Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up

Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 ± 9.19 (38–77) years were included. The mean surgery time was 35.33 ± 5.34 (28–55) min. The mean follow-up time was 28.31 ± 3.03 (24–36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 ± 7.46 (13–41) to 81.25 ± 3.77 (74–87; p = 0.0001) and the Q-DASH score had decreased from 82.34 ± 10.37 (65.91–100) to 10.28 ± 6.88 (0–23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline–final follow-up between the small, medium, large, and massive tear groups ( p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.

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10-year follow-up of non-operatively treated full thickness rotator cuff tear

Sports Orthopaedics and Traumatology ◽

10.1016/j.orthtr.2015.10.007 ◽

2016 ◽

Vol 32 (1) ◽

pp. 67-72 ◽

Cited By ~ 1

Author(s):

Shivam Upadhyaya ◽

Andrew Nathan Pike ◽

Scott D. Martin

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Full Thickness ◽

Cuff Tear

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Predicting Retear after Repair of Full-Thickness Rotator Cuff Tear: Two-Point Dixon MR Imaging Quantification of Fatty Muscle Degeneration—Initial Experience with 1-year Follow-up

Radiology ◽

10.1148/radiol.2016151789 ◽

2016 ◽

Vol 280 (2) ◽

pp. 500-509 ◽

Cited By ~ 23

Author(s):

Taiki Nozaki ◽

Atsushi Tasaki ◽

Saya Horiuchi ◽

Junko Ochi ◽

Jay Starkey ◽

...

Keyword(s):

Rotator Cuff ◽

Mr Imaging ◽

Rotator Cuff Tear ◽

Initial Experience ◽

Full Thickness ◽

Muscle Degeneration ◽

Cuff Tear

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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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Longitudinal follow up of patients undergoing mini-open repair of rotator cuff tear

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20190794 ◽

2019 ◽

Vol 5 (2) ◽

pp. 295

Author(s):

Mohammed Shabir Kassim ◽

Amlan Mohapatra ◽

Karthikraj Kuberakani

Keyword(s):

Rotator Cuff ◽

Range Of Motion ◽

Functional Outcome ◽

Rotator Cuff Tear ◽

Open Repair ◽

Full Thickness ◽

Cuff Tear ◽

Partial Thickness ◽

Mini Open

Background: Shoulder pain is a common presenting complaint. This study is aimed to understand the role of mini-open repair in the treatment of rotator cuff tear and to assess the functional outcome in such patients over a period of two years.Methods: This prospective study was conducted on patients who were operated by mini-open repair for rotator cuff tear at the Department of Orthopedics, AJ Institute of Medical Sciences January 2017 till June 2018. Using a pre-designed case report form, demographic and clinical information was noted for all patients. Functional outcome of the patients was assessed by the Constant and Murley score at post-operative follow up at 3 weeks, 6 weeks, 12 weeks, 6 months, 1 year and 2 years.Results: Partial thickness tear was present in 57% of the pateints and rest had a full thickness tear. Mean Constant and Murley score at the time of presentation was 59.50 which improved during the follow up period and at the final follow up the score was 91.80. The score was not significantly different at one year and second year follow up. The score was consistently higher among patients with partial thickness as compared to those with full thickness, though the difference was significantly different only at 6 month follow up (p=0.007).Conclusions: Significant improvement in range of motion was seen in our patients at 6 months post-operatively. Full range of motion was observed at the end of 1 year and functional outcome did not improve after that.

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Mini-Open Rotator Cuff Tear Repair: An Institutional Experience with a Midterm Follow-up

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.8274 ◽

2018 ◽

Vol 20 (5) ◽

pp. 383-387 ◽

Cited By ~ 1

Author(s):

Adil Bashir ◽

Suleiman Seth ◽

Iftikhar H. Wani ◽

Munir Farooq ◽

Naseem ul Gani ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Rotator Cuff Tears ◽

Fixation Method ◽

Full Thickness ◽

Open Procedure ◽

Cuff Tear ◽

Rotator Cuff Tear Repair ◽

Mini Open

Background. Rotator cuff tears have long been recognised as a cause of pain and disability. Over the past decades the treatment of rotator cuff tears has evolved from an open procedure to a mini-open procedure to an all-arthroscopic one. The indications and benefits of each of the procedures are still debated. The purpose of this study was to observe the results of “Mini-open repair rotator cuff tear”. Material and methods. This was a prospective study conducted in the postgraduate department of Orthopaedics Government Medical College, Srinagar, from March 2013 to January 2018 with cases followed up for a minimum of 3 years. This study included 50 patients of either sex with non-massive full thickness tears of rotator cuff. Results. The mean UCLA score improved from 10.96 preoperatively to 30.68 at final follow-up. Overall, 88% of the patients achieved excellent or good results and 92% were satisfied. No significant difference was noted in functional outcomes between traumatic and degenerative tears. Size of tear seems to be a determining factor in the functional outcome. Stiffness as a complication occurred in two patients. Conclusion. 1. Mini-open rotator cuff tear repair eliminated symptomatic full thickness rotator cuff tears with significant improvement in functional scores. 2. There were no major complications of the surgical procedure adopted or the fixation method used. 3. Mini-open rotator cuff repair remains a useful technique despite advances in arthroscopy.

