Mini-Open Rotator Cuff Tear Repair: An Institutional Experience with a Midterm Follow-up

2018 ◽  
Vol 20 (5) ◽  
pp. 383-387 ◽  
Author(s):  
Adil Bashir ◽  
Suleiman Seth ◽  
Iftikhar H. Wani ◽  
Munir Farooq ◽  
Naseem ul Gani ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Fixation Method ◽  
Full Thickness ◽  
Open Procedure ◽  
Cuff Tear ◽  
Rotator Cuff Tear Repair ◽  
Mini Open

Background. Rotator cuff tears have long been recognised as a cause of pain and disability. Over the past decades the treatment of rotator cuff tears has evolved from an open procedure to a mini-open procedure to an all-arthroscopic one. The indications and benefits of each of the procedures are still debated. The purpose of this study was to observe the results of “Mini-open repair rotator cuff tear”. Material and methods. This was a prospective study conducted in the postgraduate department of Ortho­paedics Government Medical College, Srinagar, from March 2013 to January 2018 with cases followed up for a minimum of 3 years. This study included 50 patients of either sex with non-massive full thickness tears of rotator cuff. Results. The mean UCLA score improved from 10.96 preoperatively to 30.68 at final follow-up. Overall, 88% of the patients achieved excellent or good results and 92% were satisfied. No significant difference was noted in functional outcomes between traumatic and degenerative tears. Size of tear seems to be a determining factor in the functional outcome. Stiffness as a complication occurred in two patients. Conclusion. 1. Mini-open rotator cuff tear repair eliminated sym­pto­matic full thickness rotator cuff tears with significant improvement in functional scores. 2. There were no major complications of the surgical procedure adop­ted or the fixation method used. 3. Mini-open rotator cuff repair remains a useful technique despite advan­ces in arthroscopy.

scholarly journals Longitudinal follow up of patients undergoing mini-open repair of rotator cuff tear

2019 ◽  
Vol 5 (2) ◽  
pp. 295
Author(s):  
Mohammed Shabir Kassim ◽  
Amlan Mohapatra ◽  
Karthikraj Kuberakani
Keyword(s):  
Rotator Cuff ◽  
Range Of Motion ◽  
Functional Outcome ◽  
Rotator Cuff Tear ◽  
Open Repair ◽  
Full Thickness ◽  
Cuff Tear ◽  
Partial Thickness ◽  
Mini Open

<p class="abstract"><strong>Background:</strong> Shoulder pain is a common presenting complaint. This study is aimed to understand the role of mini-open repair in the treatment of rotator cuff tear and to assess the functional outcome in such patients over a period of two years.</p><p class="abstract"><strong>Methods:</strong> This prospective study was conducted on patients who were operated by mini-open repair for rotator cuff tear at the Department of Orthopedics, AJ Institute of Medical Sciences January 2017 till June 2018. Using a pre-designed case report form, demographic and clinical information was noted for all patients. Functional outcome of the patients was assessed by the Constant and Murley score at post-operative follow up at 3 weeks, 6 weeks, 12 weeks, 6 months, 1 year and 2 years.<strong></strong></p><p class="abstract"><strong>Results:</strong> Partial thickness tear was present in 57% of the pateints and rest had a full thickness tear. Mean Constant and Murley score at the time of presentation was 59.50 which improved during the follow up period and at the final follow up the score was 91.80. The score was not significantly different at one year and second year follow up. The score was consistently higher among patients with partial thickness as compared to those with full thickness, though the difference was significantly different only at 6 month follow up (p=0.007).</p><p class="abstract"><strong>Conclusions:</strong> Significant improvement in range of motion was seen in our patients at 6 months post-operatively. Full range of motion was observed at the end of 1 year and functional outcome did not improve after that.</p>

scholarly journals Clinical and functional outcomes of a novel transosseous device to treat rotator cuff tears: A minimum 2-year follow-up

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987517 ◽  
Author(s):  
Mehmet Arican ◽  
Yalçın Turhan ◽  
Zekeriya Okan Karaduman ◽  
Tacettin Ayanoğlu
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Functional Outcomes ◽  
Dash Score ◽  
Open Approach ◽  
Full Thickness ◽  
Gold Standard Method ◽  
Cuff Tear ◽  
The Mean

