scholarly journals Ultrasound guided injection of platelet enriched plasma versus corticosteroids in patients suffering rotator cuff tendinopathy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E H Elzaher ◽  
A M Kotb ◽  
E H A Hassaan
Keyword(s):  
Rotator Cuff ◽  
Ultrasound Guided ◽  
Painful Condition ◽  
Subacromial Injection ◽  
Constant Murley Score ◽  
Group 2 ◽  
And Function ◽  
Rotator Cuff Tendinopathy ◽  
Group 1

Abstract Background Shoulder pain is the third most common musculoskeletal complaint. Rotator cuff tendinopathy is an overuse condition that manifests itself as pain in and around tendon and happens when the body fails to regenerate properly. This painful condition is associated with tendon disorganization and thickening that reduces its physical properties, which causes the tendon to fatigue, further exacerbating the painful condition with ultimate failure. A lot of trials and modalities of treatment are studied to avoid the surgical choice such as physiotherapy, NSAIDs and/or ESWT. Local injection of shoulder joint is widely used and studied but the diversity of results lead us to establish further studies. Objective The purpose of my study is to compare between two important modalities in non-surgical treatment of supraspinatus tendinopathy. Methods This study was conducted on 40 patients divided into two groups: group 1 received 3 subacromial injections of platelet rich plasma 10 days interval and group 2 received single subacromial injection of corticosteroid, both are ultrasound guided. Clinical examination using Constant Score is used to evaluate the patients before receiving treatment (0), one month (1) and six months (6) after receiving the treatment. Results We can conclude the results of the 2 groups as there is high significant improvement of the 2 groups comparing base line start. However Corticosteroids shows earlier improvement than PRP after 1 month follow up, but at the end of follow up (6 ms) PRP shows significant improvements according to Constant-Murley Score. According to group 1 there was no complications reported except a discomfort in shoulder region 24 hrs post injection up to 3 days maximum. While in group 2 there was no complications reported all through the 6 months follow up. Conclusion Ultrasound subacromial injection of corticosteroid and PRP achieved significant improvement in pain and function of shoulder joint in RCTs. Corticosteroid achieved better improvements according to Constant-Murley Score in short term follow up (4 weeks) than PRP group, while PRP achieved higher significant improvements than corticosteroid in pain and function of the joint after 6 months follow up as corticosteroid group showed decline in the pain and function results after 6 months follow up.

scholarly journals Anatomic total shoulder arthroplasty with posterior capsular plication versus reverse shoulder arthroplasty in patients with biconcave glenoids: A matched cohort study

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901876857 ◽  
Author(s):  
Eduard Alentorn-Geli ◽  
Nathan R Wanderman ◽  
Andrew T Assenmacher ◽  
John W Sperling ◽  
Robert H Cofield ◽  
...  
Keyword(s):  
Shoulder Arthroplasty ◽  
Reverse Shoulder Arthroplasty ◽  
Total Shoulder Arthroplasty ◽  
Simple Shoulder Test ◽  
Posterior Subluxation ◽  
The Mean ◽  
Group 2 ◽  
And Function ◽  
Group 1

Purpose: To compare the outcomes of total shoulder arthroplasty (TSA) with posterior capsule plication (PCP) and reverse shoulder arthroplasty (RSA) in patients with primary osteoarthritis, posterior subluxation, and bone loss (Walch B2). Patients and methods: All shoulders undergoing anatomic TSA with PCP were retrospectively identified (group 1, G1) and compared to shoulders undergoing RSA (group 2, G2) for Walch B2 osteoarthritis. There were 15 patients in G1 (mean (SD) age and follow-up of 70.5 (7.5) years and 42.8 (18.4) months, respectively) and 16 patients in G2 (mean (SD) age and follow-up of 72.6 (5.4) years and 35.1 (14.2) months, respectively). Results: Both groups had substantial improvements in pain and function. In G1, results were excellent in 80% and satisfactory in 20%, compared to 81% and 6% in G2, respectively ( p = 0.2). The mean (SD) American Shoulder and Elbow Surgeons score was 91.2 (6.7) and 80.3 (14.3) in G1 and G2, respectively ( p = 0.08). The mean Simple Shoulder Test score was 10.6 in G1 and 8.5 in G2 ( p = 0.01). There were no reoperations in either group, but G1 had seven postoperative complications. Conclusions: The outcomes of TSA with PCP are comparable to RSA in patients with osteoarthritis and biconcave glenoids. However, TSA leads to more complications while RSA leads to lower functional outcomes.

