scholarly journals Degenerative rotator cuff tear, repair or not repair? A review of current evidence

2020 ◽  
Vol 102 (4) ◽  
pp. 248-255 ◽  
Author(s):  
AA Narvani ◽  
MA Imam ◽  
A Godenèche ◽  
E Calvo ◽  
S Corbett ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Significant Risk ◽  
Tendon Healing ◽  
Rotator Cuff Tears ◽  
Current Evidence ◽  
Online Databases ◽  
History Of ◽  
Physiotherapy Programme ◽  
Rotator Cuff Tear Repair

Introduction We review the literature and highlight the important factors to consider when counselling patients with non-traumatic rotator cuff tears on which route to take. Factors include the clinical outcomes of surgical and non-surgical routes, tendon healing rates with surgery (radiological outcome) and natural history of the tears if treated non-operatively. Methods A PRISMA-compliant search was carried out, including the online databases PubMed and Embase™ from 1960 to the end of June 2018. Findings A total of 49 of the 743 (579 PubMed and 164 Embase™) results yielded by the preliminary search were included in the review. There is no doubt that the non-surgical route with an appropriate physiotherapy programme has a role in the management of degenerative rotator cuff tears. This is especially the case in patients with significant risk factors for surgery, those who do not wish to go through a surgical treatment and those with small, partial and irreparable tears. However, rotator cuff repair has a good clinical outcome with significant improvements in pain, range of motion, strength, quality of life and sleep patterns.

scholarly journals Personalized, Predictive, Participatory, Precision, and Preventive (P5) Medicine in Rotator Cuff Tears

2021 ◽  
Vol 11 (4) ◽  
pp. 255
Author(s):  
Umile Giuseppe Longo ◽  
Arianna Carnevale ◽  
Carlo Massaroni ◽  
Daniela Lo Presti ◽  
Alessandra Berton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Environmental Factors ◽  
Multidisciplinary Approach ◽  
Musculoskeletal Disorder ◽  
Scientific Evidence ◽  
Rotator Cuff Tears ◽  
Diagnosis And Therapy

Rotator cuff (RC) disease is a common musculoskeletal disorder of the shoulder entailing pain, with reduced functionality and quality of life. The main objective of this study was to present a perspective of the current scientific evidence about personalized, predictive, participatory, precision, and preventive approaches in the management of RC diseases. The personalized, predictive, participatory, precision and preventive (P5) medicine model is an interdisciplinary and multidisciplinary approach that will provide researchers and clinicians with a comprehensive patrimony of knowledge in the management of RC diseases. The ability to define genetic predispositions in conjunction with the evaluation of lifestyle and environmental factors may boost the tailoring of diagnosis and therapy in patients suffering from RC diseases.

Exploring the Business Case for Improving Quality of Care for Patients With Chronic Rotator Cuff Tears

2019 ◽  
Vol 28 (4) ◽  
pp. 209-221
Author(s):  
Breda H. Eubank ◽  
J. C. Herbert Emery ◽  
Mark R. Lafave ◽  
J. Preston Wiley ◽  
David M. Sheps ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Rotator Cuff ◽  
Business Case ◽  
Rotator Cuff Tears

scholarly journals Outcomes of the Star Repair for Large and Massive Rotator Cuff Tears: A Modified Triple-Row Technique

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712095299
Author(s):  
Mohamed G. Morsy ◽  
Hesham M. Gawish ◽  
Mostafa A. Galal ◽  
Ahmed H. Waly
Keyword(s):  
Quality Of Life ◽  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Functional Evaluation ◽  
Massive Rotator Cuff Tears ◽  
Health Related ◽  
The Mean ◽  
Cuff Repair ◽  
Disease Specific

