scholarly journals Functional Outcomes and Return To Sport With Extraarticular Plating Of Lisfranc Injuries In Athletes

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0038
Author(s):  
Stephanie M. Jones ◽  
Arthur R. McDowell ◽  
Samuel O. Ewalefo ◽  
Monique C. Chambers ◽  
Dwayne Carney ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Locking Plate ◽  
Statistical Significance ◽  
P Value ◽  
Dorsal Plate ◽  
Lisfranc Joint ◽  
Operative Outcomes ◽  
Patient Reported ◽  
Lisfranc Injuries

Objectives: Lisfranc injuries are increasingly common among athletes. Tarsometatarsal joint injuries often damage the articular cartilage and increase predisposition for post-traumatic arthritis and functional deformity of the midfoot. Injury-related morbidity in athletes has substantial consequences such as decreased performance and earlier retirement from sports. While open reduction and internal fixation (ORIF) has been established as the standard of care for unstable Lisfranc injuries, there is currently no consensus regarding the optimal technique for stabilization. Extra-articular fixation has been described as a reasonable technique for Lisfranc joint stabilization due to avoidance of iatrogenic articular disruption and subsequent morbidity. The purpose of this study was to assess the pre- and post-operative patient-reported outcomes of athletes with Lisfranc injuries following ORIF using an extra-articular dorsal locking plate. Methods: Following Institutional Review Board (IRB) approval, data was collected prospectively using an institution-based patient-reported outcomes registry. The registry was queried for patients who had undergone open treatment for tarsometatarsal dislocation (CPT 28615) between April 2015 and August 2018. Medical records were reviewed for the following criteria: athlete, 15 - 45 years of age, Lisfranc injury, ORIF, extra-articular dorsal locking plate, and completion of both pre- and post-operative outcomes surveys. 10 athletes were identified. The surveys used were as follows: VAPS, PASS, PROMIS-M, PROMIS-P, SF12-M, SF12-P, FAAM-ADL and FAAM-Sports. A comparison of pre- and post-operative outcomes was performed using paired t-tests. Statistical significance was defined as a p-value <0.05. Results: 10 athletes (5 male, 5 female) with an average age of 18.2 years were analyzed. Sports included football, gymnastics, soccer, hockey, and basketball. Competition levels included high school and college. All athletes had scheduled hardware removal between 3 - 5 months (average 4.4 months) after the initial ORIF. The FAAM-ADL scores (Δ42.49, p <0.0174) improved significantly at 6-months follow-up. The improvement of FAAM-ADL scores continued to trend positively for up to 1-year post-operatively; however, there was insufficient data to analyze for significance. There was no statistical significance observed between pre- and post-operative VAPS, PASS, PROMIS-M, PROMIS-P, SF12-M, SF12-P and FAAM-Sports scores at 6-months follow-up. 100% of athletes returned to sport at an average of 6 months. Conclusion: In athletes, extra-articular dorsal plate fixation of the Lisfranc joint demonstrates improvement in post-operative patient reports of function. Broad-statistical significance across all patient-reported measures was likely limited due to the number of participants. Patient-reported outcomes may serve as a guide to assess athlete progress during the post-operative period. Further studies are needed to compare the long-term outcomes of Lisfranc injuries in athletes following various methods of fixation.

scholarly journals Two Year Follow-Up of Patient Reported Outcomes Following Third Generation Minimally Invasive Chevron Akin Osteotomies (MICA) in Hallux Valgus Surgery

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0005
Author(s):  
Thomas L. Lewis ◽  
Robbie Ray ◽  
David Gordon
Keyword(s):  
Minimally Invasive ◽  
Hallux Valgus ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Case Series ◽  
Published Data ◽  
Third Generation ◽  
Specific Patient ◽  
Patient Reported

