Return to recreational sport and clinical outcomes with at least 2 years follow-up after arthroscopic repair of rotator cuff tears

Purpose: the aim of this study was to compare clinical outcomes of contracted immobile massive rotator cuff tears mobilised through an arthroscopic interval slide technique versus massive mobile cuff tears directly repaired without any mobilisation. Methods: twenty-five patients who underwent arthroscopic repair for massive rotator cuff tears with a minimum of 18 months follow-up were included. The patients were retrospectively divided into two groups. In group 1, a single or double interval slide was performed to achieve adequate tendon mobilisation. In group 2 (control group), massive rotator cuff tears were arthroscopically repaired without any additional release. Patients were evaluated with validated outcomes scores: subjective and objective Constant score, a Visual Analogue Scale (VAS) for pain, and single Assessment Numeric Evaluation (SANE). Results: the two groups were comparable in terms of age, gender and involvement of the dominant arm. The mean follow-up duration was 31 months in group 1 and 28 months in group 2 (p = 0.4). The two groups showed no significant differences in SANE and VAS results (group 1: SANE 77%, VAS 1.3; group 2: SANE 88%, VAS 1.6), or in total Constant score (group1: 66.5 ± 11; group 2: 75 ± 14; p = 0.1) and subjective Constant score (Group 1: 31 ± 5; group 2: 30.8 ± 7; p = 0.9). A significant difference was found for the objective Constant score, which was higher in the control group (group 1: 35.5 ± 7; group 2: 44 ± 8; p = 0.009). Conclusions: Subjective clinical outcomes of arthroscopic repair with or without interval slides did not differ and were satisfactory. Objectively, immobile cuff tears showed inferior results.The use of interval slides might be considered a first step or an alternative to more invasive procedures for low demanding patients. Level of evidence: Level III, retrospective comparative study.

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Bone Marrow Stimulation in Arthroscopic Repair for Large to Massive Rotator Cuff Tears With Incomplete Footprint Coverage

The American Journal of Sports Medicine ◽

10.1177/0363546520959314 ◽

2020 ◽

Vol 48 (13) ◽

pp. 3322-3327

Author(s):

Chul Kim ◽

Yun-Jae Lee ◽

Sung-Jae Kim ◽

Tae-Hwan Yoon ◽

Yong-Min Chun

Keyword(s):

Rotator Cuff ◽

Clinical Outcomes ◽

Functional Outcomes ◽

Structural Integrity ◽

Arthroscopic Repair ◽

Rotator Cuff Tears ◽

Bone Marrow Stimulation ◽

Marrow Stimulation ◽

Massive Rotator Cuff Tears

Background: There is no research on incomplete footprint coverage with single-row repair related to bone marrow stimulation (BMS) in large to massive rotator cuff tears (RCTs). Purpose/Hypothesis: The purpose was to compare the clinical results and structural integrity between BMS and non-BMS groups that underwent arthroscopic repair of large to massive rotator cuff tears with <50% footprint coverage. It was hypothesized that both groups would exhibit improved clinical outcomes at 2 years after surgery but the BMS group would have significantly better clinical outcomes and structural integrity. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 98 patients who underwent arthroscopic repair with <50% footprint coverage for large to massive RCTs with (BMS group; n = 56) or without (non-BMS group; n = 42) BMS. Functional outcomes at the 2-year follow-up were assessed using the visual analog scale for pain score, subjective shoulder value; American Shoulder and Elbow Surgeons score; University of California, Los Angeles, shoulder score; and active range of motion. Structural integrity was evaluated using magnetic resonance arthrography or computed tomography arthrography results at 6 months postoperatively. Results: At the 2-year follow-up, all functional outcomes significantly improved in both groups compared with preoperative values ( P < .001). However, there were no significant postoperative differences between groups. On follow-up magnetic resonance arthrography or computed tomography arthrography, the overall retear rate was not significantly different between the BMS group (30.3%; 17/56) and the non-BMS group (35.7%; 15/42). Conclusion: While both groups exhibited functional improvement after single-row repair with <50% footprint coverage for large to massive RCTs, BMS did not produce better clinical outcomes or structural integrity.

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Arthroscopic Repair of Full-Thickness Rotator Cuff Tears in Active Patients Younger Than 40 Years: 2- to 5-Year Clinical Outcomes

Orthopedics ◽

10.3928/01477447-20171114-02 ◽

2017 ◽

Vol 41 (1) ◽

pp. e52-e57 ◽

Cited By ~ 1

Author(s):

Nata Parnes ◽

Nicole R. Bartoszewski ◽

Michael J. Defranco

Keyword(s):

Rotator Cuff ◽

Clinical Outcomes ◽

Arthroscopic Repair ◽

Rotator Cuff Tears ◽

Full Thickness ◽

Active Patients

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Arthroscopic repair of partial rotator cuff tears: a minimum 2-year follow-up (SS-80)

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2004.02.078 ◽

2004 ◽

Vol 20 ◽

pp. e37-e38 ◽

Cited By ~ 1

Author(s):

William M. Butcher ◽

James C. Esch

Keyword(s):

Rotator Cuff ◽

Arthroscopic Repair ◽

Rotator Cuff Tears

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Irreparable Large to Massive Rotator Cuff Tears With Low-Grade Fatty Degeneration of the Infraspinatus Tendon: Minimum 7-Year Follow-up of Fascia Autograft Patch Procedure and Partial Repair

The American Journal of Sports Medicine ◽

10.1177/03635465211043501 ◽

2021 ◽

pp. 036354652110435

Author(s):

Daisuke Mori ◽

Kazuha Kizaki ◽

Noboru Funakoshi ◽

Fumiharu Yamashita ◽

Yasuyuki Mizuno ◽

...

