scholarly journals The clinical and radiological results of arthroscopic versus arthroscopy assisted mini-open repair of rotator cuff tears

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Muhammed Sefa Özcan ◽  
Hasan Basri Sezer ◽  
Osman Tuğrul Eren ◽  
Raffi Armağan ◽  
Muharrem Kanar
Keyword(s):  
Rotator Cuff ◽  
Open Surgery ◽  
Open Group ◽  
Rotator Cuff Tears ◽  
Radiological Results ◽  
Arthroscopically Assisted ◽  
The Mean ◽  
Clinical And Radiological Results ◽  
Mini Open

In this study we reported retrospectively the comperative clinical and radiological results of the two most common surgical procedures in rotator cuff tear repair of shoulder, the golden standart arthroscopic and alternative arthroscopically assisted mini-open surgery. We included 58 patients who admitted to our clinic for rotator cuff tear and treated surgically between january 2013 and august 2015. The two groups were composed of arthroscopically treated 29 patients and 29 patients who were treated with arthroscopically assisted mini open surgery. The arthroscopy group included 18 females and 11 males, the mini-open group included 10 females and 19 males. The mean age was 56,0 (39,0-73,0) years, in arthroscopic and 55,0 (40,0-70,0) years in mini-open surgery group. 6 patients in the arthroscopy group(20,7%) and 10 patients in the mini-open group(34,5%) were defining trauma before the beginning of their complaints. The postoperative follow up was 28,9 months in arthroscopy group and 22,6 months in the mini-open surgery group. Preoperative physical or medical treatments were documented. Any additional surgical procedures like biceps long head tenotomy, subacromial decompression and bursectomy were also noted. Patients were evaluated with ASES and Constant shoulder scales before and after the surgery. Patients were evaluated radiologically with MRI at the last follow up for healing and tendon quality. The type 2 acromion was the dominant in both groups constituting the 44,8% of the total number of patients. 24 (82,8%)patients in the arthroscopically treated patients and 18(62,1%) patients in the mini-open group were undergone at least one of the additional surgical treatments. The mean length of the surgical scar was 3,4(3-5) cm in mini open group. None of the patients complained of the surgical scar. 16 patients in the arthroscopy group and 17 patients in the mini-open group had supraspinatus tendon pathology(either tear or degeneration) in the MRI control at the last follow up. Postoperative pain was present in 1 patient in each group who were classified as bad result. There was no statistically meaningful difference between two groups in terms of clinical or radiological results. In conclusion the arthroscopy assisted mini-open surgery may be a useful tool in hands of training surgeons to prevent ineffective treatment of rotator cuff tears.

scholarly journals Minimally invasive instrumentation without fusion during posterior thoracic corpectomies: a comparison of percutaneously instrumented nonfused segments with open instrumented fused segments

2017 ◽  
Vol 27 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Darryl Lau ◽  
Dean Chou
Keyword(s):  
Implant Failure ◽  
Open Group ◽  
Perioperative Outcomes ◽  
Failure Rates ◽  
Instrumented Fusion ◽  
Percutaneous Instrumentation ◽  
The Mean ◽  
Reoperation Rates ◽  
Mini Open

