scholarly journals Early and Delayed Postoperative Rehabilitation after Arthroscopic Rotator Cuff Repair: A Comparative Study of Clinical Outcomes

2019 ◽  
Vol 22 (4) ◽  
pp. 190-194
Author(s):  
Sungwook Choi ◽  
Kyu Bum Seo ◽  
Seungjae Shim ◽  
Ju Yeon Shin ◽  
Hyunseong Kang
Keyword(s):  
Rotator Cuff ◽  
Visual Analogue Scale ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Analogue Scale ◽  
Constant Score ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Shoulder Score

Background: The duration of immobilization after arthroscopic rotator cuff repair and the optimal time to commence rehabilitation are still the subject of ongoing debates. This study was undertaken to evaluate the functional outcome and rotator cuff healing status after arthroscopic rotator cuff repair by comparing early and delayed rehabilitation.Methods: Totally, 76 patients with small, medium, and large sized rotator cuff tears underwent arthroscopic repair using the suture-bridge technique. In early rehabilitation group, 38 patients commenced passive range of motion at postoperative day 2 whereas 38 patients assigned to the delayed rehabilitation group commenced passive range of motion at postoperative week 3. At the end of the study period, clinical and functional evaluations (Constant score, the University of California, Los Angeles [UCLA] shoulder score) were carried out, subsequent to measuring the range of motion, visual analogue scale for pain, and isokinetic dynamometer test. Rotator cuff healing was confirmed by magnetic resonance imaging at least 6 months after surgery.Results: No significant difference was obtained in range of motion and visual analogue scale between both groups. Functional outcomes showed similar improvements in the Constant score (early: 67.0?88.0; delayed: 66.9?91.0; <i>p</i><0.001) and the UCLA shoulder score (early: 20.3?32.3; delayed: 20.4?32.4; <i>p</i><0.001). Furthermore, rotator cuff healing showed no significant differences between the groups (range, 6?15 months; average, 10.4 months).Conclusions: Delayed passive rehabilitation does not bring about superior outcomes. Therefore, early rehabilitation would be useful to help patients resume their daily lives.

Early Versus Delayed Passive Range of Motion Exercise for Arthroscopic Rotator Cuff Repair

2014 ◽  
Vol 43 (5) ◽  
pp. 1265-1273 ◽  
Author(s):  
Ke-Vin Chang ◽  
Chen-Yu Hung ◽  
Der-Sheng Han ◽  
Wen-Shiang Chen ◽  
Tyng-Guey Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Motion Exercise ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Biceps Tenodesis Combined With Rotator Cuff Repair Increases Functional Status And Elbow Strength In Both Operated And Contralateral Arms

2020 ◽  
Author(s):  
Ali Ihsan KILIC ◽  
Onur HAPA ◽  
Ramadan OZMANEVRA ◽  
Nihat Demirhan DEMIRKIRAN ◽  
Onur GURSAN
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Elbow Flexion ◽  
Arthroscopic Rotator Cuff Repair ◽  
Biceps Tenodesis ◽  
Significant Difference ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Purpose: Aim of the present study was to prospectively evaluate the elbow flexion and supination strengths, and the functional outcomes of patients after arthroscopic rotator cuff repair combined with simultaneous biceps tenodesis.Methods: Nineteen patients who underwent arthroscopic rotator cuff repair and biceps tenodesis with at least 24 months follow-up were included. Patients were evaluated using a visual analogue scale (VAS) for bicipital groove pain, American Shoulder and Elbow Surgeons (ASES), and constant scores(CS), biceps apex distance (BAD), elbow flexion and supination strengths.Results: VAS for biceps groove measurement averages of postoperative 6th, 12th and 24th month were lower in comparison to pre-operative data and were considered to be statistically significant (p<0.05). Constant score, an average of all post-operative measurements and scores were found higher than pre-operative values and was considered to be statistically significant (p<0,01). There was a significant difference in the comparison of operated and contralateral forearm supination and elbow flexion muscle strength measurements at postoperative 3rd and 6th-month follow-up (p<0.01).Conclusion: Arthroscopic biceps tenodesis into the anchors of lateral row combined rotator cuff repair provides an increase in strength of elbow flexion and forearm supination, while decreases pain. Level of Evidence: Level IV

