scholarly journals Preoperative Factors Associated With Subsequent Distal Clavicle Resection After Rotator Cuff Repair

2019 ◽  
Vol 7 (5) ◽  
pp. 232596711984429 ◽  
Author(s):  
Peter N. Chalmers ◽  
Erin Granger ◽  
Hunter Ross ◽  
Robert T. Burks ◽  
Robert Z. Tashjian
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Chart Review ◽  
Distal Clavicle ◽  
Ac Joint ◽  
Cuff Repair ◽  
Distal Clavicle Resection ◽  
Dominant Side

Background: Acromioclavicular osteoarthritis and rotator cuff tears are commonly coincident. Purpose: To determine the rate of subsequent distal clavicle excision (DCE) when rotator cuff repair (RCR) is performed without DCE and the risk factors for subsequent DCE after RCR. Study Design: Case-control study; Level of evidence, 3. Methods: The operative logs of 2 surgeons from 2007 to 2016 were retrospectively reviewed for all patients who underwent RCR with or without DCE. Preoperative demographic data, symptoms, physical examination, and standardized outcomes (visual analog scale for pain, Simple Shoulder Test, and American Shoulder and Elbow Surgeons score) were noted. Acromioclavicular (AC) arthritis was classified on preoperative radiographs. The rate of subsequent surgery on the AC joint was determined via chart review, and univariate and multivariate analyses were conducted to determine risk factors for revision. Results: In total, 894 patients underwent isolated RCR, and 46 underwent concomitant RCR and DCE. On retrospective chart review, of those who underwent isolated RCR, the revision rate for any reason was 7.5% (67 patients), and the rate of subsequent AC surgery was 1.1% (10 patients). Preoperatively, 88% of the total cohort was considered to have a radiographically normal AC joint. On multivariate analysis of patients who underwent isolated RCR, the risk factors for subsequent AC surgery included preoperative tenderness to palpation at the AC joint (10% vs 63%, P < .001), female sex (35% vs 80%, P < .001), and surgery on the dominant side (60% vs 100%, P = .002). On multivariate analysis, these 3 factors explained 50% of the variance in revision AC surgery. When these 3 factors were present in combination, there was a 40% rate of revision AC surgery. Conclusion: This records review found that 10 of 894 (1.1%) rotator cuff repairs underwent subsequent distal clavicle resection. Risk factors for subsequent DCE included tenderness to palpation at the AC joint, female sex, and surgery on the dominant side, with subsequent DCE performed in 40% of cases with a combination of these 3 factors. Because the duration of follow-up was short and the number of reoperations small, some caution is recommended in interpreting these results, as the analyses may be underpowered.

scholarly journals Is routine distal clavicle resection necessary in rotator cuff repair surgery? A systematic review and meta-analysis

2017 ◽  
Vol 11 (1_suppl) ◽  
pp. 39-45 ◽  
Author(s):  
Ann Livingstone ◽  
Rafik Asaid ◽  
Afshin Kamali Moaveni
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Analogue Scale ◽  
Meta Analysis ◽  
Distal Clavicle ◽  
Randomized Controlled ◽  
Cuff Repair ◽  
Distal Clavicle Resection

Background The objective of the present study was to perform a systematic review and meta-analysis of randomized controlled trials looking at the effect of distal clavicle resection in patients undergoing rotator cuff repair (RCR). Methods A systematic literature search was undertaken to identify randomized controlled trials looking at RCR +/– distal clavicle resection. Primary clinical outcome measures included in the meta-analysis were American Shoulder Elbow Society (ASES) score, pain on visual analogue scale and range of motion in forward elevation. Results The systematic review identified three studies with a total of 203 participants. Those who underwent distal clavicle resection in conjunction with RCR had worse pain and acromioclavicular joint tenderness at 3-month follow-up. This difference, however, was not observed at the 24-month follow-up. The mean difference (95% confidence interval) for the ASES score was 0.45 (–3.67 to 4.58) and pain on visual analogue scale was – 0.27 (–0.70 to 0.16). Conclusions Routine distal clavicle resection in the setting of rotator cuff repair does not result in improved outcomes for patients with no difference being observed at 24 months post surgery. The results of our systematic review and meta-analysis do not support routine distal clavicle resection when performing RCR.