OBJECTIVEDuring the mini-open posterior corpectomy, percutaneous instrumentation without fusion is performed above and below the corpectomy level. In this study, the authors' goal was to compare the perioperative and long-term implant failure rates of patients who underwent nonfused percutaneous instrumentation with those of patients who underwent traditional open instrumented fusion.METHODSAdult patients who underwent posterior thoracic corpectomies with cage reconstruction between 2009 and 2014 were identified. Patients who underwent mini-open corpectomy had percutaneous instrumentation without fusion, and patients who underwent open corpectomy had instrumented fusion above and below the corpectomy site. The authors compared perioperative outcomes and rates of implant failure requiring reoperation between the open (fused) and mini-open (unfused) groups.RESULTSA total of 75 patients were identified, and 53 patients (32 open and 21 mini-open) were available for followup. The mean patient age was 52.8 years, and 56.6% of patients were male. There were no significant differences in baseline variables between the 2 groups. The overall perioperative complication rate was 15.1%, and there was no significant difference between the open and mini-open groups (18.8% vs 9.5%; p = 0.359). The mean hospital stay was 10.5 days. The open group required a significantly longer stay than the mini-open group (12.8 vs 7.1 days; p < 0.001). Overall implant failure rates requiring reoperation were 1.9% at 6 months, 9.1% at 1 year, and 14.7% at 2 years. There were no significant differences in reoperation rates between the open and mini-open groups at 6 months (3.1% vs 0.0%, p = 0.413), 1 year (10.7% vs 6.2%, p = 0.620), and 2 years (18.2% vs 8.3%, p = 0.438). The overall mean follow-up was 29.2 months.CONCLUSIONSThese findings suggest that percutaneous instrumentation without fusion in mini-open transpedicular corpectomies offers similar implant failure and reoperation rates as open instrumented fusion as far out as 2 years of follow-up.

Clinical and radiographic comparison of mini–open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up

2008 ◽  
Vol 9 (6) ◽  
pp. 560-565 ◽  
Author(s):  
Sanjay S. Dhall ◽  
Michael Y. Wang ◽  
Praveen V. Mummaneni
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Open Group ◽  
Lumbar Interbody Fusion ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
The Mean ◽  
Mini Open

Object As minimally invasive approaches gain popularity in spine surgery, clinical outcomes and effectiveness of mini–open transforaminal lumbar interbody fusion (TLIF) compared with traditional open TLIF have yet to be established. The authors retrospectively compared the outcomes of patients who underwent mini–open TLIF with those who underwent open TLIF. Methods Between 2003 and 2006, 42 patients underwent TLIF for degenerative disc disease or spondylolisthesis; 21 patients underwent mini–open TLIF and 21 patients underwent open TLIF. The mean age in each group was 53 years, and there was no statistically significant difference in age between the groups (p = 0.98). Data were collected perioperatively. In addition, complications, length of stay (LOS), fusion rate, and modified Prolo Scale (mPS) scores were recorded at routine intervals. Results No patient was lost to follow-up. The mean follow-up was 24 months for the mini-open group and 34 months for the open group. The mean estimated blood loss was 194 ml for the mini-open group and 505 ml for the open group (p < 0.01). The mean LOS was 3 days for the mini-open group and 5.5 days for the open group (p < 0.01). The mean mPS score improved from 11 to 19 in the mini-open group and from 10 to 18 in the open group; there was no statistically significant difference in mPS score improvement between the groups (p = 0.19). In the mini-open group there were 2 cases of transient L-5 sensory loss, 1 case of a misplaced screw that required revision, and 1 case of cage migration that required revision. In the open group there was 1 case of radiculitis as well as 1 case of a misplaced screw that required revision. One patient in the mini-open group developed a pseudarthrosis that required reoperation, and all patients in the open group exhibited fusion. Conclusions Mini–open TLIF is a viable alternative to traditional open TLIF with significantly reduced estimated blood loss and LOS. However, the authors found a higher incidence of hardware-associated complications with the mini–open TLIF.

scholarly journals Osteoarthritis progression of the shoulder: A long-term follow-up after mini-open rotator cuff repair

2018 ◽  
Vol 26 (2) ◽  
pp. 230949901876810 ◽  
Author(s):  
Tomoyuki Matsuba ◽  
Yukihiko Hata ◽  
Norio Ishigaki ◽  
Koichi Nakamura ◽  
Hiroyuki Kato
Keyword(s):  
Rotator Cuff ◽  
Primary Repair ◽  
Rotator Cuff Tears ◽  
Similar Degree ◽  
Affected Side ◽  
Long Term Follow Up ◽  
Shoulder Arthritis ◽  
Osteoarthritis Progression ◽  
Mini Open

