Long-term results of arthroscopic rotator cuff repair (SS-07)

Journal of Shoulder and Elbow Surgery, 2006

Arthroscopic rotator cuff repair (RCR) has been reported to have good clinical results but high retear rates by ultrasound. We prospectively assessed postoperative cuff integrity and outcome after arthroscopic RCR (40 patients) and compared these results with open RCR (32 patients). Evaluation preoperatively and at 1 year included a physical examination and magnetic resonance imaging. American Shoulder and Elbow Surgeons and Constant scores improved significantly in both groups (P < .0001). Overall, 69% of repairs in the open group and 53% in the arthroscopic group were intact by magnetic resonance imaging. Of tears less than 3 cm in size, 74% in the open group and 84% in the arthroscopic group were intact. Of tears greater than 3 cm in size, 62% in the open group and 24% in the arthroscopic group were intact (P < .036). In the arthroscopic group, patients with an intact cuff had significantly greater strength of elevation (P = .01) and external rotation (P = .02). We conclude that open and arthroscopic RCRs have similar clinical outcomes. Cuff integrity is comparable for small tears, but large tears have twice the retear rate after arthroscopic repair.

Journal of Shoulder and Elbow Surgery, 2007

Even though several studies have revealed excellent clinical results with arthroscopic repair of rotator cuff tendons, poor healing of the repair and retearing of the tendon occur in many cases. Patterns of outcome correlating functional capacity and anatomic integrity of the repaired rotator cuff are not well defined. The goal of this prospective study was to determine the pattern of anatomic and functional outcomes among patients undergoing single-row arthroscopic rotator cuff repair. This study confirmed that single-row arthroscopic repair of smalland medium-sized supraspinatus tendon tears significantly improves rotator cuff integrity and functional outcomes. A completely healed tendon was observed in 60% of the cases. Age is a predictor of cuff integrity after the operation. Functional improvement was greater and significant in patients with complete healing at follow-up; however, a recurrent tear did not preclude positive functional results. (J Shoulder Elbow Surg 2007;16:759-765.)

IP innovative publication pvt. ltd, 2019

Introduction: Various recent clinical literature and industrial commercial interests has shifted the focus from SR rotator cuff repair towards DR repair. The Aim of our study was to evaluate the functional outcomes of patients with rotator cuff tear treated in our institute by Arthroscopic SR Rotator cuff repair. Materials and Methods: A total of 54 patients with full thickness rotator cuff tear treated with arthroscopic SR rotator cuff repair in our institute for a period from February 1, 2014 to October 31, 2016 were evaluated retrospectively after confirming the rotator cuff tear clinically and by MRI. Clinico-Functional assessment was done using UCLA score. Results: Mean UCLA Score was 18.69 ± 3.7 preoperatively to 32.07 ± 1.47 postoperatively after more than 2 years of follow up and showed significant improvement in UCLA Scores. Results were Graded as Excellent in 42 (78%), Good in 10(19%) and Poor in 2(3%) patients. On comparison of our results with other published studies, our results was statistically significant (P<0.001) but clinicofunctionally same as other studies when compared with their individual UCLA Scores. Conclusion : Results of Arthroscopic single row rotator Cuff repair in our Institute showed excellent results, is a cost effective technique with the Clinico-Functional results being Good to Excellent in majority of our cases as per UCLA score, comparable to any published series of SR RCR.

The Journal of Bone and Joint Surgery (American), 2012

Background: Little is known about the outcomes after repair of partial-thickness rotator cuff tears. The aim of this study was to assess the outcome after repair of partial-thickness rotator cuff tears compared with full-thickness tears. Our hypothesis was that repair of partial-thickness tears leads to more shoulder stiffness but fewer retears compared with repair of full-thickness tears.