Background: Large and massive rotator cuff repairs constitute a true challenge for arthroscopic shoulder surgeons. Retear rates as high as 20% have been reported after arthroscopic double-row and suture-bridge techniques used for these tears. Hypothesis: A modified triple-row repair will provide satisfactory clinical results with lower risk for retear. Study Design: Case series; Level of evidence, 4. Methods: Between March 2016 and August 2017, a total of 52 patients with large and massive rotator cuff tears received a modified triple-row cuff repair. A middle repositioning anchor was inserted between the medial and the lateral rows. The middle anchor sutures were loaded to lateral knotless anchors in a star-shaped configuration. Functional evaluation was performed using the American Shoulder and Elbow Surgeons score, University of California, Los Angeles score, Constant-Murley score, and Simple Shoulder Test. Subjective evaluation was carried out using a visual analog scale for pain and a subjective shoulder value score. Health-related as well as disease-specific quality-of-life scores were also used. Retear rates were assessed by means of musculoskeletal ultrasonography. Patients were evaluated for a minimum of 24 months. Results: This study included 34 female and 18 male patients with a mean age of 57.17 ± 6.7 years. There were 35 patients (67.3%) with large tears and 17 patients (32.7%) with massive tears. Significant improvement from preoperative values was seen in all functional and subjective scores ( P < .001). The mean forward flexion was 163° ± 9.7°, and the mean lateral abduction was 159.4° ± 9.4°. All patients had excellent scores on the general health-related and disease-specific quality-of-life scales. No retears were reported at the end of the follow-up period. Conclusion: The star-shaped, modified triple-row cuff repair is a valid and effective solution for surgical management of large and massive rotator cuff tears, providing excellent results and low risk for retears.

scholarly journals Arthroscopic-Assisted Latissimus Dorsi Tendon Transfer for Massive Rotator Cuff Tears: A Systematic Review

2018 ◽  
Vol 6 (6) ◽  
pp. 232596711877773 ◽  
Author(s):  
Muzammil Memon ◽  
Jeffrey Kay ◽  
Emily Quick ◽  
Nicole Simunovic ◽  
Andrew Duong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Shoulder Pain ◽  
Latissimus Dorsi ◽  
Tendon Transfer ◽  
Clinical Findings ◽  
Rotator Cuff Tears ◽  
Level Of Evidence ◽  
Massive Rotator Cuff Tears

Background: Arthroscopic-assisted latissimus dorsi tendon transfer (LDTT) has shown promising results with good outcomes in patients with massive rotator cuff tears (MRCTs), as reported by individual studies. However, to the best of the authors’ knowledge, no systematic review has been performed to assess the collective outcomes of these individual studies. Purpose/Hypothesis: The primary purpose of this study was to assess patient outcomes after arthroscopic-assisted LDTT for the management of MRCTs. The secondary objectives were to report on the management of MRCTs, including diagnostic investigations, surgical decision making, and arthroscopic techniques, as well as to evaluate the quality of evidence of the existing literature. It was hypothesized that nearly all patients were satisfied with arthroscopic-assisted LDTT and that they experienced improvements in pain symptoms, function, and strength after the procedure, with an overall complication rate of less than 10%. Study Design: Systematic review; Level of evidence, 4. Methods: The databases MEDLINE, Embase, and PubMed were searched from database inception (1946) until August 18, 2017, with titles, abstracts, and full-text articles screened independently by 2 reviewers. Inclusion criteria were English-language studies investigating arthroscopic-assisted LDTT for the management of MRCTs on patients of all ages. Conference papers, book chapters, review articles, and technical reports were excluded. The quality of the included studies was categorized by level of evidence and the Methodological Index for Non-Randomized Studies (MINORS) checklist. Results: In total, 8 studies (7 case series [median MINORS score, 7 of 16] and 1 prospective comparative study [median MINORS score, 14 of 24]) were identified; the studies included 258 patients (258 shoulders) with MRCTs treated with LDTT using arthroscopic-assisted techniques. The decision to pursue surgery was based on both clinical findings and investigations in 5 studies, investigations only in 2 studies, and clinical findings only in 1 study. Overall, 88% of patients were satisfied with the results of surgery and experienced significant improvement in their symptoms, including shoulder pain, strength, range of motion, and overall function, over a mean follow-up period of 34.3 months. Overall, there was a low rate of complications (7%) associated with the procedure. Conclusion: Arthroscopic-assisted LDTT for MRCTs provides patients with marked improvement in shoulder pain, strength, and function, and the procedure is associated with a low risk of complication. Further high-quality comparative studies are warranted to validate these findings in comparison with other operative techniques.

