Document Detail


Rotator cuff integrity after arthroscopic repair for large tears with less-than-optimal footprint coverage.
MedLine Citation:
PMID:  19801287     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The purpose of this study was to evaluate the clinical results and healing status of rotator cuff repairs with less than 50% footprint coverage. METHODS: During the 18-month period from October 2005 to March 2007, 89 large to massive rotator cuff tears were arthroscopically repaired. Among them, 23 consecutive large to massive rotator cuff tears were repaired completely but with less than 50% of the original footprint. All tears were arthroscopically repaired with suture anchors. Preoperative and postoperative clinical assessments were performed with the Constant score, American Shoulder and Elbow Surgeons score, and pain visual analog scale. The healing status of repaired tendon was evaluated by postoperative magnetic resonance imaging with a focus on tendon integrity, muscle fatty degeneration, and muscle atrophy. RESULTS: The mean follow-up period was 30.2 months (range, 24 to 41 months). At final follow-up visits, American Shoulder and Elbow Surgeons score, Constant score, and score on pain visual analog scale were found to have improved significantly from 40.1, 35.9, and 57.7 to 82.4, 86.6, and 12.3, respectively (P < .01). The overall retear rate was 45.5% (10 cases). However, clinical results showed no difference between the retear group and no retear group. Furthermore, rerupture size was smaller than original tear size in all 10 patients, and no significant progression of fatty degeneration or muscle atrophy of rotator cuff muscles was observed. CONCLUSIONS: Less-than-optimal coverage of the original greater tuberosity footprint during arthroscopic repair of large to massive rotator cuff tears was found to be associated with a relatively high retear rate (45.5%). However, clinical results improved significantly, and no significant difference was observed in the clinical results between the retear and no retear groups. LEVEL OF EVIDENCE: Level IV, therapeutic case series.
Authors:
Jae Chul Yoo; Jin Hwan Ahn; Kyoung Hwan Koh; Kyung Sub Lim
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  25     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-12-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1093-100     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adipose Tissue / pathology
Adult
Aged
Arthroscopy / methods*
Female
Follow-Up Studies
Humans
Humerus / pathology*
Magnetic Resonance Imaging
Male
Middle Aged
Muscular Atrophy / epidemiology,  etiology,  pathology
Pain, Postoperative / epidemiology
Postoperative Complications / etiology,  pathology
Reconstructive Surgical Procedures / instrumentation,  methods*
Recurrence
Rotator Cuff / injuries,  pathology,  surgery*
Severity of Illness Index
Shoulder Pain / epidemiology
Suture Anchors
Tendons / pathology,  surgery
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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