Retear Rate in the Late Postoperative Period After Arthroscopic Rotator Cuff Repair

Background: Arthroscopic rotator cuff repair is a common but technically difficult surgical technique. This study describes a novel arthroscopic rotator cuff repair technique where the repair was performed while visualized entirely from the glenohumeral joint. A single-row knotless tension band inverted mattress suture technique was utilized with fixation obtained via suture anchors. The technique was relatively easy to perform and demonstrated good repair strength and footprint compression in an ex vivo ovine model. Purpose: To evaluate the safety and efficacy of this technique in 1000 consecutive patients. Study Design: Case series; Level of evidence, 4. Methods: This study was a retrospective analysis of prospectively collected data in 1000 consecutive patients. Included patients underwent primary arthroscopic rotator cuff repair by a single surgeon performing the undersurface repair technique and attended 6-month follow-up with ultrasound evaluation to determine repair integrity. Exclusion criteria were irreparable tears, incomplete repairs, tendon reconstruction with a synthetic patch, and revision cases. Results: The only complication was retear. The overall retear rate at 6 months following repair with the undersurface technique was 8.5%. The mean ± SEM operative time for the technique was 16 ± 0.3 minutes (range, 4-75 minutes). There were no infections. Smaller tears were repaired faster and had better healing rates. Conclusion: The novel all-inside arthroscopic rotator cuff repair technique was safe and significantly faster and provided better healing rates than other repair techniques. The retear rate of 8.5% is, to the authors’ knowledge, the lowest reported rotator cuff retear rate in a large cohort of patients based on a single technique.

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Intra-articular injection of steroids in the early postoperative period does not have an adverse effect on the clinical outcomes and the re-tear rate after arthroscopic rotator cuff repair

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-019-05486-3 ◽

2019 ◽

Vol 27 (12) ◽

pp. 3912-3919 ◽

Cited By ~ 2

Author(s):

Wonyong Lee ◽

Sung-Jae Kim ◽

Chong-Hyuk Choi ◽

Yun-Rak Choi ◽

Yong-Min Chun

Keyword(s):

Adverse Effect ◽

Rotator Cuff ◽

Clinical Outcomes ◽

Postoperative Period ◽

Rotator Cuff Repair ◽

Early Postoperative Period ◽

Arthroscopic Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

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Application of Platelet-Rich Plasma in Arthroscopic Rotator Cuff Repair: A Systematic Review and Meta-analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211016847 ◽

2021 ◽

Vol 9 (7) ◽

pp. 232596712110168

Author(s):

Wennan Xu ◽

Qingyun Xue

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Short Term ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair ◽

Retear Rate

Background: It is unclear how and which factors affect the clinical efficacy of platelet-rich plasma (PRP) applied during arthroscopic rotator cuff repair. Purpose: To evaluate the clinical efficacy of PRP for arthroscopic repair of full-thickness rotator cuff tear and investigate the factors that affect its clinical efficacy. Study Design: Systematic review; Level of evidence, 1. Methods: We searched Cochrane Library, EMBASE, MEDLINE, and OVID to identify randomized controlled trials (RCTs) of patients who received PRP treatment and arthroscopic rotator cuff repair (PRP group) versus controls (no-PRP group). The primary outcomes included retear rate, Constant-Murley score, University of California Los Angeles (UCLA) score, short-term American Shoulder and Elbow Surgeons (ASES) score, visual analog scale (VAS) score for pain, and adverse events. Results: A total of 14 RCTs were included in this systematic review. Significant improvement in Constant-Murley, UCLA, and VAS pain scores were found in the PRP group during short-term, midterm, and long-term follow-up. The PRP group had a significantly decreased retear rate (risk ratio [RR], 0.57 [95% CI, 0.42 to 0.78]; P = .0003), especially for long-term follow-up (RR, 0.38 [95% CI, 0.17 to 0.83]; P = .02), large to massive tears (RR, 0.58 [95% CI, 0.42 to 0.80]; P = .0008), use of leukocyte-poor PRP (RR, 0.50 [95% CI, 0.33 to 0.76]; P = .001), and intraoperative application of PRP (RR, 0.57 [95% CI, 0.42 to 0.79]; P = .0007). No significant difference between the 2 groups was found in the incidence of adverse events (RR, 1.34 [95% CI, 0.83 to 2.15]; P = .23) or in ASES scores at short-term follow-up (weighted mean difference, 1.04 [95% CI, –3.10 to 5.19]; P = .62). Conclusion: The results of this review indicated that arthroscopic rotator cuff repair with PRP significantly reduced the long-term retear rate and shoulder pain and provided improved long-term shoulder function in patients. Intraoperative application of PRP, use of leukocyte-poor plasma, and large to massive tear size contributed to a significantly decreased retear rate for rotator cuff repair combined with PRP.

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Arthroscopic rotator cuff repair in patients over 70 years of age: a systematic review

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00565-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Chiara Fossati ◽

Carlo Stoppani ◽

Alessandra Menon ◽

Luca Pierannunzii ◽

Riccardo Compagnoni ◽

...

Keyword(s):

Systematic Review ◽

Rotator Cuff ◽

Rotator Cuff Repair ◽

Arthroscopic Rotator Cuff Repair ◽

Level Of Evidence ◽

Simple Shoulder Test ◽

Objective Outcomes ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair ◽

Retear Rate

Abstract Background Failure of conservative treatment in patients over 70 years of age with a rotator cuff tear makes surgery a possible option, considering the increase in life expectancy and the high functional demands of elderly patients. The purpose of this systematic review of the literature was to evaluate the subjective and objective outcomes after arthroscopic rotator cuff repair in patients over 70 years of age. Methods A systematic review was performed to identify all the studies reporting subjective and objective outcomes in patients aged 70 years or older undergoing arthroscopic rotator cuff repair. Constant Murley Score (CMS), visual analog scale (VAS), American Shoulder and Elbow Surgeons Score (ASES), and Simple Shoulder Test (SST) were used to detect any clinical improvement after surgery. Retear and satisfaction were also analyzed. Results Out of 941 studies identified, only 6 papers have been included in the review. All studies reported improvements in postoperative functional outcome scores that exceed the minimal clinically relevant difference. The mean retear rate amounts to 21.9%, which is in line with the failure rate of rotator cuff repair in general population. Moreover, postoperative satisfaction is very high (95%). Conclusion This systematic review suggests that arthroscopic rotator cuff repair in patients over 70 years of age could be a valid treatment option after failure of conservative approach. Level of evidence: 4 Trial registration The study was registered on PROSPERO (registration ID: CRD42018088613)

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