scholarly journals Biceps tenodesis combined with rotator cuff repair increases functional status and elbow strength

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110569
Author(s):  
Ali Ihsan Kilic ◽  
Onur Hapa ◽  
Ramadan Ozmanevra ◽  
Nihat Demirhan Demirkiran ◽  
Onur Gursan
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Elbow Flexion ◽  
Arthroscopic Rotator Cuff Repair ◽  
Biceps Tenodesis ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Purpose The aim of the present study was to prospectively evaluate the elbow flexion and supination strengths and the functional outcomes of patients following arthroscopic rotator cuff repair combined with simultaneous biceps tenodesis. Methods 19 patients who underwent arthroscopic rotator cuff repair and biceps tenodesis with at least 24 months of follow-up were included. Patients were evaluated using a visual analog scale (VAS) for bicipital groove pain, American Shoulder and Elbow Surgeons (ASES), and constant scores (CS), biceps apex distance (BAD), elbow flexion, and supination strengths. Results The VAS for biceps groove measurement averages in the postoperative 6th, 12th, and 24th months was lower in comparison to preoperative data and was considered to be statistically significant ( p < .05). The constant score, an average of all postoperative measurements and scores, was found to be higher than preoperative values and was considered to be statistically significant ( p < .01). There was a significant difference in the operated and non-operated forearm supination and elbow flexion muscle strength measurements at the postoperative 3- and 6-month follow-ups ( p < .01). Conclusion Arthroscopic biceps tenodesis into the anchors of the lateral row in combination with rotator cuff repair provides an increase in the strength of elbow flexion and forearm supination, while decreasing pain. Level of Evidence Level IV

Biceps Tenodesis Combined With Rotator Cuff Repair Increases Functional Status And Elbow Strength In Both Operated And Contralateral Arms

2020 ◽  
Author(s):  
Ali Ihsan KILIC ◽  
Onur HAPA ◽  
Ramadan OZMANEVRA ◽  
Nihat Demirhan DEMIRKIRAN ◽  
Onur GURSAN
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Elbow Flexion ◽  
Arthroscopic Rotator Cuff Repair ◽  
Biceps Tenodesis ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Purpose: Aim of the present study was to prospectively evaluate the elbow flexion and supination strengths, and the functional outcomes of patients after arthroscopic rotator cuff repair combined with simultaneous biceps tenodesis.Methods: Nineteen patients who underwent arthroscopic rotator cuff repair and biceps tenodesis with at least 24 months follow-up were included. Patients were evaluated using a visual analogue scale (VAS) for bicipital groove pain, American Shoulder and Elbow Surgeons (ASES), and constant scores(CS), biceps apex distance (BAD), elbow flexion and supination strengths.Results: VAS for biceps groove measurement averages of postoperative 6th, 12th and 24th month were lower in comparison to pre-operative data and were considered to be statistically significant (p<0.05). Constant score, an average of all post-operative measurements and scores were found higher than pre-operative values and was considered to be statistically significant (p<0,01). There was a significant difference in the comparison of operated and contralateral forearm supination and elbow flexion muscle strength measurements at postoperative 3rd and 6th-month follow-up (p<0.01).Conclusion: Arthroscopic biceps tenodesis into the anchors of lateral row combined rotator cuff repair provides an increase in strength of elbow flexion and forearm supination, while decreases pain. Level of Evidence: Level IV

scholarly journals The Incidence of Chronic Opioid Use Following Arthroscopic Rotator Cuff Repair and Patient Opioid Education

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0025
Author(s):  
Danielle G. Weekes ◽  
Jenna A. Feldman ◽  
Richard E. Campbell ◽  
Michael DeFrance ◽  
Fotios P. Tjoumakaris ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Shoulder Function ◽  
Arthroscopic Rotator Cuff Repair ◽  
Prescription Data ◽  
Opioid Use ◽  
Significant Difference ◽  
Chronic Opioid Use ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Objectives: Opioids are commonly prescribed for pain management following Arthroscopic Rotator Cuff Repair (ARCR). While their efficacy outweighs their risks in the short term, chronic opioid use is associated with significant adverse effects, such as dependence, endocrine imbalance or respiratory depression. The rate of chronic opioid use and dependence following ARCR is unknown. The purpose of this study is to determine the rate of chronic opioid use following ARCR and establish the effect of preoperative opioid education on reducing chronic consumption. A secondary aim is to determine if any correlation exists between chronic opioid use and shoulder functionality. Methods: A prospective, randomized study of 140 patients undergoing ARCR was performed with a minimum follow-up of 24 months. Patients were randomized to receive preoperative opioid education (risks of abuse, dependence, etc.) or no education. State registry database opioid prescription data monitoring software were utilized to search for all opioid prescriptions following ARCR in our patient population and this was compared to our electronic medical database for accuracy/discrepancy. The total number of opioid prescriptions and number of tablets was determined as well as time from surgery to most recent prescription. Patients were contacted to determine a shoulder Single Assessment Numeric Evaluation (SANE) score and Visual Analog Scale (VAS) pain score. Categorical data was analyzed via chi-squared tests as appropriate. Numeric data was analyzed using t-tests as appropriate. Results: Forty-five patients (32%) continued to fill opioid prescriptions chronically following ARCR. Seventeen (38%) of these patents received pre-operative opioid educated, whereas twenty-eight (62%) did not (p=0.05). Sixty percent of patients with a history of pre-operative opioid use continued to take opioids, while 23% of opioid naive patients continued (p< 0.01). There was no significant difference in SANE (p= 0.53) or VAS (p= 0.65) scores between the education and control group. Patients taking opioids prior to surgery had worse SANE scores (71.28) than the non-users (86.28), p< 0.01. Conclusion: Almost a third of patients will chronically use opioids following ARCR, including 23% of opioid naive patients. Preoperative opioid use is strongly associated with chronic opioid utilization, as well as decreased shoulder function 2 years after ARCR. Preoperative opioid education significantly decreased the rate of chronic opioid use; however, there is no effect on long-term shoulder function. [Table: see text]

