Thomas R Lucena1, Patrick H Lam1, Neal L Millar2, George Ac Murrell1. 1. Orthopaedic Research Institute, Research & Education Centre, St George Hospital, Sydney, Australia. 2. Institute of Infection, Immunity and Inflammation and Department of Surgery, Glasgow, UK.
Abstract
BACKGROUND: The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. METHODS: Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. RESULTS: Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. CONCLUSIONS: At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.
BACKGROUND: The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery. METHODS: Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time. RESULTS: Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group. CONCLUSIONS: At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.
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
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Authors: Sarav S Shah; Aalok Shah; Vivek Chadayammuri; Marlena McGill; Nicole Wei; David V Tuckman; Nicholas A Sgaglione Journal: J Orthop Date: 2018-01-31