Category: Bunion Introduction/Purpose: The aim of this study was to explore the 2 year results of third generation (using screw fixation) Minimally Invasive Chevron and Akin osteotomies (MICA) for hallux valgus correction. There is a paucity of published data regarding the outcomes of this relatively new technique. We present the largest series in the literature, using three separate validated patient-reported outcome measures (EQ-5DL, VAS Pain and Manchester Oxford Foot Questionnaire (MOXFQ), for this time point. Methods: A single surgeon case series of patients with hallux valgus underwent primary third generation minimally invasive chevron and akin osteotomies for hallux valgus correction. Between August 2015 and January 2018, 290 MICAs were performed in 203 patients that were eligible for 2 year follow up. Baseline and 2 year post-operative patient reported outcomes were collected for 164 feet in 130 patients (124 females; 6 males). Paired t-tests were used to determine the statistical significance of the difference between pre- and post-operative scores. Results: The mean age was 56.6 (range 29.5-81.0, standard deviation (s.d.) 10.9). At two year follow up, mean MOXFQ scores improved for each domain: Pain; baseline 40.6 (range 0-100, s.d. 22.8), reduced to 11.3 (range 0-75, s.d. 16.0, p<0.001); Walking; 36.0 (range 0-100, s.d. 25.9) reduced to 8.2 (range 0-75.0, s.d. 16.0, p<0.001); Social interaction; 46.7 (range 0-100, s.d. 24.3), reduced to 7.7 (range 0-75.0, s.d. 13.9, p<0.001). Mean VAS Pain score improved from 30.4 (range 0.0-90.0, s.d. 23.6) to 9.4 (range 0.00-70.0, s.d. 15.6, p<0.001). Mean EQ-5D index score improved from 0.750 (range 0.066-1.000, s.d. 0.148) to 0.892 (range 0.410-1.000, s.d. 0.135, p<0.001). Mean EQ-5D VAS score did not significantly improve from 81.9 (range 0-100, s.d. 17.1) to 83.0 (range 0-100, s.d. 18.0, p=0.559). Conclusion: This is the largest prospective case series of short-term patient reported outcomes using a validated assessment method for hallux valgus, following third generation MICA to date. These data show that this technique is effective at improving foot and ankle specific patient reported outcomes at 2 years. This cohort is being followed over the longer term.

scholarly journals Patient Outcomes Differences Following Ankle Fracture Fixation with or without Ankle Arthroscopy

2020 ◽  
Vol 5 (2) ◽  
pp. 2473011420S0001
Author(s):  
Kenneth S. Smith ◽  
Katherine D. Drexelius ◽  
Shanthan C. Challa ◽  
Daniel K. Moon ◽  
Joshua A. Metzl ◽  
...  
Keyword(s):  
Physical Function ◽  
Ankle Fracture ◽  
Patient Reported Outcomes ◽  
Chart Review ◽  
Ankle Arthroscopy ◽  
P Value ◽  
Function Score ◽  
Patient Reported ◽  
Physical Function Score

