Johannes Barth1, Kevin Andrieu1, Elias Fotiadis1, Gerjon Hannink2, Renaud Barthelemy3, Mo Saffarini4,5. 1. Department of Orthopaedic Surgery, Clinique des Cèdres, Grenoble, France. 2. Orthopaedic Research Laboratory, Radboud University Medical Center, 6525, Nijmegen, The Netherlands. 3. Department of Radiology, Clinique du Mail, Grenoble, France. 4. Department of Medical Research, Alliance Scientifique SAS, Lyon, France. saffarini@mac.com. 5. Department of Medical Technology, Accelerate Innovation Management SA, Geneva, Switzerland. saffarini@mac.com.
Abstract
PURPOSE: The incidence of retear following rotator cuff repair remains a major concern, and the cause and timing of retear remain unclear. The aim of this study was to prospectively investigate the timing of retears following rotator cuff repair at multiple time intervals. The hypothesis was that the 'critical period' for retears extends beyond the first three post-operative months. METHODS: The authors prospectively studied 206 shoulders that underwent arthroscopic double-row (without suture bridge) suture anchor repair for rotator cuff tears. Patients were recalled to three follow-up visits at the following post-operative time intervals: 3, 6, and 12 months or longer. Ultrasonography was performed at each visit, and Constant score was collected during the last visit. RESULTS: A total of 176 shoulders attended all required follow-up visits with mean age 56.0 years. Ultrasonography revealed retears in 16 shoulders (9.1 %) at 3 months, in 6 shoulders (3.4 %) at 6 months, and in 5 others (2.8 %) at the last follow-up, while it confirmed intact rotator cuffs in 149 shoulders (84.7 %) at the last follow-up (median 35.5; range 12-61). The incidence of retears was significantly associated with tear size (p = 0.001) and tendon degeneration (p = 0.003). CONCLUSION: The 'critical period' for healing following rotator cuff repair, during which risks of retears are high, extends to the first 6 months. The risk of retear is greatest for massive 3-tendon tears, which may require longer periods of protection. The clinical relevance of this study is the identification of patients at risk of retear and the adjustment of their rehabilitation strategy and time for return to work. LEVEL OF EVIDENCE: III.
PURPOSE: The incidence of retear following rotator cuff repair remains a major concern, and the cause and timing of retear remain unclear. The aim of this study was to prospectively investigate the timing of retears following rotator cuff repair at multiple time intervals. The hypothesis was that the 'critical period' for retears extends beyond the first three post-operative months. METHODS: The authors prospectively studied 206 shoulders that underwent arthroscopic double-row (without suture bridge) suture anchor repair for rotator cuff tears. Patients were recalled to three follow-up visits at the following post-operative time intervals: 3, 6, and 12 months or longer. Ultrasonography was performed at each visit, and Constant score was collected during the last visit. RESULTS: A total of 176 shoulders attended all required follow-up visits with mean age 56.0 years. Ultrasonography revealed retears in 16 shoulders (9.1 %) at 3 months, in 6 shoulders (3.4 %) at 6 months, and in 5 others (2.8 %) at the last follow-up, while it confirmed intact rotator cuffs in 149 shoulders (84.7 %) at the last follow-up (median 35.5; range 12-61). The incidence of retears was significantly associated with tear size (p = 0.001) and tendon degeneration (p = 0.003). CONCLUSION: The 'critical period' for healing following rotator cuff repair, during which risks of retears are high, extends to the first 6 months. The risk of retear is greatest for massive 3-tendon tears, which may require longer periods of protection. The clinical relevance of this study is the identification of patients at risk of retear and the adjustment of their rehabilitation strategy and time for return to work. LEVEL OF EVIDENCE: III.
Authors: Bruce S Miller; Brian K Downie; Robert B Kohen; Theresa Kijek; Bryson Lesniak; Jon A Jacobson; Richard E Hughes; James E Carpenter Journal: Am J Sports Med Date: 2011-07-07 Impact factor: 6.202
Authors: Patrick Henry; David Wasserstein; Sam Park; Tim Dwyer; Jaskarndip Chahal; Gerard Slobogean; Emil Schemitsch Journal: Arthroscopy Date: 2015-09-11 Impact factor: 4.772
Authors: Bradley L Young; Evan D Sheppard; Sierra Phillips; Trevor M Stubbs; Jun Kit He; Andrew Moon; Martim C Pinto; Gerald McGwin; Eugene William Brabston; Shawn R Gilbert; Brent A Ponce Journal: JSES Int Date: 2022-01-30