MVP Journal of Medical Sciences, 2020

Introduction: Rotator cuff tears is a severely debilitating condition widely prevelant amongst the elderly age group. Timely adequate repair is of utmost importance. Aims and Objectives: To study the functional outcome of arthroscopic single row repair for rotator cuff tears. Materials and Methodology: We enrolled 30 patients of rotator cuff tears. Each patient underwent arthrosocpic single row repair in the lateral position with concomitant sub acromial decompression. Post operative protocol included immobilisation for 6 weeks followed by active assisted range of motion at 6 weeks and strengthening exercises at 3 months. We assessed the patient pre operatively and post operatively at 6 weeks, 3 months and 6 months using Constant Score and Visual analog scale for pain. Results: There was significant improvement at every follow up with mean Constant Score increasing from pre operative to post operative stage at 6 months. According to individual relative Constant Score patients went from a mean of poor to good outcome. Visual analog scale for pain changed from a meanscore of severe to mild at 6 months post operatively. Conclusion: Arthroscopic single row repair is a simple, minimally invasive, cost effective procedure with good functional outcomes and pain relief.

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2008

Purpose: Recent reports document excellent outcomes with arthroscopic repair of rotator cuff tears (RCT). However, full-thickness RCT are uncommon in patients younger than 40 years, and few reports document results after repair in this population. The purpose of this study is to retrospectively report results of arthroscopic repair of full-thickness RCT in patients younger than 40 years. Methods: Twenty-three consecutive patients younger than 40 years with full-thickness RCT underwent arthroscopic repair with suture anchors. Mean age was 37 years (range, 21 to 39). The mean size of RCT was 2.4 cm in the largest dimension (range, 1 to 4 cm). The mean number of anchors used was 2.5 (range, 1 to 4). Concomitant procedures included subacromial decompression (22), distal clavicle resection (13), SLAP repair (2), biceps tenodesis (2), anterior capsulorraphy (1), and capsular releases (1), and were performed at the discretion of the surgeon. Twenty-two patients (95%) recalled a single incipient trauma; two patients sustained a dislocation. Ten patients (43%) claimed Workers' Compensation (WC). Minimum follow-up was 24 months, and mean follow-up was 26 months (range, 24 to 29). Results: Mean preoperative American Shoulder and Elbow Surgeon's (ASES) self-report score was 42 (range, 22 to 60); the mean postoperative score was 92 (range, 65 to 100; P Ͻ .01). Twenty-one patients (90%) returned to their previous level of activity and employment, including 9 (90%) with WC claims. All patients (100%) reported diminished pain, and 22 (95%) reported improvement with activities of daily living. Complications included superficial wound infection (1) and axillary nerve palsy after initial dislocation (1). Given the choice, 22 patients (95%) would have same procedure again. Conclusions: Excellent outcomes were observed following arthroscopic rotator cuff repair both with and without concomitant procedures in patients younger than 40 years. Full-thickness RCT in patients younger than 40 years appeared to be traumatic in etiology. Successful repair returns patients to their pre-injury level of function. These results support arthroscopic rotator cuff repair in young, active patients. Level of Evidence: Level IV, therapeutic case series.

Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2007

The purpose of this study was to assess cuff integrity after arthroscopic rotator cuff repair and the correlation with clinical results and healing prognostic factors. Methods: A total of 576 supraspinatus or infraspinatus tears that had undergone all-arthroscopic repairs by 9 surgeons experienced in arthroscopic surgery were involved in this multicenter study. The clinical results were evaluated by use of the Constant score. The integrity of the repair was evaluated by magnetic resonance imaging with contrast or by computed tomography arthrogram. Results: The global clinical and anatomic results after arthroscopic rotator cuff repair in this study are comparable to other published results. Although the results were most often good and excellent despite incomplete tendon healing, better functional results in terms of activity, motion, and especially strength were obtained when the cuff was clearly intact after the arthroscopic repair. The Constant pain subscore did not correlate to the integrity or lack thereof in the repaired tendon. Conclusions: The type of rupture, the location of the rupture, and the presence of interstitial delamination and fatty degeneration of the involved muscle are prognostic factors of the anatomic result in arthroscopic rotator cuff repair. The age of the patient and the delay between the initial presentation of the symptoms and the operation were also noted to be significant healing prognostic factors. Level of Evidence: Level IV, therapeutic case series.