scholarly journals The Effect of Manual Therapy and Stabilizing Exercises on Forward Head and Rounded Shoulder Postures: a six-week intervention with a one-month follow-up study (Preprint)

2017 ◽  
Author(s):  
Kiana Fatholahnezhad ◽  
Amir Letafatkar ◽  
Malihe Hadadnezhad
Keyword(s):  
Neck Pain ◽  
Manual Therapy ◽  
Combined Treatment ◽  
Control Group ◽  
Post Intervention ◽  
Before And After ◽  
Group 2 ◽  
And Function ◽  
Group 1

BACKGROUND forward head and round shoulder posture is believed to alter scapular kinematics and muscle activity placing increased stress on the shoulder, leading to shoulder pain and dysfunction. OBJECTIVE The purpose of this study was to evaluate the effect of a six-week combined treatment consisting of manual therapy and stabilizing exercises, with a one-month follow-up, on neck pain with forward head and rounded shoulder postures. METHODS A total of 60 women aged 32-42 years of age with neck pain, and forward head and rounded shoulder postures were randomized into three groups: group 1 performed stabilizing exercises and received manual therapy (n=20), group 2 performed stabilizing exercises (n=20), and group 3 (control group) performed home exercises (n=20) over six weeks.The follow-up time was one month after the post test. The craniocervical and rounded shoulder angles, pain, and function were measured before and after six-week interventions, and a one-month follow- up. RESULTS The results showed significant positive changes within the experimental groupsin all variables, but there were minor changes in the control group in all variables before and after the intervention. Also, there were significant function and pain improvement in the experimental group 1 comparing to group 2. There were no differences between post intervention and one-month follow-up on posture and function in the experimental groups. CONCLUSIONS These findings suggest that both interventions were significantly effective for reducing neck pain, and improving function and posture in patients with chronic neck pain, and forward head and rounded shoulder postures. However, the improvement in function and pain was more effective in group 1 than those of group 2 suggesting that manual therapy can be used as a supplement method to the stabilizing intervention in the treatment of neck pain. More research is needed to confirm the result of this study.

scholarly journals Atelocollagen Injection Improves Tendon Integrity in Partial-Thickness Rotator Cuff Tears: A Prospective Comparative Study

2020 ◽  
Vol 8 (2) ◽  
pp. 232596712090401
Author(s):  
Jong-Ho Kim ◽  
Dong-Jin Kim ◽  
Hyo-Jin Lee ◽  
Baek-Kyu Kim ◽  
Yang-Soo Kim
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Type I ◽  
Pain Scores ◽  
Partial Thickness ◽  
Functional Scores ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background: Ongoing controversy surrounds the best treatment modality for partial-thickness rotator cuff tears. Purpose: To investigate the effects of atelocollagen injection in patients with small, symptomatic, intratendinous rotator cuff tears. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: From January 2014 to December 2017, 94 patients who had small, symptomatic, intratendinous rotator cuff tears were enrolled and randomly allocated to 1 of 3 groups: intratendinous injection with 0.5 mL of type I atelocollagen (group 1, n = 32), intratendinous injection with 1 mL of type I atelocollagen (group 2, n = 30), and no injection of type I atelocollagen (group 3, n = 32). American Shoulder and Elbow Surgeons score, Constant Shoulder Score, visual analog scale pain score, and range of motion were evaluated before injection; at 3, 6, and 12 months after injection; and at final follow-up. Magnetic resonance imaging (MRI) was performed at least 6 months after injection to evaluate rotator cuff integrity. Results: Demographic data did not differ significantly among the 3 groups before injection ( P > .05). The mean follow-up period was 24.7 months. The functional and pain scores in groups 1 and 2 were significantly improved at final follow-up ( P < .05). No significant improvement was seen in functional or pain scores at final follow-up in group 3 ( P > .05). Groups 1 and 2 had significantly better functional scores compared with group 3 at final follow-up ( P < .05). The proportion of patients with a decrease in size of the torn tendon on follow-up MRI at least 6 months after atelocollagen injection was significantly higher in group 1 (28.1%; P = .02) and group 2 (36.7%; P = .003) compared with group 3 (6.3%). Conclusion: Atelocollagen injection can improve the functional outcome and integrity of the tendon in intratendinous rotator cuff tears.