Objective: This study aimed to investigate whether (1) the primary repair of rotator cuff tears can prevent the progression of osteoarthritis (OA) and (2) the quality of postoperative cuff integrity affects the incidence of osteoarthritic changes. Methods: A total of 86 patients treated with mini-open repair for rotator cuff tears over a minimum of 10 years of follow-up (mean ± standard deviation 11.1 ± 1.0 years) were retrospectively analyzed. Preoperative and postoperative radiographs of the affected and unaffected sides were compared, and the degree of OA was evaluated using the Samilson and Prieto classification. Magnetic resonance imaging was used to evaluate cuff integrity, classify patients into good and poor cuff integrity groups, and compare the degree of OA between the two groups. Results: OA deteriorated either significantly or to a similar degree on both sides postoperatively. However, OA progressed in significantly more cases on the affected side. A comparison between the aforementioned cuff integrity groups showed that the postoperative OA of the poor cuff integrity group was significantly worse than that of the good cuff integrity group on the affected side. Conclusion: Our study showed that even if rotator cuff tears are repaired, the progression of osteoarthritic changes cannot be halted. The progression of OA was affected by cuff integrity. Rotator cuff dysfunction due to poor cuff integrity was a risk factor for shoulder arthritis.

scholarly journals Long-term evolution of calcific tendinitis of the rotator cuff: clinical and radiological evaluation 10 years after diagnosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Riccardo Compagnoni ◽  
Alessandra Menon ◽  
Simone Radaelli ◽  
Francesco Lanzani ◽  
Mauro B. Gallazzi ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Calcific Tendinitis ◽  
Rotator Cuff Tears ◽  
Radiological Evaluation ◽  
Glenohumeral Osteoarthritis ◽  
The Mean

Abstract Background Calcific tendinitis of the shoulder has a tendon involvement that could evolve to rotator cuff tear and shoulder osteoarthritis. This study aimed to evaluate the prevalence of glenohumeral osteoarthritis and rotator cuff tears in patients affected by calcific tendinitis at a minimum follow-up of 10 years after diagnosis. Methods Patients diagnosed with calcific tendinitis of the shoulder with a minimum follow-up of 10 years were contacted and invited for a clinical and radiological evaluation. Information on the demographics, affected and dominant side, bilateral shoulder pain, type of treatment, habits, systemic or musculoskeletal diseases, reoperation of the index shoulder, and subjective satisfaction was collected. The clinical evaluation was performed using Constant–Murley score (CMS), American Shoulder and Elbow Surgeons Score (ASES), and numerical rating scale (NRS); isometric strength in forwarding flexion and abduction was also measured. Each patient also underwent an ultrasound examination to evaluate rotator cuff tendon integrity and a shoulder radiograph to evaluate osteoarthritis. Results Seventy-nine patients were available for a phone interview, and 35 agreed to be examined. The mean age was 58.89 (± 7.9) years at follow-up. The prevalence of glenohumeral osteoarthritis was 17.14% in the study population, with significant progression in 14.29% of the cases, without rotator cuff full-thickness tears. x-Ray examination showed residual calcifications in 31 patients, with a mean diameter of 5.54 mm. In 30 cases, there was a reduction of the diameter; in 4 cases, the calcification increased in size; and in 1 case, the size did not change. The mean ASES score was 74.1 (± 22.7) in the group with calcifications larger than 2 mm and 89.4 (± 8.2) in patients with smaller calcifications (p = 0.08) without correlation with the type of treatment performed. Conclusions Calcific tendinitis is a self-resolving disease without rotator cuff tears at long-term follow-up or degenerative glenohumeral progression. Level of Evidence: 3, cohort study.

scholarly journals Shoulder-specific outcomes 1 year after nontraumatic full-thickness rotator cuff repair: a systematic literature review and meta-analysis