Category: Arthroscopy; Ankle; Trauma Introduction/Purpose: Ankle fractures are one of the most common types of fractures, yet there is currently no consensus about how best to treat these patients. The treatment approach typically includes open reduction-internal fixation (ORIF), but not all patients have a good clinical outcome. Intra-articular injuries have been suggested as one potential cause of these sub-optimal outcomes. Use of arthroscopy at the time of surgery is useful in identifying intra-articular lesions in acute ankle fractures, however, there is no evidence that arthroscopic intervention changes the patient’s outcome. Ankle arthroscopy increases the duration and potential complications of anesthesia administration and also increases cost. Our study assesses the clinical impact of arthroscopy accompanying an ankle fracture ORIF, which is essential to promote positive outcomes, while decreasing unnecessary complications and costs. Methods: This is a retrospective chart review. We queried all patients that underwent operative fixation of a bimalleolar or trimalleolar ankle fracture at our institution from January 1, 2014 through November 1, 2018. From this list, we excluded patients less than 18 years old and patients that had concomitant injuries to other body parts that required surgery. In addition, we only included Weber B and Weber C fibula fracture to homogenize the data. We then performed a chart review to extract all demographic data, fracture pattern, surgical procedures performed, tourniquet times, any revision surgeries, arthroscopic findings and any interventions performed due to the arthroscopic portion of the procedure. We then conducted a phone and email survey utilizing the Patient Reported Outcomes Measurement Information System (PROMIS) Global Health Short Form and the two question Patient Acceptable Symptom State (PASS). Results: Our study included 213 total patients (142 traditional ORIF, 71 ORIF plus arthroscopy) with an average age of 40 (standard deviation 14.2). The average follow up was 32.4 (13.1) months with a survey follow up rate of 50.7%. The demographic information between the two cohorts was statistically similar. The average tourniquet time for the arthroscopy cohort is 10 minutes longer (89 minutes versus 79 minutes). During the arthroscopy, there was a 28.2% rate of full thickness osteochondral lesions, 33.8% rate of loose bodies, and a 49.2% rate of small cartilage injury not requiring intervention. The mean PROMIS physical function score amongst Weber B fibula fractures was 45.8 and 42.3 in the arthroscopy and non-arthroscopy groups respectively (P value 0.012). In addition, the patient satisfaction rate in Weber B fibula fractures was higher in those patients that underwent arthroscopy as compared to ORIF alone (93.1% versus 75.5%, P value of 0.05). Patients that suffered a tibiotalar joint dislocation at the time of the ankle fracture had a significantly higher PROMIS physical function score (46.6 versus 40.2, P value 0.005) when their surgery included arthroscopy. Conclusion: Ankle arthroscopy at the time of ORIF led to higher mean patient reported outcomes for every tested metric but this reached statistical significance only when looking at the Weber B fibula fractures and ankle dislocations. There was no increase in complication rate and the arthroscopy took only 10 minutes longer on average. [Table: see text]

scholarly journals Outcomes Following the Treatment of Talar Osteochondral Lesions with BioCartilage and Bone Marrow Aspirate Concentrate Mixture

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0004
Author(s):  
Ashraf Fansa ◽  
Mark Drakos ◽  
Taylor Cabe ◽  
Peter Fabricant
Keyword(s):  
Bone Marrow ◽  
Patient Reported Outcomes ◽  
Bone Marrow Aspirate ◽  
Statistical Significance ◽  
Osteochondral Lesions ◽  
Foot And Ankle ◽  
Bone Marrow Aspirate Concentrate ◽  
Patient Reported ◽  
The Mean