Equivalent Clinical Results of Arthroscopic Single-Row and Double-Row Suture Anchor Repair for Rotator Cuff Tears

2007 ◽  
Vol 35 (8) ◽  
pp. 1254-1260 ◽  
Author(s):  
Francesco Franceschi ◽  
Laura Ruzzini ◽  
Umile Giuseppe Longo ◽  
Francesca Maria Martina ◽  
Bruno Beomonte Zobel ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Suture Anchor ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Single Row ◽  
Group 2 ◽  
Cuff Repair ◽  
Repair Group ◽  
Group 1

Background Restoring the anatomical footprint may improve the healing and mechanical strength of repaired tendons. A double row of suture anchors increases the tendon-bone contact area, reconstituting a more anatomical configuration of the rotator cuff footprint. Hypothesis There is no difference in clinical and imaging outcome between single-row and double-row suture anchor technique repairs of rotator cuff tears. Study Design Randomized controlled trial; Level of evidence, 1. Methods The authors recruited 60 patients. In 30 patients, rotator cuff repair was performed with a single-row suture anchor technique (group 1). In the other 30 patients, rotator cuff repair was performed with a double-row suture anchor technique (group 2). Results Eight patients (4 in the single-row anchor repair group and 4 in the double-row anchor repair group) did not return at the final follow-up. At the 2-year follow-up, no statistically significant differences were seen with respect to the University of California, Los Angeles score and range of motion values. At 2-year follow-up, postoperative magnetic resonance arthrography in group 1 showed intact tendons in 14 patients, partial-thickness defects in 10 patients, and full-thickness defects in 2 patients. In group 2, magnetic resonance arthrography showed an intact rotator cuff in 18 patients, partial-thickness defects in 7 patients, and full-thickness defects in 1 patient. Conclusion Single- and double-row techniques provide comparable clinical outcome at 2 years. A double-row technique produces a mechanically superior construct compared with the single-row method in restoring the anatomical footprint of the rotator cuff, but these mechanical advantages do not translate into superior clinical performance.

scholarly journals EFFECTIVENESS OF ULTRASOUND-GUIDED CORTICOSTEROID INJECTION AND ALCOHOL NEUROLYSIS IN THE TREATMENT OF MERALGIA PARESTHETICA DURING A 28-MONTH FOLLOW-UP PERIOD: A RETROSPECTIVE COHORT STUDY

2021 ◽  
Author(s):  
Özge Yapıcı ◽  
Meriç Uğurlar
Keyword(s):  
Corticosteroid Injection ◽  
Ultrasound Guided ◽  
Recurrence Rates ◽  
Meralgia Paresthetica ◽  
Femoral Cutaneous Nerve ◽  
Retrospective Clinical Study ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Objectives Meralgia paresthetica is a very rare sensory mononeuropathy of the lateral femoral cutaneous nerve (LFCN). The purpose of this study was to evaluate the outcomes and compare the results of ultrasound-guided corticosteroid injection and ultrasound-guided alcohol neurolysis in the treatment of meralgia paresthetica. Methods We performed a retrospective clinical study of 26 patients with a diagnosis of marelgia paresthetica with a duration of ≥10 months. The patients were divided into 2 groups, with the Group 1 receiving ultrasound-guided local corticosteroid injection and Group 2 receiving ultrasound-guided alcohol neurolysis to the entrapment site of the LFCN. Results The mean age of the patients in Group 1 was 42.2 years and in Group 2 was 40.8 years. The mean follow-up period of Group 1 was 28.7 months and Group 2 was 28.4 months. At the end of the follow-up period 9 patients in Group 1 and 10 patients in Group 2 declared full pain relief and improvement in cutaneous sensitivity. Conclusion Once meralgia paresthetica has persisted corticosteroid injection and alcohol neurolysis are both effective methods. Although the recurrence rates are higher in corticosteroid injection, both treatment methods decreased the pain and improved the patients’ satisfaction and long-term curative effect.