2017 ◽  
Vol 9 (4) ◽  
pp. 247-257 ◽  
Author(s):  
Navin Gurnani ◽  
Derek F. P. van Deurzen ◽  
Michel P. J. van den Bekerom
Keyword(s):  
Los Angeles ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Meta Analysis ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
The Mean ◽  
Cuff Repair ◽  
Mini Open

Background Nontraumatic full-thickness rotator cuff tears are commonly initially treated conservatively. If conservative treatment fails, rotator cuff repair is a viable subsequent option. The objective of the present meta-analysis is to evaluate the shoulder-specific outcomes one year after arthroscopic or mini-open rotator cuff repair of nontraumatic rotator cuff tears. Methods A literature search was conducted in PubMed and EMBASE within the period January 2000 to January 2017. All studies measuring the clinical outcome at 12 months after nontraumatic rotator cuff repair of full-thickness rotator cuff tears were listed. Results We included 16 randomized controlled trials that met our inclusion criteria with a total of 1.221 shoulders. At 12 months after rotator cuff repair, the mean Constant score had increased 29.5 points; the mean American Shoulder and Elbow Score score increased by 38.6 points; mean Simple Shoulder Test score was 5.6 points; mean University of California Los Angeles score improved by 13.0 points; and finally, mean Visual Analogue Scale score decreased by 4.1 points. Conclusions Based on this meta-analysis, significant improvements in the shoulder-specific indices are observed 12 months after nontraumatic arthroscopic or mini-open rotator cuff repair.

scholarly journals Lesions of the Long Head of the Biceps Tendon Concomitant with Rotator Cuff Tears: Tenotomy or Subpectoral Mini‐open Tenodesis? A Comparative Short to Mid‐term Follow‐up Study

2019 ◽  
Vol 11 (5) ◽  
pp. 857-863 ◽  
Author(s):  
Jing‐hua Fang ◽  
Xue‐song Dai ◽  
Xin‐ning Yu ◽  
Jian‐yang Luo ◽  
Xiao‐nan Liu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Biceps Tendon ◽  
Rotator Cuff Tears ◽  
Follow Up Study ◽  
Long Head ◽  
Mini Open

scholarly journals Posterior thoracic corpectomy with cage reconstruction for metastatic spinal tumors: comparing the mini-open approach to the open approach

2015 ◽  
Vol 23 (2) ◽  
pp. 217-227 ◽  
Author(s):  
Darryl Lau ◽  
Dean Chou
Keyword(s):  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Open Surgery ◽  
Operative Time ◽  
Spinal Metastases ◽  
Open Group ◽  
Open Approach ◽  
Mini Open

OBJECT Spinal metastases most commonly affect the vertebral bodies of the spinal column, and spinal cord compression is an indication for surgery. Commonly, an open posterior approach is employed to perform a transpedicular costotransversectomy or lateral extracavitary corpectomy. Because of the short life expectancies in patients with metastatic spinal disease, decreasing the morbidity of surgical treatment and recovery time is critical. One potential approach to decreasing morbidity is utilizing minimally invasive surgery (MIS). Although significant advances have been made in MIS of the spine, data supporting the utility of MIS are still emerging. This study compared outcomes of patients who underwent mini-open versus traditional open transpedicular corpectomy for spinal metastases in the thoracic spine. METHODS A consecutive cohort from 2006 to 2013 of 49 adult patients who underwent thoracic transpedicular corpectomies for spinal metastases was retrospectively identified. Patients were categorized into one of 2 groups: open surgery and mini-open surgery. Mini-open transpedicular corpectomy was performed with a midline facial incision over only the corpectomy level of interest and percutaneous instrumentation above and below that level. The open procedure consisted of a traditional posterior transpedicular corpectomy. Chi-square test, 2-tailed t-test, and ANOVA models were employed to compare perioperative and follow-up outcomes between the 2 groups. RESULTS In the analysis, there were 21 patients who had mini-open surgery and 28 patients who had open surgery. The mean age was 57.9 years, and 59.2% were male. The tumor types encountered were lung (18.3%), renal/bladder (16.3%), breast (14.3%), hematological (14.3%), gastrointestinal tract (10.2%), prostate (8.2%), melanoma (4.1%), and other/unknown (14.3%). There were no significant intergroup differences in demographics, comorbidities, neurological status (American Spinal Injury Association [ASIA] grade), number of corpectomies performed, and number of levels instrumented. The open group had a mean operative time of 413.6 minutes, and the mini-open group had a mean operative time of 452.4 minutes (p = 0.329). Compared with the open group, the mini-open group had significantly less blood loss (917.7 ml vs 1697.3 ml, p = 0.019) and a significantly shorter hospital stay (7.4 days vs 11.4 days, p = 0.001). There was a trend toward a lower perioperative complication rate in the mini-open group (9.5%) compared with the open group (21.4%), but this was not statistically significant (p = 0.265). At follow-up, there were no significant differences in ASIA grade (p = 0.342), complication rate after the 30-day postoperative period (p = 0.999), or need for surgical revision (p = 0.803). The open approach had a higher overall infection rate of 17.9% compared with that in the mini-open approach of 9.5%, but this was not statistically significant (p = 0.409). CONCLUSIONS The mini-open transpedicular corpectomy is associated with less blood loss and shorter hospital stay compared with open transpedicular corpectomy. The mini-open corpectomy also trended toward lower infection and complication rates, but these did not reach statistical significance.

