Does a reconstructed larg and massive rotator cuff tear survive a 10 years follow up study

Background: The subscapularis tendon is essential in maintaining normal glenohumeral biomechanics. However, few studies have addressed the outcomes of tears extending to the subscapularis tendon in massive rotator cuff tears. Purpose: To assess the clinical and structural outcomes of arthroscopic repair of massive rotator cuff tears involving the subscapularis. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and January 2014, 122 consecutive patients with massive rotator cuff tear underwent arthroscopic rotator cuff repair. Overall, 122 patients were enrolled (mean age, 66 years; mean follow-up period, 39.5 months). Patients were categorized into 3 groups based on subscapularis tendon status: intact subscapularis tendon (I group; n = 45), tear involving less than the superior one-third (P group; n = 35), and tear involving more than one-third of the subscapularis tendon (C group; n = 42). All rotator cuff tears were repaired; however, subscapularis tendon tears involving less than the superior one-third in P group were only debrided. Pain visual analog scale, Constant, and American Shoulder and Elbow Surgeons scores and passive range of motion were measured preoperatively and at the final follow-up. Rotator cuff integrity, global fatty degeneration index, and occupation ratio were determined via magnetic resonance imaging preoperatively and 6 months postoperatively. Results: We identified 37 retears (31.1%) based on postoperative magnetic resonance imaging evaluation. Retear rate in patients in the C group (47.6%) was higher than that in the I group (22.9%) or P group (20.0%) ( P = .011). Retear subclassification based on the involved tendons showed that subsequent subscapularis tendon retears were noted in only the C group. The improvement in clinical scores after repair was statistically significant in all groups but not different among the groups. Between-group comparison showed significant differences in preoperative external rotation ( P = .021). However, no statistically significant difference was found in any shoulder range of motion measurements after surgery. Conclusion: Arthroscopic repair of massive tears results in substantial improvements in shoulder function, despite the presence of combined subscapularis tears. However, this study showed a high failure rate of massive posterosuperior rotator cuff tear repair extending more than one-third of the subscapularis tendon. When combined subscapularis tendon tear was less than the superior one-third of the subscapularis tendon, arthroscopic debridement was a reasonable treatment method where comparable clinical and anatomic outcomes could be expected.

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Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears

Clinics in Shoulder and Elbow ◽

10.5397/cise.2014.17.1.44 ◽

2014 ◽

Vol 17 (1) ◽

pp. 44-47 ◽

Cited By ~ 1

Author(s):

Sung Jae Kim ◽

Young Hwan Kim ◽

Yong Min Chun

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Functional Outcomes ◽

Muscle Quality ◽

Rotator Cuff Tears ◽

Massive Rotator Cuff Tear ◽

Cuff Tear ◽

Partial Repair ◽

Tendon Coverage

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

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A Follow-Up Study of Rotator Cuff Tear Using Magnetic Resonance Imaging

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2018.53.1.38 ◽

2018 ◽

Vol 53 (1) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Jun-Sung Won ◽

Woo-Seung Lee ◽

Jae-Hong Park ◽

Seung-Nam Ko ◽

In-Wook Seo

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rotator Cuff ◽

Rotator Cuff Tear ◽

Resonance Imaging ◽

Cuff Tear ◽

Follow Up Study

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OUTCOMES OF REVERSE ARTHROPLASTY IN PATIENTS WITH SHOULDER ARTHROPATHY AND MASSIVE ROTATOR CUFF TEAR

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2018-24-2-7-18 ◽

2018 ◽

Vol 24 (2) ◽

pp. 7-18 ◽

Cited By ~ 1

Author(s):

S. Yu. Dokolin ◽

A. P. Varfolomeev ◽

V. I. Kuz’mina ◽

V. A. Artyukh ◽

I. V. Marchenko

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Reverse Shoulder Arthroplasty ◽

Treatment Options ◽

Pain Syndrome ◽

X Rays ◽

Massive Rotator Cuff Tear ◽

Cuff Tear ◽

Functional Scores

Purpose— to evaluate mid-term outcomes of reverse joint replacement in patients with shoulder arthropathy and massive rotator cuff tear.Material and Methods. Reverse shoulder arthroplasty with delTa xTeNd (depuy) was performed in 38 patients in the period from december 2010 to december 2016 by the same surgical team. patients’ age ranged from 38 to 82 years. Indications for replacement were pain syndrome and pseudoparalysis of the upper limb in presence of a large or massive Rc tear as well as shoulder arthropathy of various severity degree. Outcomes were evaluated by standard aSeS, cS and ucla scales. Roentgenological examination included ap and axial x-rays during follow up from 1 to 6 years after the surgery with analysis of implants positioning. Mean follow up was 24,2±6,6 months.Results. good outcomes were reported in 6 (15,8%) patients. average functional scores were: aSeS 87,4±2,1, ucla 29,7±1,5 and cS 14,0±2,3. Satisfactory outcomes were observed in 27 (14,2%) patients: aSeS 76,2±2,3, ucla 26,8±1,3 and cS 22,0±1,4 scores. poor outcomes were reported in 5 (14,2%) patients with persisting pain syndrome.Conclusion.To avoid significant and multiple complications after reverse shoulder replacement a precise preoperative planning considering particular destructive changes of glenoid fossa is required. For young and physically active patients the authors recommend to use alternative treatment options aiming at restoration of normal shoulder biomechanics and prophylaxis of arthropathy.

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Late results of reconstruction of large and massive rotator cuff tear. A 10 years follow up

Journal of Shoulder and Elbow Surgery ◽

10.1016/s1058-2746(96)80306-5 ◽

1996 ◽

Vol 5 (2) ◽

pp. S65

Author(s):

B.A. Fleega

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Late Results ◽

Massive Rotator Cuff Tear ◽

Cuff Tear

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Open repair for massive rotator cuff tear with a modified transosseous-equivalent procedure: preliminary results at short-term follow-up

Journal of Orthopaedic Science ◽

10.1007/s00776-011-0092-9 ◽

2011 ◽

Vol 16 (4) ◽

pp. 398-404 ◽

Cited By ~ 23

Author(s):

Hiroshi Yamaguchi ◽

Fuminori Kanaya ◽

Naoki Suenaga ◽

Naomi Oizumi ◽

Yoshihiro Hosokawa

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Open Repair ◽

Short Term ◽

Massive Rotator Cuff Tear ◽

Preliminary Results ◽

Cuff Tear

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Massive Acromioclavicular Joint Cyst with Intramuscular Extension: Case Report and Review

Case Reports in Orthopedics ◽

10.1155/2018/7602549 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Yiyang Zhang ◽

Jason Old

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Trapezius Muscle ◽

Ac Joint ◽

En Bloc ◽

Massive Rotator Cuff Tear ◽

Cuff Tear ◽

First Case ◽

Oscillating Saw

Acromioclavicular cysts are an uncommon manifestation secondary to a massive rotator cuff tear and/or a degenerative osteoarthritic AC joint. We present a case of an 80-year-old female with a symptomatic acromioclavicular cyst that extended intramuscularly into the trapezius. She did not complain of symptoms associated with a massive rotator cuff tear; however, the cyst has been increasing in size and she was interested in having it removed. Intraoperatively, the mass extended into the trapezius muscle and was removed en bloc after dissecting it down to the stalk. A distal clavicle excision was then performed using an oscillating saw. After the cyst was excised, it was incised revealing thick mucoid content. The patient did well postoperatively at the three-month follow-up without signs of recurrence. To our knowledge, this is the first case of AC joint cyst with intramuscular extension that was managed operatively.

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