Category: Arthroscopy Introduction/Purpose: With reported incidence rates ranging from 40% to 70% post ankle sprains and fractures, osteochondral lesions of the talus (OLT) are not uncommon. However, management of such defects remains challenging. Microfracturing is considered the standard treatment for symptomatic OLTs.Larger lesions however typically require more invasive restorative procedures such as autologous osteochondral transplantation. Microfracture results are variable due to the fact that the resulting reparative fibrocartilage is weaker and biomechanically inferior to native hyaline cartilage. In this study, we examine the functional and radiological outcomes following use of a new arthroscopic technique utilizing a mixture of micronized allograft cartilage matrix (BioCartilage) (Arthrex, Naples, FL) soaked in Bone Marrow Aspirate Concentrate (BMAC) to fill OLTs. Methods: Eighty-six consecutive patients treated for OLT using arthroscopic debridement and BioCartilage matrix soaked in BMAC were identified. All patients were treated by a single fellowship-trained sports medicine and foot and ankle surgeon. Functional outcomes were assessed using the Foot and Ankle Outcome Score (FAOS) and Patient-Reported Outcomes Measurement Information System (PROMIS). This information was obtained from a prospective registry at the authors’ institution. Wilcoxon signed rank tests were used to determine statistical significance between pre and postoperative clinical scores. Additionally, an attending radiologist assessed the reparative cartilage morphology on postoperative MRI scans. This was evaluated and scored using a modified magnetic resonance observation of cartilage tissue (MOCART) scoring system. Results: Thirty-one patients (19 Females; 12 Males) with a mean age of 37.8 years (Range 15–54) had a minimum follow-up duration of 12 months and were thus included in this review. Mean follow-up duration was 15.8 months (Range 12 –25.7). The mean patient BMI was 27.4 (Range 19.6 – 39.4), while the average osteochondral lesion size was 85.9 mm2 (Range 35 – 220). The Physical Function domain of the PROMIS score, demonstrated statistically significant change, improving from 40.63 ±8.31 to 48.31 ±10.07 (p=0.02). The Pain Intensity domain also improved significantly from 49.06 ±9.32 to 42.14 ±9.38 (p=0.03). The Pain Interference domain and FAOS scores did improve but not reaching statistical significance. The mean MRI MOCART score was 69 ±13.34 with 13.3 months average follow-up duration. Conclusion: Achieving the longest duration possible of symptom-free functioning postoperatively is the main goal of any cartilage repair procedure. Augmentation of an articular lesion’s infill with BioCartilage and BMAC may help enhance the biomechanical properties of the reparative fibrocartilage construct and its longevity. Our initial findings demonstrate favorable patient-reported outcomes. Moreover, postoperative MRIs demonstrate the majority of the lesions showed either complete or hypertrophic infill, complete or hypertrophic integration, homogenous repair tissue, and isointense signals. Long-term studies prospectively assessing the effectiveness of this technique in maintaining pain-free-function of the ankle joint are warranted.

scholarly journals Imageless computer assisted navigation in ceramic-on-ceramic total hip arthroplasty vs. manual approach: a single-centre retrospective study

10.29007/9gpf ◽  
2019 ◽  
Author(s):  
John McLoughlin ◽  
Mo Mathew ◽  
Stephen Grant
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Computer Assisted ◽  
Total Hip ◽  
Patient Reported ◽  
Cup Positioning

Background: Acetabular cup positioning is vital to the long-term survivorship of total hip arthroplasty (THA). Malalignment has been linked to dislocation, wear and osteolysis. Although there are many studies demonstrating the reduction in variability of cup positioning with computer-assisted techniques, there are relatively few reporting long-term patient reported outcomes and revision rates. Aim: The aim of this study was to review whether those patients who underwent navigated THA had better long-term survivorship or better patient reported outcomes. Methods: We compared revision rates and Oxford hip scores of 152 THAs (47 navigated and 105 non-navigated) performed at a single site between 2003 and 2008, with a minimum follow-up of 10 years. Results: 9 of the non-navigated and none of the navigated hips were revised at 10 year follow-up (p=0.057). There were no observable differences in 10-year Oxford hip scores between the navigated and non-navigated hips, 44.82 and 43.38 respectively. Conclusion: With respect to the rate of revision, although statistical significance was not achieved, it can be shown from our data that there was a clinically significant reduction in revision rates with navigated vs. non-navigated techniques. More data with higher patient numbers in the navigated cohort may be required to validate the results of our study.

scholarly journals Ankle fractures: What role does level of insurance play in recovery and outcomes?

Trauma ◽  
2018 ◽  
Vol 22 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Wajeeh Bakhsh ◽  
Sean Childs ◽  
Kyle Judd ◽  
Gillian Soles ◽  
Catherine Humphrey ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Insurance Coverage ◽  
Ankle Fractures ◽  
Complication Rates ◽  
Fracture Characteristics ◽  
Operative Outcomes ◽  
Pain Scores ◽  
Patient Reported ◽  
Perioperative Complication