scholarly journals Comparison of Superior Capsular Reconstruction and Partial Infraspinatus Repair: A Matched-Pair Analysis of Irreparable Rotator Cuff Tears

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098426
Author(s):  
Stefan Greiner ◽  
Max Kaeaeb ◽  
Andreas Voss ◽  
Robert Lawton ◽  
Pushkar Bhide ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Constant Score ◽  
Rotator Cuff Tears ◽  
Matched Pair ◽  
Dash Score ◽  
Western Ontario Rotator Cuff ◽  
Superior Capsular Reconstruction ◽  
Patient Reported ◽  
The Mean

Background: Superior capsular reconstruction (SCR) represents a new option for the treatment of irreparable rotator cuff tears. Purpose/Hypothesis: This study aimed to evaluate the clinical and radiologic outcomes of SCR and compare them with the outcomes of partial repair (PR) of the infraspinatus tendon. The hypothesis was that there would be no significant differences between the clinical and radiologic outcome parameters of SCR and PR after a minimum follow-up of 2 years. Study Design: Cohort study; Level of evidence, 3. Methods: Of 21 patients who underwent SCR, 20 patients were matched in a 1:1 ratio according to sex, age, and tear configuration with 20 of 60 patients who had undergone PR; all patients were prospectively evaluated for a minimum follow-up of 2 years. The investigated outcome measures included the Constant score; Western Ontario Rotator Cuff (WORC) index; Disabilities of the Arm, Shoulder and Hand (DASH) score; and radiologic analysis of acromiohumeral distance (AHD) and humeral head centralization (HHC). Results: There were no differences in the demographic data between the SCR and PR groups. The mean age of both groups was 62.3 years (range, 47-79 years), the mean tear configuration was Bateman 3.0 and Patte 2.8, and the mean follow-up period was 29.4 months (range, 24-53 months). At final follow-up, no significant differences were seen between the SCR and PR groups with regard to Constant score (77.1 vs 82.7), age- and sex-adapted Constant score (85.5% vs 91.4%), DASH score (15.6 vs 7.8), or WORC index (81.1 vs 90.4). No significant differences in the AHD or HHC were seen between the groups. The reoperation rate was 4.8% (1/21) in the SCR cohort and 15% (9/60) in the PR cohort. Conclusion: Both SCR and PR resulted in significant improvements in patient-reported outcomes at 2-year follow-up, with no significant differences in clinical outcomes between the 2 techniques. Further follow-up is needed to determine whether there are long-term differences in HHC and development of cuff tear arthropathy. Further investigations should also focus on the cost-effectiveness of the respective procedures.

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