How to Perform a Distal Clavicle Resection During Rotator Cuff Repair Surgery

2015 ◽  
Vol 16 (2) ◽  
pp. 63-67
Author(s):  
Chris R. Mellano ◽  
Michael Khair ◽  
Jason J. Shin ◽  
Tibor Warganich ◽  
Anthony A. Romeo ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Distal Clavicle ◽  
Cuff Repair ◽  
Distal Clavicle Resection

Factors Predictive of Healing in Large Rotator Cuff Tears: Is It Possible to Predict Retear Preoperatively?

2018 ◽  
Vol 46 (7) ◽  
pp. 1693-1700 ◽  
Author(s):  
Ho Yeon Jeong ◽  
Hwan Jin Kim ◽  
Yoon Sang Jeon ◽  
Yong Girl Rhee
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Fatty Infiltration ◽  
Arthroscopic Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Many studies have identified risk factors that cause retear after rotator cuff repair. However, it is still questionable whether retears can be predicted preoperatively. Purpose: To determine the risk factors related to retear after arthroscopic rotator cuff repair and to evaluate whether it is possible to predict the occurrence of retear preoperatively. Study Design: Case-control study; Level of evidence, 3. Methods: This study enrolled 112 patients who underwent arthroscopic rotator cuff repair with single-row technique for a large-sized tear, defined as a tear with a mediolateral length of 3 to 5 cm. All patients underwent routine magnetic resonance imaging (MRI) at 9 months postoperatively to assess tendon integrity. The sample included 61 patients (54.5%) in the healed group and 51 (45.5%) in the retear group. Results: In multivariate analysis, the independent predictors of retears were supraspinatus muscle atrophy ( P < .001) and fatty infiltration of the infraspinatus ( P = .027), which could be preoperatively measured by MRI. A significant difference was found between the two groups in sex, the acromiohumeral interval, tendon tension, and preoperative or intraoperative mediolateral tear length and musculotendinous junction position in univariate analysis. However, these variables were not independent predictors in multivariate analysis. The cutoff values of occupation ratio of supraspinatus and fatty infiltration of the infraspinatus were 43% and grade 2, respectively. The occupation ratio of supraspinatus <43% and grade ≥2 fatty infiltration of the infraspinatus were the strongest predictors of retear, with an area under the curve of 0.908, sensitivity of 98.0%, and specificity of 83.6% (accuracy = 90.2%). Conclusion: In patients with large rotator cuff tears, it was possible to predict the retear before rotator cuff repair regardless of intraoperative factors. The retear could be predicted most effectively when the occupation ratio of supraspinatus was <43% or the fatty infiltration of infraspinatus was grade ≥2. Predicting retear preoperatively may help surgeons determine proper treatment and predict the postoperative prognosis.

scholarly journals Benefits of distal clavicle resection during rotator cuff repair: Prospective randomized single-blind study

2020 ◽  
Vol 106 (8) ◽  
pp. S207-S211
Author(s):  
David Gallinet ◽  
Johannes Barth ◽  
Ludovic Labattut ◽  
Philippe Collin ◽  
Pierre Metais ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Blind Study ◽  
Distal Clavicle ◽  
Cuff Repair ◽  
Distal Clavicle Resection ◽  
Single Blind

scholarly journals Pulmonary Embolism after Arthroscopic Rotator Cuff Repair: A Case Report

2014 ◽  
Vol 17 (1) ◽  
pp. 31-35
Author(s):  
Ji Yong Gwark ◽  
Jin Sin Koh ◽  
Hyung Bin Park
Keyword(s):  
Risk Factors ◽  
Pulmonary Embolism ◽  
Case Report ◽  
Rotator Cuff ◽  
Orthopedic Surgery ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Shoulder Surgery ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Pulmonary embolism (PE) is a serious complication that can occur after orthopedic surgery. Most instances of PE in the orthopedic field have occurred after hip or knee arthroplasties or after fracture surgeries. The occurrence of PE related to arthroscopic shoulder surgery is very rare. We report a case of PE that developed after arthroscopic rotator cuff repair, in which the patient did not show preoperatively any remarkable risk factors for PE. We also review the current literature related to this topic.

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