Purpose: Despite the improvements in the repair equipment techniques of rotator cuff, a gold standard method has not been defined yet and transosseous fixation through deltoid-splitting (mini-open) approach is still regarded as a good option. The primary purpose of this study is to present satisfactory clinical and functional outcomes with a novel transosseous device in full-thickness rotator cuff tear through deltoid-splitting. Materials and Methods: This retrospective study was performed on 70 consecutive patients who underwent surgery by a single surgeon from June 2014 to June 2016 for a full-thickness rotator cuff tear and was managed with a novel transosseous device. Total number of patients, mean age, percentage of male and female patients, mean duration of follow-up, percentage of involvement of the dominant extremity, affected shoulder, and tear size were recorded. Functional and clinical outcomes were assessed baseline and postoperatively at 3 and 6 months and final follow-up using Disabilities of the Arm, Shoulder and Hand (Q-DASH) and Constant-Murley scores. Results: A total of 70 (49 (70%) female, 21 (30%) male) patients whose mean age was 58.66 ± 9.19 (38–77) years were included. The mean surgery time was 35.33 ± 5.34 (28–55) min. The mean follow-up time was 28.31 ± 3.03 (24–36) months. According to the DeOrio and Cofield classification, 15 (21.43%) tears were small, 33 (47.14%) medium, 16 (22.86%) large, and 6 (8.57%) massive. By the final follow-up, the mean Constant-Murley score had significantly improved from 27.67 ± 7.46 (13–41) to 81.25 ± 3.77 (74–87; p = 0.0001) and the Q-DASH score had decreased from 82.34 ± 10.37 (65.91–100) to 10.28 ± 6.88 (0–23.45; p = 0.0001). There were no significant differences in the Constant-Murley or Q-DASH score at baseline–final follow-up between the small, medium, large, and massive tear groups ( p > 0.05). Conclusions: Treatment of full-thickness rotator cuff tear using this novel transosseous device significantly improved functional and clinical scores. However, further long-term prospective randomized multicenter trials involving comparative studies are necessary to confirm these findings.

10-year follow-up of non-operatively treated full thickness rotator cuff tear

2016 ◽  
Vol 32 (1) ◽  
pp. 67-72 ◽  
Author(s):  
Shivam Upadhyaya ◽  
Andrew Nathan Pike ◽  
Scott D. Martin
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Full Thickness ◽  
Cuff Tear

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.

Comparison of Clinical and Structural Outcomes by Subscapularis Tendon Status in Massive Rotator Cuff Tear

2017 ◽  
Vol 45 (11) ◽  
pp. 2555-2562 ◽  
Author(s):  
Sung Hyun Lee ◽  
Dae Jin Nam ◽  
Se Jin Kim ◽  
Jeong Woo Kim
Keyword(s):  
Magnetic Resonance Imaging ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Subscapularis Tendon ◽  
Resonance Imaging ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Massive Rotator Cuff Tears

Background: The subscapularis tendon is essential in maintaining normal glenohumeral biomechanics. However, few studies have addressed the outcomes of tears extending to the subscapularis tendon in massive rotator cuff tears. Purpose: To assess the clinical and structural outcomes of arthroscopic repair of massive rotator cuff tears involving the subscapularis. Study Design: Cohort study; Level of evidence, 3. Methods: Between January 2010 and January 2014, 122 consecutive patients with massive rotator cuff tear underwent arthroscopic rotator cuff repair. Overall, 122 patients were enrolled (mean age, 66 years; mean follow-up period, 39.5 months). Patients were categorized into 3 groups based on subscapularis tendon status: intact subscapularis tendon (I group; n = 45), tear involving less than the superior one-third (P group; n = 35), and tear involving more than one-third of the subscapularis tendon (C group; n = 42). All rotator cuff tears were repaired; however, subscapularis tendon tears involving less than the superior one-third in P group were only debrided. Pain visual analog scale, Constant, and American Shoulder and Elbow Surgeons scores and passive range of motion were measured preoperatively and at the final follow-up. Rotator cuff integrity, global fatty degeneration index, and occupation ratio were determined via magnetic resonance imaging preoperatively and 6 months postoperatively. Results: We identified 37 retears (31.1%) based on postoperative magnetic resonance imaging evaluation. Retear rate in patients in the C group (47.6%) was higher than that in the I group (22.9%) or P group (20.0%) ( P = .011). Retear subclassification based on the involved tendons showed that subsequent subscapularis tendon retears were noted in only the C group. The improvement in clinical scores after repair was statistically significant in all groups but not different among the groups. Between-group comparison showed significant differences in preoperative external rotation ( P = .021). However, no statistically significant difference was found in any shoulder range of motion measurements after surgery. Conclusion: Arthroscopic repair of massive tears results in substantial improvements in shoulder function, despite the presence of combined subscapularis tears. However, this study showed a high failure rate of massive posterosuperior rotator cuff tear repair extending more than one-third of the subscapularis tendon. When combined subscapularis tendon tear was less than the superior one-third of the subscapularis tendon, arthroscopic debridement was a reasonable treatment method where comparable clinical and anatomic outcomes could be expected.