Keyword(s):

Logistic Regression ◽

Rotator Cuff ◽

Clinical Outcomes ◽

Fatty Degeneration ◽

Rotator Cuff Tears ◽

Low Grade ◽

Partial Repair ◽

Massive Rotator Cuff Tears ◽

Infraspinatus Tendon

Background: In shoulders with irreparable massive rotator cuff tears (RCTs) with high-grade fatty degeneration (Goutallier stage 3 or 4) of the supraspinatus tendon and low-grade fatty degeneration (Goutallier stage 1 or 2) of the infraspinatus tendon (ISP), arthroscopic patch grafting (PG) has been reported as superior to partial repair (PR) regarding the ISP retear rate at short-term to midterm follow-up. However, the longer term outcomes are unclear. Purpose: To compare clinical and structural outcomes in the PG and PR groups at a minimum of 7 years postoperatively. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 24 patients in the PG group and 24 patients in the PR group. We primarily used the Constant score for clinical outcomes and performed magnetic resonance imaging for structural outcomes in the PG and PR groups. The risk factors for a retear of the ISP were identified by univariate and multivariate (forward stepwise selection method) logistic regression analyses. We primarily compared values at midterm follow-up (<4 years) with values at the final follow-up (minimum 7 years) for each patient. Results: The mean midterm and final follow-up times for the PG group were 41.0 and 95.1 months, respectively, compared with 35.7 and 99.3 months, respectively, for the PR group. We found significant differences for the midterm and final follow-up Constant total scores in the PG and PR groups (midterm follow-up: 79.1 vs 69.9, respectively [ P = .001]; final follow-up: 76.0 vs 65.3, respectively [ P = .006]) and in the Constant strength scores (midterm follow-up: 14.6 vs 8.5, respectively [ P < .001]; final follow-up: 13.1 vs 8.3, respectively [ P = .001]). Treatment group (PR) was a significant predictor of an ISP retear in the logistic regression analysis (odds ratio, 3.545; P = .043). Conclusion: Patients with low-grade massive RCTs treated with PG or PR improved significantly in terms of clinical outcomes at the midterm and final follow-up time points. However, Constant scores were significantly better in the PG group at the final follow-up.

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Clinical outcomes and structural integrity of C-shaped rotator cuff tears after arthroscopic repair: comparison with crescent-shaped tears

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-018-0863-5 ◽

2018 ◽

Vol 13 (1) ◽

Author(s):

Wonyong Lee ◽

Sung-Jae Kim ◽

Chong-Hyuk Choi ◽

Yun-Rak Choi ◽

Yong-Min Chun

Keyword(s):

Rotator Cuff ◽

Clinical Outcomes ◽

Structural Integrity ◽

Arthroscopic Repair ◽

Rotator Cuff Tears

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All-Suture and Solid Medial Row Anchors Produce Similar Clinical Outcomes for Double Row Suture Bridge Rotator Cuff Repair (227)

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00335 ◽

2021 ◽

Vol 9 (10_suppl5) ◽

pp. 2325967121S0033

Author(s):

John Feldman ◽

Mims Ochsner ◽

Glenn Fleisig ◽

Rob Tatum ◽

Lindsay Grosz ◽

...

Keyword(s):

Rotator Cuff ◽

Clinical Outcomes ◽

Rotator Cuff Repair ◽

Sports Medicine ◽

Rotator Cuff Tears ◽

Double Row ◽

Suture Bridge ◽

Cuff Repair ◽

Anchor Fixation

Objectives: All-suture anchor use for rotator cuff repair is increasing. Potential benefits of these anchors include less bone loss from anchor hole drilling and decreased injury to the chondral surface with anchor pullout. Minimal evidence exists comparing clinical outcomes of all suture to solid medial row anchor fixation in double row suture bridge rotator cuff repair. The purpose of this study was to compare patient-reported outcomes for rotator cuff tears treated with all-suture medial row anchors to those treated with more traditional solid anchors. The null hypothesis was that there is no difference in outcomes between the all-suture and solid anchor rotator cuff repairs. Methods: Three sports medicine fellowship trained surgeons performed rotator cuff repairs using the double row suture bridge technique with minimum 3 years of follow up. Patients were separated into two groups based on whether or not they received all-suture or solid anchor fixation for the medial row of their repair. All lateral row fixation was performed with solid anchors. Primary outcomes were evaluated with telephone follow-up and included the American Shoulder and Elbow Surgery Score (ASES), Single Assessment Numeric Evaluation (SANE), and Visual Analog Scale (VAS). The Rehabilitation protocol was the same for all subjects in the study. Results: 3 sports medicine fellowship trained orthopaedic surgeons performed 153 rotator cuff repairs. 91 of these subjects had all-suture fixation of the medial row and 62 received solid anchor fixation. Follow up was 3.6 years ± 0.6 for the all-suture group and 3.7 years ± 0.6 in the solid anchor group (p= 0.28). ASES scores were 92 ± 16 in the all-suture group and 90 ± 17 in the solid group (p =0.35). SANE scores were 91 ± 13 in the all-suture and also 91 ± 13 in the solid anchor cohort (p = 0.97). VAS scores were 1.1 ± 2.0 in the all-suture and 0.7± 1.8 in the solid anchor group (p=0.17). There were no significant differences between groups with regards to re-operation rate or anchor configuration. Conclusions: All suture anchors used in medial row fixation for double row suture bridge rotator cuff repairs have similar clinical outcomes to rotator cuff tears treated in similar fashion with solid medial row anchors.

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