Document Detail


Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair.
MedLine Citation:
PMID:  20198404     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The surgical treatment of massive rotator cuff tears (RCT) is still controversial and can be based on a variety of different surgical repair methods. This study investigated the effectiveness of arthroscopic debridement or arthroscopic partial repair in patients with massive RCT.
MATERIALS AND METHODS: This prospective, randomized study involved forty-two patients with massive RCT (fatty infiltration stage 3 or 4) treated with either arthroscopic partial repair or arthroscopic debridement were selected to detect possible differences in functional outcome. Both groups were matched according to age and gender. Patients were examined before, and 16 +/- 3 and 24 +/- 2 months after surgery. The status of the rotator cuff repair was determined using ultrasonographic evaluation.
RESULTS: Regardless of the treatment group, postoperative results demonstrated highly significant improvements compared with preoperative values in most parameters. The overall Constant score in the partial repair group was superior to the outcome in the debridement group (P < 0.01, F = 8.561), according to better results in abduction (P < 0.01, F = 13.249), activity (P < 0.01, F = 21.391) and motion (P < 0.01, F = 4.967). All treatment groups had similar pain relief (P = 0.172, F = 1.802) and satisfaction, reflected in equal values of disabilities of the arm, shoulder and hand (DASH) score (P = 0.948, F = 0.004). Ultrasonography revealed structural failure of the partial rotator cuff repair in 52% at final follow-up.
CONCLUSIONS: During the follow-up period all patients in our series had good or satisfactory outcome after rotator cuff surgery. Regardless of high rates of structural failure of the partial rotator cuff repair, the results of arthroscopic partial rotator cuff repair demonstrated slightly better functional outcome than debridement.
Authors:
Alexander Berth; Wolfram Neumann; Friedemann Awiszus; Géza Pap
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-03-03
Journal Detail:
Title:  Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology     Volume:  11     ISSN:  1590-9999     ISO Abbreviation:  J Orthop Traumatol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-15     Completed Date:  2010-06-10     Revised Date:  2013-05-30    
Medline Journal Info:
Nlm Unique ID:  101090931     Medline TA:  J Orthop Traumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  13-20     Citation Subset:  IM    
Affiliation:
Department of Orthopaedics, Otto-von-Guericke-University, Magdeburg, Germany. alexander.berth@med.ovgu.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Arthroscopy / methods*
Debridement / methods*
Female
Humans
Male
Middle Aged
Postoperative Complications
Prospective Studies
Recovery of Function
Reoperation
Rotator Cuff / injuries*,  surgery*,  ultrasonography
Tendon Injuries / rehabilitation,  surgery*,  ultrasonography
Treatment Outcome
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