scholarly journals Treating the torn rotator cuff: current practice in the UK

2011 ◽  
Vol 93 (7) ◽  
pp. 532-536 ◽  
Author(s):  
PM Robinson ◽  
HA Doll ◽  
BR Roy
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
The Elderly ◽  
Median Number ◽  
Rotator Cuff Tears ◽  
Conflicting Evidence ◽  
Repair Activity ◽  
The Uk ◽  
Cuff Repair ◽  
Mini Open

INTRODUCTION The aim of this study was to characterise current rotator cuff repair activity in the UK with emphasis on the management of rotator cuff tears in the elderly population (over 70s). METHODS A one-page web-based survey was created. All British Elbow and Shoulder Society (BESS) members and surgeons who listed the shoulder as an area of specialist interest on the website http://www.specialistInfo.com/ were invited to complete this. RESULTS A total of 103 surgeons completed the survey; most (n=89, 86%) were BESS members. They had spent a median of 10 years (range: 9 months — 30 years) in consultant practice and performed an annual median of 200 (range: 0—1,000) arthroscopic shoulder procedures. For rotator cuff repair the favoured method was arthroscopic for 47 consultants (46.5%), open or mini-open for 41 (40.6%) and both for 13 (12.9%). The annual median number of arthroscopic and open cuff repairs was 20 (range: 0—250) and 12 (range: 0—100) respectively. The longer the time in practice, the fewer the reported number of arthroscopic cuff repairs (rs=-0.22, p=0.027) and the greater the number of open and mini-open cuff repairs (rs=0.33, p=0.001). In the management of a full-thickness rotator cuff tear in a patient over 70 years of age, 27 (26.7%) would perform an open or mini-open repair, 43 (42.6%) an arthroscopic repair and 22 (21.8%) would not attempt a repair. CONCLUSIONS Surgeons performing a higher volume of arthroscopic cuff repairs annually were more likely to repair cuff tears and they predicted significantly better outcomes of cuff repair for both pain and shoulder movement. Our results reflect the existing conflicting evidence regarding the indications for and methods of treatment of rotator cuff disease.

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.

Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis

2021 ◽  
Vol 49 (12) ◽  
pp. 3184-3195
Author(s):  
Joy C. MacDermid ◽  
Dianne Bryant ◽  
Richard Holtby ◽  
Helen Razmjou ◽  
Kenneth Faber ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Adverse Events ◽  
Rotator Cuff Repair ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Mean Difference ◽  
Rotator Cuff Tears ◽  
Standardized Mean Difference ◽  
Cuff Repair ◽  
Mini Open

Background: Patients with complete rotator cuff tears who fail a course of nonoperative therapy can benefit from surgical repair. Purpose: This randomized trial compared mini-open (MO) versus all-arthroscopic (AA) rotator cuff repair. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Patients with rotator cuff tears were randomized to undergo MO or AA repair at 9 centers by 23 surgeons. The primary outcome (Western Ontario Rotator Cuff Index [WORC]) and secondary outcomes (American Shoulder and Elbow Surgeons [ASES] score, Shoulder Pain and Disability Index [SPADI] pain subscale, 12-Item Short Form Health Survey [SF-12], reported medication use, adverse events), as well as measurements of range of motion and strength, were collected at 1 month before surgery; at 2 and 6 weeks postoperatively; and at 3, 6, 12, 18, and 24 months postoperatively. A blinded radiologist evaluated rotator cuff integrity on magnetic resonance imaging (MRI) at baseline and 1 year. Intention-to-treat analysis of covariance with the preoperative WORC score, age, and tear size as covariates assessed continuous outcomes. Sex differences were assessed. A meta-analysis synthesized the primary outcome between MO and AA repair with previous trials. Results: From 954 patients screened, 411 were ineligible (276 because of recovery with physical therapy), 449 were screened at surgery (175 ineligible), and 274 completed follow-up (138 MO and 136 AA). The AA and MO groups were similar before surgery. WORC scores improved from 40 preoperatively to 89 (AA) and 93 (MO) at 2 years, for an adjusted mean difference of 3.4 (95% CI, –0.4 to 7.2). There were no statistically significant differences between the AA and MO groups at any time point. All secondary patient-reported outcomes were not significantly different between the MO and AA groups, except the 2-year SPADI pain score (8 vs 12, respectively; P = .02). A similar recovery in range of motion and strength occurred in both groups over time. MRI indicated minimal improvement in muscle relative to fat (AA: n = 3; MO: n = 2), with most worsening (AA: n = 25; MO: n = 24) or remaining unchanged (AA: n = 70; MO: n = 70). Opioid use was significantly reduced after surgery (from 21% to 5%). The meta-analysis indicated no significant standardized mean difference between groups in the primary outcome across all pooled studies (standardized mean difference, –0.06 [95% CI, –0.34 to 0.22]). Conclusion: Both AA and MO rotator cuff repair provide large clinical benefits, with few adverse events. There is strong evidence of equivalent clinical improvements. Trial Registration: NCT00128076.

