Jeung Yeol Jeong1, Seung Yeop Song1, Jae Chul Yoo2, Keun Min Park1, Sang Min Lee3. 1. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea. 2. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea. Electronic address: shoulderyoo@gmail.com. 3. Division of Sports Medicine, Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs. METHODS: This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT. Another 36 patients matched for age, sex, and tear size, who underwent arthroscopic rotator cuff repair after 6 months of onset of symptoms (chronic RCT group), were selected from our institution's database within the same time frame. Postoperative indirect magnetic resonance arthrogram was obtained 6 months after the repair, and rotator cuff integrity was graded according to the guidelines as described by Sugaya. Patients were evaluated using the visual analog scale for pain, American Shoulder and Elbow Surgeons Shoulder Assessment score, and Constant scores. Scores and measurements were obtained preoperatively and at 6, 12, and 24 months after surgery. RESULTS: The clinical outcomes and range of motion recovery were better in the acute-on-chronic RCT group. Although statistically not significant, the acute-on-chronic RCT group's repair appeared closer to the complete repair and was associated with a lesser incidence of retear than the chronic RCT group. CONCLUSION: Early repair of an acute-on-chronic full-thickness RCT results in a statistically and clinically superior improvement in outcomes compared with repairs of chronic RCTs.
BACKGROUND: The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs. METHODS: This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT. Another 36 patients matched for age, sex, and tear size, who underwent arthroscopic rotator cuff repair after 6 months of onset of symptoms (chronic RCT group), were selected from our institution's database within the same time frame. Postoperative indirect magnetic resonance arthrogram was obtained 6 months after the repair, and rotator cuff integrity was graded according to the guidelines as described by Sugaya. Patients were evaluated using the visual analog scale for pain, American Shoulder and Elbow Surgeons Shoulder Assessment score, and Constant scores. Scores and measurements were obtained preoperatively and at 6, 12, and 24 months after surgery. RESULTS: The clinical outcomes and range of motion recovery were better in the acute-on-chronic RCT group. Although statistically not significant, the acute-on-chronic RCT group's repair appeared closer to the complete repair and was associated with a lesser incidence of retear than the chronic RCT group. CONCLUSION: Early repair of an acute-on-chronic full-thickness RCT results in a statistically and clinically superior improvement in outcomes compared with repairs of chronic RCTs.
Authors: Brian Forsythe; Avinesh Agarwalla; Richard N Puzzitiello; Bhavik H Patel; Yining Lu; Nikhil N Verma; Anthony A Romeo; Brian J Cole Journal: Orthop J Sports Med Date: 2020-01-03
Authors: Birgitte H Kjær; Birgit Juul-Kristensen; Susan Warming; S Peter Magnusson; Michael R Krogsgaard; Eleanor Boyle; Marius Henriksen Journal: JSES Int Date: 2020-01-14