The Relationship Between In-Vivo Glenohumeral Joint Motion and Joint Morphology in Rotator Cuff Repair Patients and Healthy Control Subjects

2011 ◽  
Author(s):  
Cathryn D. Peltz ◽  
Kristin Ciarelli ◽  
Jeffrey A. Haladik ◽  
Michael J. McDonald ◽  
Nicole Ramo ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Glenohumeral Joint ◽  
Rotator Cuff Tears ◽  
Joint Motion ◽  
Healthy Control ◽  
The Relationship ◽  
Cuff Repair

Rotator cuff tears are a common condition that adversely affect function and quality of life. Altered glenohumeral joint (GHJ) motion is believed to contribute to the development of rotator cuff tears. Previous research has demonstrated relationships between in-vivo joint motion and bony morphology (particularly in the knee [e.g., 1]), and similar relationships have been reported in cadaveric shoulder studies [2, 3]. However, the extent to which these relationships exist under in-vivo conditions or if these relationships are altered in shoulders with pathologic conditions is not known. Thus, the objective of this study was to assess the relationship between glenoid/humerus morphology and in-vivo GHJ motion in healthy control shoulders and rotator cuff repair patients. We hypothesized that a relationship exists between glenoid/humerus morphology and GHJ motion in healthy control shoulders, but that this relationship is altered in rotator cuff patients.

Partial-Thickness Rotator Cuff Tears

2005 ◽  
Vol 33 (9) ◽  
pp. 1405-1417 ◽  
Author(s):  
Matthew J. Matava ◽  
Derek B. Purcell ◽  
Jonas R. Rudzki
Keyword(s):  
Rotator Cuff ◽  
Natural History ◽  
Diagnostic Techniques ◽  
Relative Accuracy ◽  
Diagnostic Methods ◽  
Rotator Cuff Tears ◽  
Full Thickness ◽  
Operative Repair ◽  
Partial Thickness ◽  
History Of

Partial-thickness tears of the rotator cuff have been diagnosed with increased frequency because of a heightened awareness of the condition by clinicians and improved diagnostic methods. Research into the causes, natural history, and optimal treatment of this condition lags behind that of full-thickness tears. However, despite the limitations in the existing literature, there has emerged a consensus among shoulder experts that partial-thickness rotator cuff tears should be aggressively treated in the active athlete because of the unfavorable natural history of these lesions and success of accepted surgical algorithms. This review will provide an overview of the theories regarding the origins of partial-thickness rotator cuff tears, discuss the relative accuracy of accepted diagnostic techniques, and summarize the indications and methods of operative repair with an emphasis on the results of various treatment approaches.

Return to Sport After Rotator Cuff Tear Repair

2015 ◽  
Vol 44 (7) ◽  
pp. 1877-1887 ◽  
Author(s):  
Shahnaz Klouche ◽  
Nicolas Lefevre ◽  
Serge Herman ◽  
Antoine Gerometta ◽  
Yoann Bohu
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Meta Analysis ◽  
Return To Sport ◽  
Rate Of Return ◽  
Rotator Cuff Tears ◽  
Recreational Athletes ◽  
Cuff Tear ◽  
Competitive Athletes ◽  
Rotator Cuff Tear Repair