scholarly journals Arthroscopic Partial Repair of Massive Contracted Rotator Cuff Tears

2014 ◽  
Vol 17 (1) ◽  
pp. 44-47 ◽  
Author(s):  
Sung Jae Kim ◽  
Young Hwan Kim ◽  
Yong Min Chun
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Functional Outcomes ◽  
Muscle Quality ◽  
Rotator Cuff Tears ◽  
Massive Rotator Cuff Tear ◽  
Cuff Tear ◽  
Partial Repair ◽  
Tendon Coverage

Typically, massive rotator cuff tears have stiff and retracted tendon with poor muscle quality, in such cases orthopaedic surgeons are confronted with big challenging to restore the cuff to its native footprint. Furthermore, even with some restoration of the footprint, it is related with a high re-tear rate due to less tension free repair and less tendon coverage. In this tough circumstance, the partial repair has yielded satisfactory outcomes at relatively short follow-up by re-creating the transverse force couple of the rotator cuff. Through this partial repair, the massive rotator cuff tear can be converted to the "functional rotator cuff tear" and provide improvement in pain and functional outcomes in patient's shoulder.

scholarly journals Arthroscopic Versus Mini-Open Salvage Repair of the Rotator Cuff Tear : Outcome Analysis at Two to Six Years Follow-up

2002 ◽  
Vol 5 (2) ◽  
pp. 88-97
Author(s):  
Seung-Ho Kim ◽  
Kwon-lck Ha ◽  
Jong-Hyuk Park ◽  
Jin-Seok Kang ◽  
Sung-Kyun Oh ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Outcome Analysis ◽  
Cuff Tear ◽  
Mini Open

scholarly journals Characteristics and Clinical Outcomes in Overhead Sports Athletes after Rotator Cuff Repair

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Tomoyuki Muto ◽  
Hiroaki Inui ◽  
Hiroki Ninomiya ◽  
Hiroshi Tanaka ◽  
Katsuya Nobuhara
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Tears ◽  
Aged Patients ◽  
Overhead Athletes ◽  
Cuff Tear ◽  
Rotator Cuff Injuries ◽  
Overhead Sports ◽  
Infraspinatus Tendon

Rotator cuff tears in young overhead sports athletes are rare. The pathomechanism causing rotator cuff tears in young overhead athletes is different from that in aged patients. The purpose of this study was to investigate rotator cuff tear characteristics in young overhead sports athletes to reveal the pathomechanism causing these injuries. This study included 25 overhead sports athletes less than 30 years old with atraumatic rotator cuff tears necessitating repair. Rotator cuff tear characteristics were evaluated intraoperatively, including rotator cuff tear shape and injured rotator cuff tendon. Clinical outcome measures were assessed before surgery and at the final follow-up. In this study, 22 patients reported minimal to no shoulder pain and returned to sports without significant complaints at last follow-up. The isolated infraspinatus tendon was most often injured; the incidence rate of the tear at this site was 32% (8 cases). In the deceleration phase of overhead motion, the eccentric contraction force of the ISP (infraspinatus) tendon peaks and the increased load leads to injury at the ISP tendon. The pathomechanism of rotator cuff injuries in young overhead athletes might be not only internal or subacromial impingement, but also these mechanisms.

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