Rotator Cuff Calcific Tendinitis: Ultrasound-Guided Needling and Lavage Versus Subacromial Corticosteroids: Five-Year Outcomes of a Randomized Controlled Trial

2017 ◽  
Vol 45 (14) ◽  
pp. 3305-3314 ◽  
Author(s):  
Pieter Bas de Witte ◽  
Arjen Kolk ◽  
Ferdinand Overes ◽  
Rob G.H.H. Nelissen ◽  
Monique Reijnierse
Keyword(s):  
Randomized Controlled Trial ◽  
Rotator Cuff ◽  
Repeated Measures ◽  
Mixed Model ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Barbotage (needling and lavage) is often applied in the treatment of calcific tendinitis of the rotator cuff (RCCT). In a previously published randomized controlled trial, we reported superior clinical and radiological 1-year outcomes for barbotage combined with a corticosteroid injection in the subacromial bursa (SAIC) compared with an isolated SAIC. There are no trials with a midterm or long-term follow-up of barbotage available. Purpose: To compare the 5-year results of 2 regularly applied treatments of RCCT: ultrasound (US)–guided barbotage combined with a SAIC (group 1) versus an isolated US-guided SAIC (group 2). Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients were randomly assigned to group 1 or 2 and evaluated before and after treatment at regular time points until 12 months and also at 5 years using the Constant score (CS), the Western Ontario Rotator Cuff Index (WORC), and the Disabilities of the Arm, Shoulder and Hand (DASH). The calcification location and size and Gärtner classification were assessed on radiographs. The rotator cuff condition was evaluated with US. Results were analyzed using t tests, linear regression, and a mixed model for repeated measures. Results: Forty-eight patients were included (mean age, 52.0 ± 7.3 years; 25 [52%] female) with a mean baseline CS of 68.7 ± 11.9. After a mean follow-up of 5.1 ± 0.5 years, the mean CS was 90 (95% CI, 83.0-95.9) in group 1 versus 87 (95% CI, 80.5-93.5) in group 2 ( P = .58). The mean improvement in the CS in group 1 was 18 (95% CI, 12.3-23.0) versus 21 (95% CI, 16.2-26.2) in group 2 ( P = .32). There was total resorption in 62% of group 1 and 73% of group 2 ( P = .45). The US evaluation of the rotator cuff condition showed no significant differences between the groups. With the mixed model for repeated measures, taking into account the baseline CS and Gärtner classification, the mean treatment effect for barbotage was 6 (95% CI, –8.9 to 21.5), but without statistical significance. Follow-up scores were significantly associated with baseline scores and the duration of follow-up. Results for the DASH and WORC were similar. There were no significant complications, but 4 patients in group 1 and 16 in group 2 underwent additional treatment during the follow-up period ( P < .001). Conclusion: No more significant differences were found in the clinical and radiological outcomes between barbotage combined with a SAIC versus an isolated SAIC after 5 years of follow-up. Registration: NTR2282 (Dutch Trial Registry).

scholarly journals Comparing Clinical Outcomes After Subacromial Spacer Insertion Versus Other Reconstruction Methods in the Treatment of Irreparable Massive Rotator Cuff Tears

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711986960
Author(s):  
Joo Han Oh ◽  
Joo Hyun Park ◽  
Hyeon Jang Jeong ◽  
Sung-Min Rhee
Keyword(s):  
Rotator Cuff ◽  
Fatty Degeneration ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tears ◽  
Reconstruction Methods ◽  
Functional Scores ◽  
Group 2 ◽  
Tear Size ◽  
Group 1

