PURPOSE: To evaluate the effectiveness of arthroscopic debridement (DB), partial (PR), and complete repair (CR) for massive rotator cuff tears (mRCT) in terms of functional and subjective parameters, and repair integrity. METHODS: For this single-centre study, 68 consecutive shoulders with mRCT involving at least three tendons and treated with arthroscopic DB (n = 23), PR (n = 22), and CR (n = 23) were included. All patients (52-81 years) were prospectively assessed before and at a mean of 45 months after surgery using functional and subjective parameters. Preoperative tendon rupture pattern and post-operative repair integrity were assessed by MRI. A coding system describing accurately rotator cuff rupture, treatment, and integrity was established. RESULTS: All treatment groups improved significantly from pre- to post-operative (P < 0.01), while preoperative parameters, except fatty degeneration, were not significantly different. However, post-operative comparisons revealed similar scores with DB (constant score, CS 65.8 ± 14.7, qDASH 24.1 ± 20.6) and PR (CS 67.5 ± 9.9, P = n.s.; qDASH 20.5 ± 14.4, P = n.s.), while CR were significantly better (CS 80.3 ± 8.9; qDASH 7.0 ± 8.7; P ≤ 0.001). Force couple restoration of PR did not significantly influence outcome. Re-tear rates with CR (29 %) were lower compared to PR (53 %). Intact CR compared to intact PR showed better CS (83.4 ± 7.3 vs. 68.5 ± 10.6, P = 0.009) and qDASH (5.4 ± 8.3 vs. 21.2 ± 9.5, P = 0.006). The vast majority of patients were satisfied with their arthroscopic procedure (DB 87 %; PR 86 %; CR 91 %). CONCLUSION: Arthroscopic DB, PR, and CR were effective in treating mRCT involving at least three tendons. Reparability of mRCT was influenced by fatty degeneration of the muscles. However, CR showed the most favourable short-term improvements. LEVEL OF EVIDENCE: IV.
PURPOSE: To evaluate the effectiveness of arthroscopic debridement (DB), partial (PR), and complete repair (CR) for massive rotator cuff tears (mRCT) in terms of functional and subjective parameters, and repair integrity. METHODS: For this single-centre study, 68 consecutive shoulders with mRCT involving at least three tendons and treated with arthroscopic DB (n = 23), PR (n = 22), and CR (n = 23) were included. All patients (52-81 years) were prospectively assessed before and at a mean of 45 months after surgery using functional and subjective parameters. Preoperative tendon rupture pattern and post-operative repair integrity were assessed by MRI. A coding system describing accurately rotator cuff rupture, treatment, and integrity was established. RESULTS: All treatment groups improved significantly from pre- to post-operative (P < 0.01), while preoperative parameters, except fatty degeneration, were not significantly different. However, post-operative comparisons revealed similar scores with DB (constant score, CS 65.8 ± 14.7, qDASH 24.1 ± 20.6) and PR (CS 67.5 ± 9.9, P = n.s.; qDASH 20.5 ± 14.4, P = n.s.), while CR were significantly better (CS 80.3 ± 8.9; qDASH 7.0 ± 8.7; P ≤ 0.001). Force couple restoration of PR did not significantly influence outcome. Re-tear rates with CR (29 %) were lower compared to PR (53 %). Intact CR compared to intact PR showed better CS (83.4 ± 7.3 vs. 68.5 ± 10.6, P = 0.009) and qDASH (5.4 ± 8.3 vs. 21.2 ± 9.5, P = 0.006). The vast majority of patients were satisfied with their arthroscopic procedure (DB 87 %; PR 86 %; CR 91 %). CONCLUSION: Arthroscopic DB, PR, and CR were effective in treating mRCT involving at least three tendons. Reparability of mRCT was influenced by fatty degeneration of the muscles. However, CR showed the most favourable short-term improvements. LEVEL OF EVIDENCE: IV.
Authors: Leesa M Galatz; Craig M Ball; Sharlene A Teefey; William D Middleton; Ken Yamaguchi Journal: J Bone Joint Surg Am Date: 2004-02 Impact factor: 5.284
Authors: Randa Berdusco; John N Trantalis; Atiba A Nelson; Stephen Sohmer; Kristie D More; Benjamin Wong; Richard S Boorman; Ian K Y Lo Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-09-22 Impact factor: 4.342
Authors: Stephen S Burkhart; Johannes R H Barth; David P Richards; Michael B Zlatkin; Mitchell Larsen Journal: Arthroscopy Date: 2007-04 Impact factor: 4.772
Authors: Jonas Pogorzelski; Brooke M DelVecchio; Zaamin B Hussain; Erik M Fritz; Jonathan A Godin; Peter J Millett Journal: Int J Sports Phys Ther Date: 2017-06
Authors: David Kovacevic; Robert J Suriani; Brian M Grawe; Edward H Yian; Mohit N Gilotra; S Ashfaq Hasan; Umasuthan Srikumaran; Samer S Hasan; Frances Cuomo; Robert T Burks; Andrew G Green; Wesley M Nottage; Sai Theja; Hafiz F Kassam; Maarouf A Saad; Miguel A Ramirez; Rodney J Stanley; Matthew D Williams; Vidushan Nadarajah; Alexis C Konja; Jason L Koh; Andrew S Rokito; Charles M Jobin; William N Levine; Christopher C Schmidt Journal: J Shoulder Elbow Surg Date: 2020-08-04 Impact factor: 3.019
Authors: Philipp R Heuberer; Leo Pauzenberger; Michael S Gruber; Bernhard Kriegleder; Roman C Ostermann; Brenda Laky; Werner Anderl Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-05-06 Impact factor: 4.342