scholarly journals Factors affecting return to work following arthroscopic rotator cuff repair: A retrospective observational study in an occupational medicine clinic and single-surgeon practice

2021 ◽  
Author(s):  
Ijaz Khan ◽  
Manaal Fatima ◽  
Corey Scholes ◽  
Vikram Kandhari ◽  
K.M. Ponnanna ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Return To Work ◽  
Rotator Cuff Repair ◽  
Activity Level ◽  
Arthroscopic Rotator Cuff Repair ◽  
Factors Affecting ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Chi Square Analysis ◽  
Cuff Repair

Background: Return to work (RTW) following arthroscopic rotator cuff repair (aRCR) within New South Wales (NSW), Australia, under compensable schemes has not been reported. Aims: Determine factors affecting RTW status and time in patients treated with aRCR under state-based compensation schemes, compared to those outside such schemes. Methods: Patients undergoing aRCR by one surgeon with minimum 1-year follow-up were grouped into those under (CP) or outside (non-CP) workers or vehicle accident compensation schemes, matched by age and gender. RTW status and time were assessed using chi-square analysis and multivariable linear regression. Results: Of 1054 available patients, 90 CP patients were identified with 29 consented and matched to non-CP (N=29). A higher proportion of CP patients (17.2 vs 0%, P<0.001) never returned to work and a lower proportion resumed pre-injury duties at first RTW (3 vs 52%, P<0.01). Median time to first RTW did not differ between CP and non-CP groups (5.1 vs 4.4, P=0.86). Smoking (P=0.007) and post-injury activity level (P=0.004) were significantly associated with longer time to first RTW, whereas compensation status was not. Conclusions: CP patients undergoing aRCR in NSW are at risk of not returning to work. For those that return, there is no significant difference compared to non-CP in time to first RTW. Particularly, patient and management factors associated with extended time to first RTW have been identified. Interventions aimed at modifiable factors such as smoking cessation and increasing preoperative activity may improve future outcomes.

scholarly journals Patients With Diabetes Mellitus Have a Higher Risk of Tendon Retear After Arthroscopic Rotator Cuff Repair: A Meta-analysis

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096140 ◽  
Author(s):  
Chih-Kai Hong ◽  
Chao-Jui Chang ◽  
Fa-Chuan Kuan ◽  
Kai-Lan Hsu ◽  
Yueh Chen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
English Language ◽  
Arthroscopic Rotator Cuff Repair ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Retear of a repaired rotator cuff tendon is a major issue for shoulder surgeons. It is possible that diabetes mellitus (DM) is associated with a greater risk of tendon retear after arthroscopic rotator cuff repair. Purpose: To determine whether patients with DM have a higher tendon retear risk after arthroscopic rotator cuff repair. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the Web of Science, PubMed, and Embase databases. Inclusion criteria were articles written in the English language that included patients undergoing arthroscopic rotator cuff repair surgeries, reported the numbers of patients with and those without DM, and reported the number of rotator cuff retears. Data relevant to this study were extracted and statistically analyzed. Random-effects models were used to generate pooled odds ratio estimates and CIs. Results: A total of 160 studies were identified from the initial search, and 5 of them met the inclusion criteria. A total of 1065 patients (207 patients with DM and 858 patients without DM) were included. The pooled results showed that the patients in the DM group had a significantly higher tendon retear risk than did those in the non-DM group (relative risk, 2.25; 95% CI, 1.14-4.45; P = .02). Conclusion: Patients with DM have a 2.25 times higher risk of tendon retear after arthroscopic rotator cuff repair compared with patients without DM.

scholarly journals Early and Delayed Postoperative Rehabilitation after Arthroscopic Rotator Cuff Repair: A Comparative Study of Clinical Outcomes