A Randomized Clinical Trial Comparing Open to Arthroscopic Acromioplasty with Mini-Open Rotator Cuff Repair for Full-Thickness Rotator Cuff Tears

2008 ◽  
Vol 36 (6) ◽  
pp. 1043-1051 ◽  
Author(s):  
Nicholas G. Mohtadi ◽  
Robert M. Hollinshead ◽  
Treny M. Sasyniuk ◽  
Jennifer A. Fletcher ◽  
Denise S. Chan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Rotator Cuff ◽  
Randomized Clinical Trial ◽  
Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Cuff Repair ◽  
Mini Open

Arthroscopically assisted mini-open rotator cuff repair

2002 ◽  
Vol 18 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Theodore J. Shinners ◽  
Peter G. Noordsij ◽  
John F. Orwin
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Arthroscopically Assisted ◽  
Cuff Repair ◽  
Mini Open

Freeze-dried chitosan-platelet-rich plasma implants improve supraspinatus tendon attachment in a transosseous rotator cuff repair model in the rabbit

2018 ◽  
Vol 33 (6) ◽  
pp. 792-807 ◽  
Author(s):  
Gabrielle Deprés-Tremblay ◽  
Anik Chevrier ◽  
Martyn Snow ◽  
Scott Rodeo ◽  
Michael D Buschmann
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Platelet Rich Plasma ◽  
Rabbit Model ◽  
Supraspinatus Tendon ◽  
Rotator Cuff Tears ◽  
Polymorphonuclear Cells ◽  
Post Surgery ◽  
Freeze Dried ◽  
Cuff Repair

Rotator cuff tears result in shoulder pain, stiffness, weakness and loss of motion. After surgical repair, high failure rates have been reported based on objective imaging and it is recognized that current surgical treatments need improvement. The aim of the study was to assess whether implants composed of freeze-dried chitosan (CS) solubilized in autologous platelet-rich plasma (PRP) can improve rotator cuff repair in a rabbit model. Complete tears were created bilaterally in the supraspinatus tendon of New Zealand White rabbits ( n = 4 in a pilot feasibility study followed by n = 13 in a larger efficacy study), which were repaired using transosseous suturing. On the treated side, CS-PRP implants were injected into the transosseous tunnels and the tendon itself, and healing was assessed histologically at time points ranging from one day to two months post-surgery. CS-PRP implants were resident within transosseous tunnels and adhered to tendon surfaces at one day post-surgery and induced recruitment of polymorphonuclear cells from 1 to 14 days. CS-PRP implants improved attachment of the supraspinatus tendon to the humeral head through increased bone remodelling at the greater tuberosity and also inhibited heterotopic ossification of the supraspinatus tendon at two months. In addition, the implants did not induce any detectable deleterious effects. This preliminary study provides the first evidence that CS-PRP implants could be effective in improving rotator cuff tendon attachment in a small animal model.

Arthroscopic versus Mini-Open Rotator Cuff Repair

2008 ◽  
Vol 36 (9) ◽  
pp. 1824-1828 ◽  
Author(s):  
Kenneth Morse ◽  
A. David Davis ◽  
Robert Afra ◽  
Elizabeth Krall Kaye ◽  
Anthony Schepsis ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Cuff Repair ◽  
Mini Open

Mini-open Rotator Cuff Repair

2011 ◽  
pp. 31-39
Author(s):  
W. Anthony Frisella ◽  
Frances Cuomo
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Cuff Repair ◽  
Mini Open

scholarly journals Mini-open Rotator Cuff Repair Using Anterolateral Approach

2010 ◽  
Vol 13 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Chul-Hyun Cho ◽  
Kyung-Ki Yeo ◽  
Sung-Yoon Lee ◽  
Gu-Hee Jung
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Anterolateral Approach ◽  
Cuff Repair ◽  
Mini Open

scholarly journals Outcome and Structural Integrity of Rotator Cuff after Arthroscopic Treatment of Large and Massive Tears with Double Row Technique: A 2-Year Followup

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ignacio Carbonel ◽  
Angel A. Martínez ◽  
Elisa Aldea ◽  
Jorge Ripalda ◽  
Antonio Herrera
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Rotator Cuff Repair ◽  
Structural Integrity ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Double Row ◽  
Massive Rotator Cuff Tears ◽  
Cuff Repair

Purpose. The purpose of this study was to evaluate the functional outcome and the tendon healing after arthroscopic double row rotator cuff repair of large and massive rotator cuff tears.Methods. 82 patients with a full-thickness large and massive rotator cuff tear underwent arthroscopic repair with double row technique. Results were evaluated by use of the UCLA, ASES, and Constant questionnaires, the Shoulder Strength Index (SSI), and range of motion. Follow-up time was 2 years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and 2 years after repair.Results. 100% of the patients were followed up. UCLA, ASES, and Constant questionnaires showed significant improvement compared with preoperatively (P<0.001). Range of motion and SSI in flexion, abduction, and internal and external rotation also showed significant improvement (P<0.001). MRI studies showed 24 cases of tear after repair (29%). Only 8 cases were a full-thickness tear.Conclusions. At two years of followup, in large and massive rotator cuff tears, an arthroscopic double row rotator cuff repair technique produces an excellent functional outcome and structural integrity.

Sign in / Sign up

Export Citation Format

Share Document