Background: Previous studies on subacromial spacer (SAS) insertion have been limited to case series that did not compare the effectiveness of this technique with other techniques. Hypothesis: Outcomes after SAS insertion for the treatment of irreparable massive rotator cuff tears (IMRCTs) will be similar to those of other techniques. Study Design: Cohort study; Level of evidence, 3. Methods: This retrospective study was based on data collected from patients who underwent correction of IMRCTs between January 2010 and October 2017. Group 1 patients (n = 17) received SAS insertion with or without partial repair; group 2 patients (n = 36) were treated with other techniques (isolated partial repairs or bridging grafts). Preoperative tear size and global fatty degeneration index values were evaluated. Range of motion, visual analog scale for pain, American Shoulder and Elbow Surgeons (ASES) score, Constant score, Simple Shoulder Test (SST), Disabilities of the Arm, Shoulder and Hand score, and acromiohumeral distance (AHD) were assessed preoperatively and at final follow-up at least 2 years after the surgery (range, 24-60 months). In both groups, ultrasonographic examination was performed at 3 and 6 months postoperatively, and magnetic resonance imaging (MRI) was performed at 1 year. Results: Tear size and preoperative global fatty degeneration index were not significantly different between the groups (all P > .05). There were no differences in functional scores between the groups at final follow-up (all P > .05). AHD was maintained at final follow-up in group 1 (mean ± SD: 6.2 ± 2.1 mm [postoperatively] vs 6.7 ± 2.3 mm [final follow-up]; P = .678), and there was no difference compared with group 2 (7.2 ± 3.2 mm; P = .244). Patients with retears in group 2 (23 of 36, 63.9%) had lower ASES ( P = .041) and SST ( P = .027) scores at final follow-up when compared with patients in group 1. Six patients (35.3%) in group 1 had partial repairs; these patients had better external rotation at 90° ( P = .047), better SST scores ( P = .036), and higher AHDs at final follow-up ( P = .046) than those in group 1 who had no repair. Three patients (50%) showed retears of partially repaired tendons on MRI. Of 13 patients (76.5%) in group 1 with postoperative MRI, 12 (92.3%) showed fibrotic tissue in the subacromial space not seen preoperatively. Conclusion: There was no difference in outcomes between SAS and the other reconstruction methods for treating IMRCTs. However, given the high retear rate associated with other techniques and poor functional outcomes after retear, SAS insertion could be a viable option for treating IMRCTs.

scholarly journals What is better for rotator cuff tendinopathy: dextrose prolotherapy, platelet-rich plasma, or corticosteroid injections? A randomized controlled study

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Hala M. Abd Elsabour Sabaah ◽  
Mary A. Nassif
Keyword(s):  
Rotator Cuff ◽  
Platelet Rich Plasma ◽  
Tendon Healing ◽  
Controlled Study ◽  
Clinical Trial Registry ◽  
Western Ontario Rotator Cuff ◽  
Group 3 ◽  
Group 2 ◽  
Rotator Cuff Tendinopathy ◽  
Group 1

Abstract Background Rotator cuff tendinopathy (RCT) is a leading cause of shoulder pain and disability. Management is mainly conservative, but the limited ability of tendons to regenerate is the main cause of unsatisfactory results. So, we conducted our study to compare the efficacy of deep prolotherapy (glucose 25%), platelet-rich plasma (PRP), and betamethasone corticosteroid for treatment of RCT to find the most effective one based on clinical, functional, and radiological assessment. Results Regarding visual analog scale (VAS), it was significantly (p < 0.001) improved after injection among group 1 (prolotherapy group) and group 3 (steroid group) patients, while no significant improvement was noted among group 2 (PRP group) (p = 0.212) patients. The Western Ontario Rotator Cuff (WORC) Index significantly improved among the studied groups (p < 0.001, p = 0.049, and p < 0.001, respectively) after injection. Regarding the range of motion (ROM), a significant improvement (p = 0.029) was achieved in group 1 after injection but no significant improvements were noted among group 2 and 3 patients (p = 0.529 and 0.121, respectively). There was a significant improvement among group 1 and 2 patients (p < 0.001 and p = 0.020, respectively) regarding the grade of tendon lesions but no improvement occurred among group 3 patients (p = 0.470). Conclusion Prolotherapy injections improve shoulder ROM, VAS, WORC index, and rotator cuff tendon healing while PRP injections improve WORC index and tendon healing but steroid injection has no effect on healing. Trial registration PACTR202005610509496. Retrospective registration on May 25, 2020, Pan African Clinical Trial Registry.