2019 ◽  
Vol 22 (4) ◽  
pp. 190-194
Author(s):  
Sungwook Choi ◽  
Kyu Bum Seo ◽  
Seungjae Shim ◽  
Ju Yeon Shin ◽  
Hyunseong Kang
Keyword(s):  
Rotator Cuff ◽  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Analogue Scale ◽  
Constant Score ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Shoulder Score

Background: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation.Methods: Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suture-bridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery.Results: No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0?88.0; delayed: 66.9?91.0; <i>p</i><0.001) and the UCLA shoulder score (early: 20.3?32.3; delayed: 20.4?32.4; <i>p</i><0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6?15 months; average, 10.4 months).Conclusions: Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.

scholarly journals Repair Integrity in Patients Returning for an Unscheduled Visit After Arthroscopic Rotator Cuff Repair: Retorn or Not?

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877506 ◽  
Author(s):  
Syed Mohammed Taif Rizvi ◽  
Patrick Lam ◽  
George A.C. Murrell
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Clinic Visit ◽  
Arthroscopic Rotator Cuff Repair ◽  
Level Of Evidence ◽  
Postoperative Visit ◽  
Healing Response ◽  
Ultrasound Assessment ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: After rotator cuff repair, some patients have ongoing problems significant enough to warrant presentation to a clinic for reassessment. Purpose/Hypothesis: The purpose of this study was to determine whether this cohort of patients was more likely to have a healed rotator cuff. We hypothesized that patients who had an unscheduled postoperative visit were more likely to have a healed rotator cuff than those who did not have an unscheduled postoperative visit. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 321 consecutive patients who underwent arthroscopic rotator cuff repair were evaluated; of these, 50 patients had an unscheduled return to clinic that included an ultrasound assessment of the cuff repair within 4 months postoperatively. Repair integrity was evaluated in all patients at 6 months postoperatively via ultrasonography. Results: The failure-to-heal rate was greater in patients who had an unscheduled assessment (8/50; 16%) than in those who did not (14/275; 5%) ( P = .01). The patients most likely to have a repair failure were those who were assessed before 2 weeks and after 12 weeks (7/18; 39%) compared with those who were assessed between 3 and 12 weeks (1/32; 3%) ( P = .001). The failure-to-heal rate was very low in patients who had an unscheduled assessment with a tear size smaller than 4 cm2 (0/34; 0%) compared with those with tear sizes greater than 4 cm2 (8/16; 50%) ( P < .0001, Fisher exact text). Conclusion: Patients who had an unscheduled clinic visit after rotator cuff repair had a 16% chance of a failed healing response, whereas those who did not have an unscheduled visit had a 5% rate of failed healing. The risk of a failed healing response was greater if the tear was larger than 4 cm2, if patients presented within 2 weeks following surgery, or if they presented after 12 weeks postsurgery.

Postoperative Outcomes of Single-Stage Versus Staged Bilateral Rotator Cuff Repair in Patients with Bilateral Rotator Cuff Tear: A Retrospective Study

2021 ◽  
Author(s):  
Chen Wang ◽  
Pu Yang ◽  
Dongfang Zhang ◽  
In-Ho Jeon ◽  
Tengbo Yu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Single Stage ◽  
Arthroscopic Rotator Cuff Repair ◽  
Vas Score ◽  
Ucla Score ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Background: In the present study, we aimed to compare the clinical outcomes of patients who underwent single-stage or staged bilateral arthroscopic rotator cuff repair.Methods: From March 2013 to May 2018, a retrospective review on all patients who underwent bilateral arthroscopic rotator cuff repair at our department was performed. There were 24 patients in the single-stage group and 27 patients in the staged group. The minimum follow-up period was 2 years. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Constant-Murley (Constant) score, and the range of motion (ROM) of the shoulder were evaluated for comparison between the two groups before and after the operation. Moreover, the hospitalization costs in the two groups were also recorded.Results: All 51 patients were available throughout follow-up. There was no significant difference in the VAS score (P=0.424), ASES score (P=0.325), UCLA score (P=0.170), and Constant score (P=0.275) between the single-stage group and the staged group before the operation. Postoperative clinical scores were significantly improved in both groups. The VAS score, ASES score, UCLA score, and Constant score were significantly different between the two groups at 6 months postoperatively (P<0.05). At 12, 18, and 24 months after the operation, the VAS score, UCLA score, Constant score, and ASES score were not significantly different between the two groups. At follow-up, the ROM of the shoulder was not significantly different between the two groups. Besides, there was a significant difference in hospitalization costs between the two groups (P<0.05). Furthermore, there was no significant difference in the VAS score, UCLA score, Constant score, ASES score, and ROM between the first surgery and second surgery in the single-stage group postoperatively.Conclusion: Patients receiving single-stage or staged bilateral arthroscopic rotator cuff repair showed similarly good clinical outcomes at follow-up. Moreover, good outcomes were observed on both sides of the single-stage group.

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