Establishing Maximal Medical Improvement After Arthroscopic Rotator Cuff Repair

2017 ◽  
Vol 46 (4) ◽  
pp. 1000-1007 ◽  
Author(s):  
William A. Zuke ◽  
Timothy S. Leroux ◽  
Bonnie P. Gregory ◽  
Austin Black ◽  
Brian Forsythe ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Patient Reported Outcomes ◽  
Arthroscopic Rotator Cuff Repair ◽  
Orthopaedic Care ◽  
Patient Reported ◽  
Clinically Significant ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: As health care transitions from a pay-for-service to a pay-for-performance infrastructure, the value of orthopaedic care must be defined accurately. Significant efforts have been made in defining quality and cost in arthroplasty; however, there remains a lag in ambulatory orthopaedic care. Purpose: Two-year follow-up has been a general requirement for reporting outcomes after rotator cuff repair. However, this time requirement has not been established scientifically and is of increasing importance in the era of value-based health care. Given that arthroscopic rotator cuff repair is a common ambulatory orthopaedic procedure, the purpose of this study was to establish a time frame for maximal medical improvement (the state when improvement has stabilized) after arthroscopic rotator cuff repair. Study Design: Systematic review. Methods: A systematic review of the literature was conducted, identifying studies reporting sequential patient-reported outcomes up to a minimum of 2 years after arthroscopic rotator cuff repair. The primary clinical outcome was patient-reported outcomes at 3-month, 6-month, 1-year, and 2-year follow-up. Secondary clinical outcomes included range of motion, strength, retears, and complications. Clinically significant improvement was determined between various time intervals by use of the minimal clinically important difference. Results: The review included 19 studies including 1370 patients who underwent rotator cuff repair. Clinically significant improvement in patient-reported outcomes was seen up to 1 year after rotator cuff repair, but no clinical significance was noted from 1 year to 2 years. The majority of improvement in strength and range of motion was seen up to 6 months, but no clinically meaningful improvement was seen thereafter. All reported complications and the majority of retears occurred within 6 months after rotator cuff repair. Conclusion: After rotator cuff repair, a clinically significant improvement in patient-reported outcomes, range of motion, and strength was seen up to 1 year after surgery, but not beyond this. This information is important not only to establish appropriate patient expectations but also to determine a time frame for outcome collection after surgery to better define value in orthopaedic care.

scholarly journals Arthroscopic repair of rotator cuff tears: analysis and functional outcome

2020 ◽  
Vol 6 (2) ◽  
pp. 256
Author(s):  
Rejo V. Jacob ◽  
Prateek Girotra ◽  
K. Prashanth Kumar
Keyword(s):  
Rotator Cuff ◽  
Functional Outcome ◽  
Rotator Cuff Repair ◽  
Arthroscopic Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Daily Routine ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Shoulder Score

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>Rotator cuff injuries are common injuries occurring around the shoulder with an incidence ranging from 5 to 39%. Rotator cuff tears can be either partial thickness or full thickness. If remains untreated, may lead to persistent shoulder pain, functional limitation and decreased quality of life. In the present study, we assess the functional outcome following arthroscopic repair of rotator cuff tears. We also assess the various parameters affecting the functional outcome following repair.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>15 patients with rotator cuff tears were subjected to this study. Preoperative evaluation of the American Shoulder and Elbow Surgeons (ASES) shoulder score and University of California and Los Angeles (UCLA) shoulder score was done. Arthroscopic rotator cuff repair using single row repair with suture anchors was done. The patients were followed up at 6 weeks, 3 months and 6 months where ASES score and UCLA score were assessed<span lang="EN-US">.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>Of the 15 patients, 14 had supraspinatus tear, 2 patients had infraspinatus tear and 2 patients had subscapularis tear. According to UCLA scoring system 22% patients had excellent, 43% patients had good results, 23% patients had fair results and 12% patients had poor results. ASES score also showed progressive improvement at subsequent follow ups at 3 and 6 months.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>From our present study we conclude that arthroscopic rotator cuff repair is a good modality showing excellent functional outcome with less morbidity, minimal postoperative pain, better cosmesis and early resumption of daily routine activities.</p><p> </p>

Postoperative Outcomes of Single-Stage Versus Staged Bilateral Rotator Cuff Repair in Patients with Bilateral Rotator Cuff Tear: A Retrospective Study