Is It Safe to Inject Corticosteroids Into the Glenohumeral Joint After Arthroscopic Rotator Cuff Repair?

2019 ◽  
Vol 47 (7) ◽  
pp. 1694-1700 ◽  
Author(s):  
Yang-Soo Kim ◽  
Hong-Ki Jin ◽  
Hyo-Jin Lee ◽  
Hyung-Lae Cho ◽  
Wan-Seok Lee ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
External Rotation ◽  
Significant Difference ◽  
Group 2 ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Group 1

Background: Injection of intra-articular corticosteroids is effective for improving the recovery of range of motion (ROM) and pain in various conditions of the shoulder but its use is limited after rotator cuff repair owing to concern over the possible harmful effects of steroids on the repaired tendon. Purpose: To evaluate the effect of intra-articular corticosteroid injections on the clinical outcomes and cuff integrity of patients after rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Between March 2011 and April 2014, 80 patients with a small- to medium-sized rotator cuff tear were enrolled in this study and underwent arthroscopic rotator cuff repair. Forty patients received an injection of triamcinolone (40 mg) and lidocaine (1.5 mL) into the glenohumeral joint 8 weeks after surgery (group 1), while the remaining 40 patients received normal saline injection (group 2). Outcome measures—including ROM, American Shoulder and Elbow Surgeons (ASES) score, Constant score, pain visual analog scale, and Simple Shoulder Test score—were evaluated at 3, 6, and 12 months after surgery and at the last follow-up. The integrity of the repaired tendon was evaluated by magnetic resonance imaging (MRI) and classified per Sugaya classification at 8 weeks (before injection) and 12 months after surgery. Results: The mean follow-up period was 25.7 months. At 3 months postoperatively, patients in group 1 had a significantly higher ROM with respect to forward flexion ( P = .05), external rotation at the side ( P = .05), and external rotation at abduction ( P = .04) as compared with group 2, whereas no significant difference was noted between the groups for internal rotation behind the back ( P = .65). Patients in group 1 had significantly lower visual analog scale pain scores ( P = .02) and higher ASES scores (group 1, 68.90; group 2, 60.28; P = .02) at 3-month follow-up. However, there was no significant difference after 6 months with respect to ROM and ASES scores (group 1, 77.80; group 2, 75.88; P = .33). Retears (Sugaya classification IV and V) were determined by MRI at 12 months and observed in a total of 7 patients (8.8%): 3 from group 1 (7.5%) and 4 from group 2 (10%). No retears were observed on MRI in the remaining 73 patients (91.2%): 37 patients from group 1 and 36 patients from group 2. There was no statistically significant difference in rate of retears between groups ( P = .69). Conclusion: Intra-articular injection of corticosteroids after rotator cuff repair does not increase the risk of retears and is thus an effective and safe treatment method for increasing ROM (forward flexion, external rotation) and improving clinical score (ASES) during the early postoperative period of patients undergoing rotator cuff repair.

scholarly journals How do massive immobile rotator cuff tears behave after arthroscopic interval slides? Comparison with mobile tears

Joints ◽  
2014 ◽  
Vol 02 (02) ◽  
pp. 66-70 ◽  
Author(s):  
Chiara Fossati ◽  
Paolo Arrigoni ◽  
Vincenza Ragone ◽  
Pietro Spennacchio ◽  
Giuseppe Banfi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Constant Score ◽  
Arthroscopic Repair ◽  
Rotator Cuff Tears ◽  
Control Group ◽  
Massive Rotator Cuff Tears ◽  
Group 2 ◽  
Group 1

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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