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Rotator Cuff Repair and the Bovine Bioinductive Patch: Excellent Functional Outcomes and Satisfaction in Patients with Comorbidities (238)

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00346 ◽

2021 ◽

Vol 9 (10_suppl5) ◽

pp. 2325967121S0034

Author(s):

Kevin Plancher ◽

Stephanie Petterson

Keyword(s):

Patient Satisfaction ◽

Rotator Cuff ◽

Muscle Strength ◽

Rotator Cuff Repair ◽

Functional Outcomes ◽

Consecutive Series ◽

Dash Score ◽

Full Thickness ◽

Cuff Repair

Objectives: Structural failure of rotator cuff repair (RCR) has been reported to occur in 20-94% at one to two-year follow-up with 80% of these failures occurring within three months of surgical intervention. Poor functional outcomes as well as higher rates of retear have been reported in patients with compromised healing potential due to comorbidities such as diabetes, smoking, obesity, and hypercholesterolemia. Augmentation with growth factors and stem cells and/or biologically augmented patches has been shown to decrease re-tear rates. Biologically-augmented patches provide an environment that is conducive for cell and vessel migration. We investigated patient outcomes following RCR plus bovine bioinductive patch augmentation. Methods: A consecutive series of patients (2015-2018) that underwent RCR plus bovine bioinductive patch by a single surgeon were identified. Patients with diabetes, obesity, hypercholesterolemia, and smokers were included. Patients were excluded with revision rotator cuff repairs. Physical exam included shoulder ROM and manual muscle strength. Patients completed DASH, SF-12 physical and mental, VAS pain and patient satisfaction scores to assess postoperative functional outcomes. Paired sample t-tests were used to assess differences before and after surgery (p<0.05). Results: Sixteen patients (5 females, 62.3±14 years of age, BMI 32.3±13.7) that underwent arthroscopic RCR plus bovine bioinductive patch augmentation were included. Twelve patients had symptomatic 50-90% partial tears and four patients had full thickness tears. Average follow-up was 25.8±13.1 months. Mean shoulder flexion increased from 148.8°±17.5° to 164.7°±15.0° (p=0.0097), external rotation at 90° abduction increased from 67.8°±36.4° to 88.4°±3.5° (p=0.0316). No significant changes were seen in internal rotation behind the back (p=0.1750) or shoulder muscle strength measurements (all p>0.4471). Postoperative DASH score was 10.4±12.8, SF-12 physical score was 52.8±5, SF-12 mental score was 54.2±5.6, VAS pain score was 0.56±0.88, and patient satisfaction was 8.5±0.55. There were no complications or clinical failures at average 3-year follow-up. Patients returned to preoperative sports, including tennis, swimming, bowling, and weightlifting at an average of 21.9±14.3 weeks. Conclusions: RCR with bovine bioinductive patch augmentation is a good alternative treatment for patients with multiple comorbidities and partial and full thickness rotator cuff tears yielding high patient satisfaction, no loss of shoulder ROM or strength, good functional outcomes, and return to preoperative sports.

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Full-thickness rotator cuff tear in rat results in distinct temporal expression of multiple proteases in tendon, muscle, and cartilage

Journal of Orthopaedic Research® ◽

10.1002/jor.24179 ◽

2018 ◽

Vol 37 (2) ◽

pp. 490-502 ◽

Cited By ~ 2

Author(s):

Elda A. Treviño ◽

Jennifer McFaline-Figueroa ◽

Robert E. Guldberg ◽

Manu O. Platt ◽

Johnna S. Temenoff

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Full Thickness ◽

Temporal Expression ◽

Cuff Tear ◽

And Cartilage

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Midterm outcome after rotator cuff reconstruction

Orvosi Hetilap ◽

10.1556/oh.2012.29352 ◽

2012 ◽

Vol 153 (17) ◽

pp. 655-661 ◽

Cited By ~ 2

Author(s):

Eszter Kővári ◽

Ádám Koteczki ◽

Balázs Kovács ◽

Péter Magyar ◽

Imre Antal ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tear ◽

Ultrasound Examination ◽

Constant Score ◽

Functional Results ◽

Full Thickness ◽

Clinical Tests ◽

Cuff Tear ◽

Midterm Outcome ◽

Acromiohumeral Distance

Rotator cuff tear is a common degenerative shoulder disorder that often requires surgical treatment. However, the correlation between the size of the tear and the functional results is somewhat controversial, which generates inconsistency among orthopaedic surgeons about the indications for and methods of rotator cuff reconstruction. Aims: The aim of the authors was to evaluate the midterm functional outcome after rotator cuff reconstruction and the possible connection between the results and the surgical technique or the postoperative ultrasound examination. In addition, recently published corresponding studies are also reviewed by the authors. Methods: Twenty-seven patients with full thickness rotator cuff tear were enrolled into the study who were treated either by arthroscopic (14 patients) or by open repair (13 patients) technique. Functional results were assessed using clinical tests. Ultrasound examination was also performed. Results: The average postoperative Constant Score was 73, the average DASH (Disabilities of the arm, shoulder and hand score) was 14. The Constant scores averaged 80 for the arthroscopic and 70 for the open group. Ultrasound examination showed partial or full thickness retear of the cuff in 40% of the cases. Conclusion: More than 70% of the patients had excellent or good results two years after the reconstruction. The change in the acromiohumeral distance or partial retear failed to affect the results significantly, but full thickness tear had an effect on them. Orv. Hetil., 2012, 153, 655–661.

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