2021 ◽  
Author(s):  
Chen Wang ◽  
Pu Yang ◽  
Dongfang Zhang ◽  
In-Ho Jeon ◽  
Tengbo Yu ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Constant Score ◽  
Single Stage ◽  
Arthroscopic Rotator Cuff Repair ◽  
Vas Score ◽  
Ucla Score ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Abstract Background: In the present study, we aimed to compare the clinical outcomes of patients who underwent single-stage or staged bilateral arthroscopic rotator cuff repair.Methods: From March 2013 to May 2018, a retrospective review on all patients who underwent bilateral arthroscopic rotator cuff repair at our department was performed. There were 24 patients in the single-stage group and 27 patients in the staged group. The minimum follow-up period was 2 years. The visual analog scale (VAS), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, Constant-Murley (Constant) score, and the range of motion (ROM) of the shoulder were evaluated for comparison between the two groups before and after the operation. Moreover, the hospitalization costs in the two groups were also recorded.Results: All 51 patients were available throughout follow-up. There was no significant difference in the VAS score (P=0.424), ASES score (P=0.325), UCLA score (P=0.170), and Constant score (P=0.275) between the single-stage group and the staged group before the operation. Postoperative clinical scores were significantly improved in both groups. The VAS score, ASES score, UCLA score, and Constant score were significantly different between the two groups at 6 months postoperatively (P<0.05). At 12, 18, and 24 months after the operation, the VAS score, UCLA score, Constant score, and ASES score were not significantly different between the two groups. At follow-up, the ROM of the shoulder was not significantly different between the two groups. Besides, there was a significant difference in hospitalization costs between the two groups (P<0.05). Furthermore, there was no significant difference in the VAS score, UCLA score, Constant score, ASES score, and ROM between the first surgery and second surgery in the single-stage group postoperatively.Conclusion: Patients receiving single-stage or staged bilateral arthroscopic rotator cuff repair showed similarly good clinical outcomes at follow-up. Moreover, good outcomes were observed on both sides of the single-stage group.

Superior Capsule Reconstruction for Reinforcement of Arthroscopic Rotator Cuff Repair Improves Cuff Integrity

2018 ◽  
Vol 47 (2) ◽  
pp. 379-388 ◽  
Author(s):  
Teruhisa Mihata ◽  
Thay Q. Lee ◽  
Akihiko Hasegawa ◽  
Kunimoto Fukunishi ◽  
Takeshi Kawakami ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Range Of Motion ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Rotator Cuff Tears ◽  
Resonance Imaging ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Background: Retear of repaired rotator cuff tendons worsens patient outcome and decreases patient satisfaction. Superior capsule reconstruction (SCR) was developed to center the humeral head and thus restore the force couple for patients with rotator cuff tears. Purpose: To evaluate whether SCR for reinforcement before arthroscopic rotator cuff repair (ARCR) improves cuff integrity. Study Design: Cohort study; Level of evidence, 3. Methods: Thirty-four consecutive patients (mean age, 69.1 years) with severely degenerated but reparable rotator cuff tears underwent SCR with fascia lata autografts for reinforcement before ARCR. All tears were medium (1-3 cm) or large (3-5 cm), and the number of torn tendons was 2 (supraspinatus and infraspinatus) in 29 shoulders and 3 (supraspinatus, infraspinatus, subscapularis) in 5 shoulders. To assess the benefit of SCR for reinforcement, all data were compared with those after ARCR alone among 91 consecutive patients with medium or large rotator cuff tears (mean age, 63.6 years). The American Shoulder and Elbow Surgeons (ASES) and Japanese Orthopaedic Association (JOA) scores, active shoulder range of motion, and cuff integrity (Sugaya magnetic resonance imaging classification) were compared ( t test and chi-square test) between ARCR with and without SCR, as well as before surgery and at final follow-up. Results: All 34 patients who underwent SCR before ARCR had neither postoperative retear nor type III cuff integrity, whereas those treated with ARCR alone had a 4% incidence (4 of 91) of retear and 8% incidence of type III cuff integrity. ASES and JOA scores, active elevation, active external rotation, and active internal rotation increased in both treatment groups ( P < .001). Postoperative ASES score and active range of motion did not differ between groups, although the Goutallier grade of the supraspinatus was higher for ARCR with SCR (mean, 2.8) than ARCR alone (mean, 2.1; P < .0001). Conclusion: SCR for reinforcement prevented retear at 1 year after ARCR and improved the quality of the repaired tendon on magnetic resonance imaging. Functional outcomes were similar between groups, even though degeneration of the torn tendons was greater among patients who underwent ARCR with SCR.

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