◽  
Arthroscopic Rotator Cuff Repair ◽  
Significant Difference ◽  
Outcome Scores ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Background Bilateral rotator cuff tears are not uncommon and the timing of the surgical treatment of both shoulders is debated. In the present study, we aimed to compare the clinical outcomes of patients who underwent single-stage or staged bilateral arthroscopic rotator cuff repair. Methods From March 2013 to May 2018, a retrospective review on all patients who underwent bilateral arthroscopic rotator cuff repair at our department was performed. Patients were separated into 2 groups: single-stage and staged. The minimum follow-up period was 2 years. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Constant-Murley (Constant) score, the range of motion (ROM) of the shoulder and the hospitalization costs were evaluated for comparison between the two groups before and after the operation. Differences between groups were assessed using t-tests and ANOVA. Results All 51 patients completed follow-up of 2 years, single stage (n = 24) and staged group (n = 27). There was no significant difference in the VAS, ASES, UCLA and Constant scores between the single-stage group and the staged group before the operation. Postoperative clinical scores were significantly improved in both groups (P < 0.05). All outcome scores were significantly different between the two groups at 6 months postoperatively, and the staged scored better than the single-stage (P < 0.05). At 12, 18, and 24 months after the operation, the outcome scores were not significantly different between the two groups. At follow-up, the ROM of the shoulder was not significantly different between the two groups. In the single-stage group, the outcome scores and ROM were similar for both shoulders and comparable to the staged group. We also found significant cost savings in the single-stage group (4440.89 ± 130.55 USD) compared to the staged group (5065.73 ± 254.76 USD) (p < 0.05). Conclusions Patients receiving single-stage or staged bilateral arthroscopic rotator cuff repair showed similarly good clinical outcomes at follow-ups longer than 6 months. Moreover, good outcomes were observed on both sides of the single-stage group.

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