Background: One of the most frequent demands from athletes after rotator cuff tear repair is to return to sport, if possible at the same level of play. Purpose: The main goal of this study was to determine the rate of return to sport after treatment of rotator cuff tears. Study Design: Meta-analysis and systematic review. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review and meta-analysis of the results in the literature, as well as for the presentation of results. A search of the literature was performed on the electronic databases MEDLINE, Scopus, EMBASE, and the Cochrane Library. The quality of the included studies was evaluated according to the MINORS (Methodological Index for Nonrandomized Studies) checklist. Inclusion criteria were studies in English evaluating return to sport after treatment of traumatic, degenerative, partial or full-thickness rotator cuff tears in patients practicing a sport regularly, whatever the level, all ages and sports included. The main judgment criterion was the number of patients who returned to a sports activity after treatment of a rotator cuff tear. The criterion was analyzed in 2 ways: return to sport (yes/no) and the level of play (identical or higher/lower level). Results: Twenty-five studies were reviewed, including 859 patients (683 athletes), all treated surgically after a mean follow-up of 3.4 years (range, 0.3-13.4 years). The level of sports was recorded in 23 studies or 635 (93%) athletes and included 286 competitive or professional athletes and 349 recreational athletes. The most commonly practiced sports were baseball (224 participants), tennis (104 participants), and golf (54 participants). The overall rate of return to sport was 84.7% (95% CI, 77.6%-89.8%), including 65.9% (95% CI, 54.9%-75.4%) at an equivalent level of play, after 4 to 17 months. Of the professional and competitive athletes, 49.9% (95% CI, 35.3-64.6%) returned to the same level of play. Conclusion: Most recreational athletes return to sports at the same level of play as before their injury, but only half of professional and competitive athletes return to an equivalent level of play.

scholarly journals Functional repair in massive immobile rotator cuff tears leads to satisfactory quality of living: results at 3-year follow-up

2013 ◽  
Vol 97 (S1) ◽  
pp. 73-77 ◽  
Author(s):  
P. Arrigoni ◽  
C. Fossati ◽  
L. Zottarelli ◽  
V. Ragone ◽  
P. Randelli
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tears ◽  
Quality Of Living ◽  
Satisfactory Quality

Arthroscopic Single-Row Versus Double-Row Suture Bridge Technique for Rotator Cuff Tears in Patients Younger Than 55 Years: A Prospective Comparative Study

2017 ◽  
Vol 46 (1) ◽  
pp. 116-121 ◽  
Author(s):  
Michael E. Hantes ◽  
Yohei Ono ◽  
Vasilios A. Raoulis ◽  
Nikolaos Doxariotis ◽  
Aaron Venouziou ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Clinical Outcomes ◽  
Constant Score ◽  
Tendon Healing ◽  
Rotator Cuff Tears ◽  
Double Row ◽  
Single Row ◽  
Suture Bridge ◽  
Ucla Score ◽  
Arthroscopic Rotator Cuff

Background: When arthroscopic rotator cuff repair is performed on a young patient, long-lasting structural and functional tendon integrity is desired. A fixation technique that potentially provides superior tendon healing should be considered for the younger population to achieve long-term clinical success. Hypothesis/Purpose: The purpose was to compare the radiological and clinical midterm results between single-row and double-row (ie, suture bridge) fixation techniques for arthroscopic rotator cuff repair in patients younger than 55 years. We hypothesized that a double-row technique would lead to improved tendon healing, resulting in superior mid- to long-term clinical outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: A consecutive series of 66 patients younger than 55 years with a medium to large full-thickness tear of supraspinatus and infraspinatus tendons who underwent arthroscopic single-row or double-row (ie, suture bridge) repair were enrolled and prospectively observed. Thirty-four and 32 patients were assigned to single-row and double-row groups, respectively. Postoperatively, tendon integrity was assessed by MRI following Sugaya’s classification at a minimum of 12 months, and clinical outcomes were assessed with the Constant score and the University of California, Los Angeles (UCLA) score at a minimum of 2 years. Results: Mean follow-up time was 46 months (range, 28-50 months). A higher tendon healing rate was obtained in the double-row group compared with the single-row group (84% and 61%, respectively [ P < .05]). Although no difference in outcome scores was observed between the 2 techniques, patients with healed tendon demonstrated superior clinical outcomes compared with patients who had retorn tendon (UCLA score, 34.2 and 27.6, respectively [ P < .05]; Constant score, 94 and 76, respectively [ P < .05]). Conclusion: The double-row repair technique potentially provides superior tendon healing compared with the single-row technique. Double-row repair should be considered for patients younger than 55 years with medium to large rotator cuff tears.

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