scholarly journals Large Footprint Bone Cyst: Arthroscopic Autologous Cylinder Press-Fit with Buddy Anchor Interference-Fit for Rotator Cuff Repair

2021 ◽  
Vol 11 (8) ◽  
Author(s):  
Aurélien Traverso ◽  
Katharina Johanna Friedrich ◽  
Winfried Reichert ◽  
Stefan Bauer
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Iliac Crest ◽  
Bone Cyst ◽  
Dash Score ◽  
Bone Cysts ◽  
Bone Stock ◽  
Interference Fit ◽  
Press Fit ◽  
Cuff Repair

Background: About 20–25% of all rotator cuff tears are associated with footprint bone cysts. Large cysts (>10 mm2) are rare but can be problematic for anchor fixation and rotator cuff repair. So far treatment of footprint bone cysts was described using large or several anchors, cement, or compaction grafting mostly with allograft bone being biologically inferior to restore bone stock compared to autologous grafts. Methods/Results: We report about a 57-year-old manual laborer with persistent pain and loss of shoulder function (subjective shoulder value [SSV] 50%). Magnetic resonance imaging showed a high-grade partial supraspinatus tendon tear (>50%) associated with a large supraspinatus footprint bone cyst (10 mm × 11 mm × 17 mm). An efficient setup in lateral position for arthroscopic autologous press-fit grafting from the iliac crest is described for single-stage arthroscopic rotator cuff repair. Improved fixation was achieved using a buddy anchor interference-fit technique. Conclusion: The clinical follow-up after 12 months showed an excellent outcome (SSV >90%, DASH-Score 14 points, and Constant-Score 87 points) with dynamic ultrasound and radiographs confirming tendon and bone stock restoration. Keywords: Footprint bone cyst, arthroscopic filling, iliac crest autologous grafting, anchor, rotator cuff repair.

scholarly journals Does Conservative Rehabilitation Program Lead to Long-Term Stiffness after Arthroscopic Rotator Cuff Repair?

2018 ◽  
Vol 24 (1) ◽  
pp. 47-51
Author(s):  
Chan Chun Ming ◽  
Li Pang Hei
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Rehabilitation Program ◽  
Arthroscopic Rotator Cuff Repair ◽  
Dash Score ◽  
Power Deficit ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background Evidence on the ideal rehabilitation program for arthroscopic rotator cuff repair is lacking. Most data and results are conflicting with no consensus made. This study aims to compare between an early aggressive program with immediate postoperative range-of-motion (ROM) exercises and a more conservative program with early restriction of motion in Hong Kong Chinese population. Materials and Methods We retrospectively evaluated 37 arthroscopic rotator cuff repair cases who underwent a standardized delayed rehabilitation protocol of immobilization for 4 weeks to 6 weeks before formal passive ROM exercises. Patients were evaluated at 3 months, 6 months, and 12 months after the surgery, for which they would be tested on passive forward flexion (FF). They were categorized as “stiff if FF was less than 100°. Constant score, Disability of Arm, Shoulder and Hand (DASH) score, Visual Analog Scale (VAS) score, and isometric abduction power deficit percentage were parameters to assess the functional outcome, and they were obtained in all of the patients’ last follow-up assessments. Results Two cases (5.4%) are considered “stiff 6 months after the surgery. At 1 year, the stiffness in both cases resolved, resulting in 0% rate of stiffness. The mean FF at 1 year was 153.33 ± 20.15, which is comparable to the literature. Two cases (5.4%) of clinical retear occurred. Mean Constant score at the latest follow-up was 62.4 ± 13.2. Mean VAS score was 1.1 ± 1.8 at rest and 2.8 ± 2.0 on exertion. Mean DASH score was 25.3 ± 21.9. Mean isometric abduction power deficit was 42.7% ± 0.2%. Discussion Historically, due to concerns on long-term stiffness, an early aggressive postoperative rehabilitation protocol was used. We found that an early restriction of ROM with 4 weeks to 6 weeks of immobilization did not lead to long-term stiffness and functional disadvantage. This includes patients with stiffness even before the operations. Conclusions Immobilization for 4 weeks to 6 weeks after arthroscopic rotator cuff repair does not result in long-term stiffness and may even be beneficial to cuff tendon healing.

scholarly journals Rotator Cuff Repair and the Bovine Bioinductive Patch: Excellent Functional Outcomes and Satisfaction in Patients with Comorbidities (238)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0034
Author(s):  
Kevin Plancher ◽  
Stephanie Petterson
Keyword(s):  
Patient Satisfaction ◽  
Rotator Cuff ◽  
Muscle Strength ◽  
Rotator Cuff Repair ◽  
Functional Outcomes ◽  
Consecutive Series ◽  
Dash Score ◽  
Full Thickness ◽  
Cuff Repair

Objectives: Structural failure of rotator cuff repair (RCR) has been reported to occur in 20-94% at one to two-year follow-up with 80% of these failures occurring within three months of surgical intervention. Poor functional outcomes as well as higher rates of retear have been reported in patients with compromised healing potential due to comorbidities such as diabetes, smoking, obesity, and hypercholesterolemia. Augmentation with growth factors and stem cells and/or biologically augmented patches has been shown to decrease re-tear rates. Biologically-augmented patches provide an environment that is conducive for cell and vessel migration. We investigated patient outcomes following RCR plus bovine bioinductive patch augmentation. Methods: A consecutive series of patients (2015-2018) that underwent RCR plus bovine bioinductive patch by a single surgeon were identified. Patients with diabetes, obesity, hypercholesterolemia, and smokers were included. Patients were excluded with revision rotator cuff repairs. Physical exam included shoulder ROM and manual muscle strength. Patients completed DASH, SF-12 physical and mental, VAS pain and patient satisfaction scores to assess postoperative functional outcomes. Paired sample t-tests were used to assess differences before and after surgery (p<0.05). Results: Sixteen patients (5 females, 62.3±14 years of age, BMI 32.3±13.7) that underwent arthroscopic RCR plus bovine bioinductive patch augmentation were included. Twelve patients had symptomatic 50-90% partial tears and four patients had full thickness tears. Average follow-up was 25.8±13.1 months. Mean shoulder flexion increased from 148.8°±17.5° to 164.7°±15.0° (p=0.0097), external rotation at 90° abduction increased from 67.8°±36.4° to 88.4°±3.5° (p=0.0316). No significant changes were seen in internal rotation behind the back (p=0.1750) or shoulder muscle strength measurements (all p>0.4471). Postoperative DASH score was 10.4±12.8, SF-12 physical score was 52.8±5, SF-12 mental score was 54.2±5.6, VAS pain score was 0.56±0.88, and patient satisfaction was 8.5±0.55. There were no complications or clinical failures at average 3-year follow-up. Patients returned to preoperative sports, including tennis, swimming, bowling, and weightlifting at an average of 21.9±14.3 weeks. Conclusions: RCR with bovine bioinductive patch augmentation is a good alternative treatment for patients with multiple comorbidities and partial and full thickness rotator cuff tears yielding high patient satisfaction, no loss of shoulder ROM or strength, good functional outcomes, and return to preoperative sports.

Advantages and Techniques of Utilizing Anterolateral Portal in Delaminated Rotator Cuff Repair

2014 ◽  
Vol 23 (03) ◽  
pp. 170-173
Author(s):  
Prithviraj Chavan ◽  
Todd K. Gothelf ◽  
Keith M. Nord ◽  
William H. Garrett ◽  
Keith D. Nord
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Anterolateral Portal ◽  
Cuff Repair
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