Introduction A number of factors including socioeconomic status have been correlated with post-operative outcomes in orthopedic trauma. The objective of this study is to compare post-operative courses and patient-reported outcomes following operatively managed ankle fractures taking into account a patient's level of insurance coverage. Methods A retrospective cohort study was performed at a single level I trauma center. Patients were identified by billing code for operative intervention of ankle fractures (OTA 44) from January 2014 to January 2015. Study outcomes included narcotic refills, compliance with follow-up visits, visual analog scale (VAS) pain scores, Patient-Reported Outcomes Measurement Information System (PROMIS) survey data, and perioperative complication rates. Statistical analysis included mean comparison between insurance groups and multivariate regression modeling. Results From January 2014 to January 2015, 209 patients met the inclusion criteria (45 patients under/uninsured vs. 164 fully insured). No differences were found amongst demographic data or fracture characteristics. The underinsured group had a higher average number of narcotic prescriptions (2.6 refills vs. 1.5 refills, p < 0.05). The underinsured group also demonstrated a significantly greater number of missed post-operative clinic visits (0.8 vs. 0.3 visits p < 0.05); the total number of post-operative visits were similar (6.4 vs. 6.9, p = 0.38). At one-year follow-up, the underinsured group had higher pain scores (VAS 3.8 vs. 2.1, p < 0.05), and significantly worse PROMIS scores with respect to mood (54 vs. 49.1, p < 0.05), pain (59.6 vs. 55.5, p < 0.05), and functional outcomes (38 vs. 44.7, p < 0.05). There was no difference in perioperative complication rates. Multivariate regression modeling found insurance (p < 0.05), age (p < 0.05), and smoking (p < 0.05) to be significant determinants of post-operative outcomes. Conclusion Despite similar demographic and fracture characteristics, patients with decreased insurance coverage demonstrated higher narcotic requirements and missed more appointments. They had worse subjective and objective outcomes. As physician reimbursement becomes increasingly dependent on outcomes, further understanding of the psychosocial factors of this subset of patients is needed to establish realistic expectations and identify avenues for further intervention.

Subtalar Fusion for Correction of Forefoot Abduction in Stage II Adult-Acquired Flatfoot Deformity

2020 ◽  
pp. 193864002095105
Author(s):  
James P. Davies ◽  
Xiaoyue Ma ◽  
Jonathan Garfinkel ◽  
Matthew Roberts ◽  
Mark Drakos ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Chart Review ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Stage Ii ◽  
Primary Study ◽  
Study Objective ◽  
Subtalar Fusion ◽  
Patient Reported

Background Correction of talonavicular uncoverage (TNU) in adult-acquired flatfoot deformities (AAFD) can be a challenge. Lateral column lengthening (LCL) traditionally is utilized to address this. The primary study objective is examining stage II AAFD patients and determining if correction can be achieved with subtalar fusion (STF) comparable to LCL. Methods Following institutional review board approval, retrospective chart review performed identifying patients meeting criteria for stage IIB AAFD who underwent either STF with concomitant flatfoot procedures (but not LCL) to correct TNU, or who underwent LCL as part of their flatfoot reconstruction. Patients indicated for STF had one or more of the following: higher body mass index (BMI), were older, had greater deformity, lateral impingement pain, intraoperative spring ligament hyperlaxity. Patients without 1-year follow-up or compete records were excluded. All other patients were included. A total of 27 isolated STFs identified, along with 143 who underwent LCL. Pre-/postoperative radiographic parameters obtained as well as PROMIS (Patient-Reported Outcomes Measurement Information System) and FAOS (Foot and Ankle Outcome Score) scores. Radiographic and patient reported outcomes both preoperatively and at 1-year follow-up evaluated for both groups. Results STF patients were older ( P < .05), with higher BMIs ( P < .004). STF had significantly worse TNU ( P < .001) than LCL patients, and average change in STF TNU was larger than LCL change postoperatively ( P = .006), after adjusting for age, BMI, gender. PROMIS STF improvement reached statistical significance in Physical Function (P 0.011), for FAOS Pain (P 0.025) and Function ( P = 0.04). Conclusions STF can be used in appropriately indicated patients to correct flatfoot deformity without compromising radiographic or clinical, correcting not only hindfoot valgus, but also talonavicular uncoverage (TNU) and corresponding medial arch collapse. Levels of Evidence: Level III: Retrospective chart review comparison study (case control)

scholarly journals Long-term Follow-up of Lisfranc Injuries Treated With Open Reduction Internal Fixation Patient-Reported Outcomes

