Mini-open repair for massive and irreparable rotator cuff tears with long head of biceps including technique: results at 5 years of follow-up

Abstract Introduction The long head of biceps tendon is frequently involved in degenerative rotator cuff tears. Therefore, this study explored the clinical results of an isolated biceps tenotomy and identified prognostic factors for improvement in pain and function. Materials and methods Between 2008 and 2017, an arthroscopic isolated biceps tenotomy was performed on 64 patients with a degenerative rotator cuff tear (> 65 years). Primary outcome was patient-perceived improvement in pain and function. Potential prognostic factors for improvement in pain and function were identified. Results A perceived improvement in pain was reported in 78% of the patients at three months after surgery and in 75% at a mean follow-up of 4.2 years (1–7 years; n = 55). A perceived improvement in function was observed in 49% of patients at three months and in 76% of patients at follow-up. Patients with a preoperatively normal acromiohumeral distance (> 10 mm) reported an improvement in pain and function significantly more often. Retraction of the supraspinatus tendon Patte 3 was significantly associated with worse functional outcome. Conclusions A biceps tenotomy can be a reliable treatment option for patients with symptomatic degenerative cuff tears who fail conservative treatment and have a normal acromiohumeral distance (> 10 mm).

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Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears

Medicine ◽

10.1097/md.0000000000006322 ◽

2017 ◽

Vol 96 (11) ◽

pp. e6322 ◽

Cited By ~ 10

Author(s):

Jin Liu ◽

Lin Fan ◽

Yingbo Zhu ◽

Haotong Yu ◽

Tianyang Xu ◽

...

Keyword(s):

Rotator Cuff ◽

Clinical Outcomes ◽

Open Repair ◽

Rotator Cuff Tears ◽

Mini Open

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Early Postoperative Outcomes Between Arthroscopic and Mini-open Repair for Rotator Cuff Tears

Orthopedics ◽

10.3928/01477447-20120822-20 ◽

2012 ◽

Vol 35 (9) ◽

pp. e1347-e1352 ◽

Cited By ~ 21

Author(s):

Chul-Hyun Cho ◽

Kwang-Soon Song ◽

Gu-Hee Jung ◽

Young-Kuk Lee ◽

Hong-Kwan Shin

Keyword(s):

Rotator Cuff ◽

Open Repair ◽

Postoperative Outcomes ◽

Rotator Cuff Tears ◽

Mini Open

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Osteoarthritis progression of the shoulder: A long-term follow-up after mini-open rotator cuff repair

Journal of Orthopaedic Surgery ◽

10.1177/2309499018768106 ◽

2018 ◽

Vol 26 (2) ◽

pp. 230949901876810 ◽

Cited By ~ 6

Author(s):

Tomoyuki Matsuba ◽

Yukihiko Hata ◽

Norio Ishigaki ◽

Koichi Nakamura ◽

Hiroyuki Kato

Keyword(s):

Rotator Cuff ◽

Primary Repair ◽

Rotator Cuff Tears ◽

Similar Degree ◽

Affected Side ◽

Long Term Follow Up ◽

Shoulder Arthritis ◽

Osteoarthritis Progression ◽

Mini Open

Objective: This study aimed to investigate whether (1) the primary repair of rotator cuff tears can prevent the progression of osteoarthritis (OA) and (2) the quality of postoperative cuff integrity affects the incidence of osteoarthritic changes. Methods: A total of 86 patients treated with mini-open repair for rotator cuff tears over a minimum of 10 years of follow-up (mean ± standard deviation 11.1 ± 1.0 years) were retrospectively analyzed. Preoperative and postoperative radiographs of the affected and unaffected sides were compared, and the degree of OA was evaluated using the Samilson and Prieto classification. Magnetic resonance imaging was used to evaluate cuff integrity, classify patients into good and poor cuff integrity groups, and compare the degree of OA between the two groups. Results: OA deteriorated either significantly or to a similar degree on both sides postoperatively. However, OA progressed in significantly more cases on the affected side. A comparison between the aforementioned cuff integrity groups showed that the postoperative OA of the poor cuff integrity group was significantly worse than that of the good cuff integrity group on the affected side. Conclusion: Our study showed that even if rotator cuff tears are repaired, the progression of osteoarthritic changes cannot be halted. The progression of OA was affected by cuff integrity. Rotator cuff dysfunction due to poor cuff integrity was a risk factor for shoulder arthritis.

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PRP-Therapy for Tendinopathies of Rotator Cuff and Long Head of Biceps

Traumatology and Orthopedics of Russia ◽

10.21823/2311-2905-2019-25-3-57-66 ◽

2019 ◽

Vol 25 (3) ◽

pp. 57-66

Author(s):

D. A. Malanin ◽

A. I. Norkin ◽

A. S. Tregubov ◽

M. V. Demeshchenko ◽

L. L. Cherezov

Keyword(s):

Rotator Cuff ◽

Treatment Outcomes ◽

Platelet Rich Plasma ◽

Impingement Syndrome ◽

Subacromial Impingement Syndrome ◽

Subacromial Impingement ◽

Long Head Of Biceps ◽

Functional Scores ◽

Long Head

Relevance. Owing to its controlling action on the inflammatory process, pain-relieving and reparative effects the RPR-therapy became quite demanded for treatment of certain types of tendinopathies specified by prevalence of degenerative process and poor reparative potential. Purpose of the study — to evaluate the efficiency of PRP-therapy in patients with tendinopathies of rotator cuff (RC) long head of biceps (LHB) tendons. Material and Methods. The paper presents the results of two-center prospective study for application of autologous platelet rich plasma in treatment of 122 patients: 53 men and 69 women aging 46.8±6.8 years who suffered RC tendinopathy (66%), subacromial impingement syndrome and RC tendinopathy (17%) and LHB tendinopathy (17%). Treatment outcomes were evaluated in 1, 3 and 6 months after PRP-therapy using various scales — VAS, UCLA , DASH, — and instrumental examination methods (US, MRI). Results. The authors observed statistically significant improvement in pain and functional scores in all three groups as compared to reported scores prior to PRP-therapy during 6 months follow up. During this period of evaluation, the scores of UCLA and DASH in patients with RC tendinopathy improved at 8.6 and 36.4 points, with subacromial impingement syndrome and RC tendinopathy — at 9.6 and 38.8 points, with LHB tendinopathy — at 11.5 and 44.1 point, respectively. The most notable reduction of pain syndrome by VAS was achieved in treatment of LHB tendinopathy (at 5.4 points) and RC tendinopathy (at 5.2 point). The highest average scores of satisfaction with treatment outcomes were reported in patients with RC tendinopathy (2.3) and LHB tendinopathy (2.2). MRI and ultrasound examinations after PRP-therapy demonstrated improved structure of RC and LHB tendons — decreased or eliminated swelling, areas of hypoechoic signal. Conclusion. PRP-therapy in patients with RC and LHB tendons and with subacromial impingement syndrome with RC tendinopathy significantly reduces severity of pain and improved the shoulder joint function with positive dynamics during 6 months follow up.

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