Open Access Macedonian Journal of Medical Sciences, 2019

BACKGROUND: Rotator cuff tear (RCT) is a common injury of the shoulder, especially middle-aged people. Nonoperative treatment, cortisone injections are only effective at an early stage. Open surgery causes postoperative atrophy of the deltoid muscle, so results are limited. Arthroscopic rotator cuff repair surgery has been performed in Vietnam for about ten years, with many advantages such as the ability to accurately assess the lesions and less invasive procedure. In order to have a clearer view, we performed a mid-term assessment of the effectiveness of this surgery. AIM: Evaluate results over 2 years of patients with rotator cuff tears treated with arthroscopic surgery and their quality of life. METHOD: A group of 30 patients were diagnosed with RCT and surgery by arthroscopy to treat at Hanoi Medical University Hospital and Saint Paul Hospital between Jun 2015 and April 2017. The results of the surgeries were assessed by the degree of pain, muscle power, motion of the shoulder j...

2010

The rotator cuff (RC), formed posteriorly by the tendons of the supraspinatus (Ss), infraspinatus (Is) and teres minor (Tm) and, anteriorly by the tendon of the subscapularis (Sc), has an important contribution in the shoulder mobility and stability functions. Lesions of this structure represent one of the main causes of incapacity in the shoulder.1,2 Satisfactory results of the conservative treatment vary in literature between 40 and 82%, whereas factors such as: age, comorbidities, activity levels and degree of shoulder dysfunction interfere therein. With the increase of functional demand such as practice of sports, work and/or daily activities, etc., in some patients the conservative treatment might not be successful. This situation has occurred more frequently due to the increase in life expectancy and quality.2-4 In these cases, surgical repair has proven efficient, attaining a high level of satisfaction, with pain relief and function improvement, ranging between 70 and 95%.5-9...

The Journal of Bone and Joint Surgery-American Volume, 2010

Background: Literature regarding the outcomes of revision rotator cuff repair is limited. The purposes of the present study were to report the tendon repair integrity and clinical outcomes for a cohort of patients following revision arthroscopic rotator cuff repair and to examine factors related to tendon healing and the influence of healing on clinical outcomes. Methods: Twenty-one of twenty-nine consecutive revision arthroscopic rotator cuff repairs with a minimum of two years of postoperative follow-up were retrospectively reviewed. Outcomes were evaluated on the basis of a visual analog pain scale, the range of motion of the shoulder, the Simple Shoulder Test, the American Shoulder and Elbow Surgeons score, and the Constant score. Ultrasonography was used to examine repair integrity at a minimum of one year following surgery. Ten shoulders underwent arthroscopic repair of a recurrent single-tendon posterior rotator cuff tear, whereas eleven shoulders had repair of both the supraspinatus and infraspinatus. Results: The mean age of the twenty-one subjects was 55.6 years; thirteen subjects were male and eight were female. Complete preoperative and postoperative clinical data were available for nineteen subjects after an average duration of follow-up of thirty-three months. Significant improvements were seen in terms of postoperative pain (p < 0.05), the Simple Shoulder Test score (p < 0.05), the American Shoulder and Elbow Surgeons function (p < 0.05) and total scores (p < 0.05), active forward elevation (p < 0.05), and active external rotation (p < 0.05). Postoperative ultrasound data were available for all twenty-one shoulders after a mean duration of follow-up of twenty-five months. Ten (48%) of the twentyone shoulders had an intact repair. Seven (70%) of the ten single-tendon repairs were intact, compared with three (27%) of the eleven supraspinatus/infraspinatus repairs (p = 0.05). Patient age (p < 0.05) and the number of torn tendons (p = 0.05) had significant effects on postoperative tendon repair integrity. Shoulders with an intact repair had better postoperative Constant scores (p < 0.05) and scapular plane elevation strength (p < 0.05) in comparison with those with a recurrent tear. Conclusions: Revision arthroscopic rotator cuff repair results in reliable pain relief and improvement in shoulder function in selected cases. Approximately half of the revision repairs can be expected to be intact at a minimum of one year following surgery. Patient age and the number of torn tendons are related to postoperative tendon integrity. The postoperative integrity of the rotator cuff can have a significant influence on shoulder abduction strength and the Constant score.