2021 ◽  
Vol 6 (3) ◽  
pp. 247301142110394
Author(s):  
Kempland C. Walley ◽  
Derek J. Semaan ◽  
Ronit Shah ◽  
Christopher Robbins ◽  
David M. Walton ◽  
...  
Keyword(s):  
Physical Function ◽  
Visual Analog Scale ◽  
Patient Reported Outcomes ◽  
Foot And Ankle ◽  
Analog Scale ◽  
Patient Reported ◽  
The Mean ◽  
Lisfranc Injuries

Background: There remains a paucity of data regarding long-term patient-reported outcomes following Lisfranc injuries. We sought to collect long-term clinical outcome data following Lisfranc injuries using PROMIS Physical Function (PROMIS-PF) and visual analog scale–foot and ankle (VAS-FA). Methods: A chart review was performed to identify all patients who had surgical treatment of an acute Lisfranc injury at our institution from 2005 to 2014. Of the 45 patients identified, we were able to recruit 19 for a follow-up clinic visit consisting of physical examination, administration of questionnaires addressing pain and medication usage, radiographs, and completion of outcome surveys including PROMIS-Physical Function and visual analog scale–foot and ankle. Results: There were 14 female and 5 male patients enrolled in the study with a mean time of 6.25 years from the time of injury. Within this cohort, the mean PROMIS-PF score was 52.4±8.2 and the mean VAS–foot and ankle score was 76.6±22.3. Conclusion: We report satisfactory long-term patient-reported outcomes using PROMIS-PF and VAS-FA. Level of Evidence: Level III, retrospective cohort study.

Individualized cancer follow-up supported by electronic Patient-Reported Outcomes: Development and evaluation (Preprint)

2020 ◽  
Author(s):  
Sissel Ravn ◽  
Henriette Vind Thaysen ◽  
Lene Seibaek ◽  
Victor Jilbert Verwaal ◽  
Lene Hjerrild Iversen
Keyword(s):  
Ct Scan ◽  
Advanced Cancer ◽  
Patient Reported Outcomes ◽  
Cost Benefit Analysis ◽  
Cost Benefit ◽  
Structured Interviews ◽  
European Organization ◽  
Individualized Care ◽  
Patient Reported

BACKGROUND Cancer survivors experience unmet needs during follow-up. Besides recurrence, a follow-up includes detection of late side effects, rehabilitation, palliation and individualized care. OBJECTIVE We aimed to describe the development and evaluate the feasibility of an intervention providing individualized cancer follow-up supported by electronic patient-reported outcomes (e-PRO). METHODS The study was carried out as an interventional study at a Surgical and a Gynecological Department offering complex cancer surgery and follow-up for advanced cancer. The e-PRO screened for a priori defined clinical important symptoms and needs providing individualized follow-up. We included following questionnaires in the e-PRO; the general European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and the EORTC validated for colorectal and ovarian cancer patients. To support individualization, we included three prioritized issues of the patient’s preference in each e-PRO. The response-algorithm was aggregated based on the severity of the patient’s response. To ensure the sensitivity of the e-PRO, we performed semi-structured interviews with five patients. All clinicians (surgeons and gynecologists) performing the consultations reviewed the e-PRO. The evaluation was divided in two, 1)The feasibility was assessed by a)Patients’ response rate of the e-PRO, b)Number of follow-up visits documenting the use of e-PRO and c)Patients’ prioritized issues prior to the consultation(‘yes’ / ‘no’), and after the follow-up 2)Patients assessment of a)The need and purpose of the follow-up visit and b)the support provided during the follow-up visit. RESULTS In total, 187 patients were included in the study, of which 73%(n=136/187) patients responded to the e-PRO and were subjected to an individualized follow-up. The e-PRO was documented as applied in 79% of the follow-up visits. In total, 23% of the prioritized issues did not include a response. Stratified by time since surgery, significantly more patients did not fill out a prioritized issue had a follow-up >6 months since surgery. In total, 72 % follow-up visits were evaluated to be necessary in order to discuss the outcome of the CT scan, symptoms, and/or prioritized issues. Contrary, 19% of the follow-up visits were evaluated to be necessary only to discuss the result of the CT scan. A range from 19.3–56.3% of patients assessed the follow-up visit to provide support with respect to physical (42% of patients), mental (56%), sexual (19%) or dietary (27%) issues. Further, a range from 34–60% of the patients reported that they did not need support regarding physical (43% of patients), mental (34%), sexual (63%) or dietary (57%) issues. CONCLUSIONS An individualized follow-up based on e-PRO is feasible, and support most patients surgically treated for advanced cancer. However, results indicate that follow-up based on e-PRO may not be beneficial for all patients and circumstances. A thorough cost-benefit analysis may be warranted before implementation in routine clinic.

Minimum 10-Year Outcomes of Primary Arthroscopic Transosseous-Equivalent Double-Row Rotator Cuff Repair

2021 ◽  
pp. 036354652110154
Author(s):  
Adam M. Johannsen ◽  
Justin W. Arner ◽  
Bryant P. Elrick ◽  
Philip-C. Nolte ◽  
Dylan R. Rakowski ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Revision Surgery ◽  
Rotator Cuff Repair ◽  
Patient Reported Outcomes ◽  
Long Term Results ◽  
Double Row ◽  
Kaplan Meier ◽  
Patient Reported ◽  
Cuff Repair

Background: Modern rotator cuff repair techniques demonstrate favorable early and midterm outcomes, but long-term results have yet to be reported. Purpose: To determine 10-year outcomes and survivorship after arthroscopic double-row transosseous-equivalent (TOE) rotator cuff repair. Study Design: Case series; Level of evidence 4. Methods: The primary TOE rotator cuff repair procedure was performed using either a knotted suture bridge or knotless tape bridge technique on a series of patients with 1 to 3 tendon full-thickness rotator cuff tears involving the supraspinatus. Only patients who were 10 years postsurgery were included. Patient-reported outcomes were collected pre- and postoperatively, including American Shoulder and Elbow Surgeons (ASES), 12-Item Short Form Health Survey (SF-12), Single Assessment Numeric Evaluation (SANE), shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH), and satisfaction. Kaplan-Meier survivorship analysis was performed. Failure was defined as progression to revision surgery. Results: A total of 91 shoulders (56 men, 31 women) were included between October 2005 and December 2009. Mean follow-up was 11.5 years (range, 10.0-14.1 years). Of 91 shoulders, 5 (5.5%) failed and required revision surgery. Patient-reported outcomes for patients who survived were known for 80% (69/86). Outcomes scores at final follow-up were as follows: ASES, 93.1 ± 10.8; SANE, 87.5 ± 14.2; QuickDASH, 11.1 ± 13.5; and SF-12 physical component summary (PCS), 49.2 ± 10.1. There were statistically significant declines in ASES, SANE, and SF-12 PCS from the 5-year to 10-year follow-up, but none of these changes met the minimally clinically important difference threshold. Median satisfaction at final follow-up was 10 (range, 3-10). From this cohort, Kaplan-Meier survivorship demonstrated a 94.4% survival rate at a minimum of 10 years. Conclusion: Arthroscopic TOE rotator cuff repair demonstrates high patient satisfaction and low revision rates at a mean follow-up of 11.5 years. This information may be directly utilized in surgical decision making and preoperative patient counseling regarding the longevity of modern double-row rotator cuff repair.

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