Julien Deranlot1, Olivier Herisson2, Geoffroy Nourissat2, David Zbili3, Jean David Werthel3, Marie Vigan4, Francois Bruchou5. 1. Clinique Drouot, Paris, France; Clinique Groupe Maussins, Paris, France. Electronic address: dr.deranlot@gmail.com. 2. Clinique Groupe Maussins, Paris, France. 3. Hôpitaux Universitaires Paris Ile-de-France Ouest, Université de Versailles Saint-Quentin-en-Yvelines, Boulogne-Billancourt, France. 4. Clinique Drouot, Paris, France. 5. Hôpital Privée de l'Ouest Parisien Groupe OrthoWest, Trappes, France.
Abstract
PURPOSE: To evaluate the clinical and radiographic outcome of a biodegradable subacromial spacer in the treatment of massive irreparable rotator cuff tear. METHODS: Between January 2011 and December 2014, all shoulders with symptomatic massive irreparable rotator cuff tears treated at our institution with arthroscopic implantation of a biodegradable subacromial spacer followed for at least 1 year were included in our series. Patients with osteoarthritis ≥ grade 3 in the Hamada classification were excluded. Outcome measures included pre- and postoperative, range of motion, Constant score, acromiohumeral distance, and Hamada classification on anteroposterior and lateral radiographs. RESULTS: Thirty-nine consecutive shoulders (37 patients) met the inclusion criteria. The mean age of patients was 69.8 (53-84) years. At the last follow-up (mean 32.8 ± 12.4 months), range of motion was significantly increased for all patients in anterior elevation (from 130° to 160°, P = .02), abduction (from 100° to 160°, P = .01), and external rotation (from 30° to 45°, P = .0001). The mean Constant score was also significantly (P < .001) improved from 44.8 (±15.2) preoperatively to 76.0 (±17.1) at the last follow-up. The mean acromiohumeral distance significantly (P = .002) decreased from 8.2 mm (±3.4) to 6.2 mm (±3.1) at the last follow-up. The Hamada score progressed of 1 radiographic stage in 4 shoulders (15%) and progressed of 3 stages in 2 (4%), whereas the other 32 shoulders remained stable. No intra- or postoperative complications were found except for 1 patient who required a revision for spacer migration. CONCLUSIONS: Arthroscopic implantation of a subacromial spacer for irreparable rotator cuff tear leads to significant improvement in shoulder function at a minimum of 1 year postoperatively. LEVEL OF EVIDENCE: Level IV, therapeutic case series; treatment study.
PURPOSE: To evaluate the clinical and radiographic outcome of a biodegradable subacromial spacer in the treatment of massive irreparable rotator cuff tear. METHODS: Between January 2011 and December 2014, all shoulders with symptomatic massive irreparable rotator cuff tears treated at our institution with arthroscopic implantation of a biodegradable subacromial spacer followed for at least 1 year were included in our series. Patients with osteoarthritis ≥ grade 3 in the Hamada classification were excluded. Outcome measures included pre- and postoperative, range of motion, Constant score, acromiohumeral distance, and Hamada classification on anteroposterior and lateral radiographs. RESULTS: Thirty-nine consecutive shoulders (37 patients) met the inclusion criteria. The mean age of patients was 69.8 (53-84) years. At the last follow-up (mean 32.8 ± 12.4 months), range of motion was significantly increased for all patients in anterior elevation (from 130° to 160°, P = .02), abduction (from 100° to 160°, P = .01), and external rotation (from 30° to 45°, P = .0001). The mean Constant score was also significantly (P < .001) improved from 44.8 (±15.2) preoperatively to 76.0 (±17.1) at the last follow-up. The mean acromiohumeral distance significantly (P = .002) decreased from 8.2 mm (±3.4) to 6.2 mm (±3.1) at the last follow-up. The Hamada score progressed of 1 radiographic stage in 4 shoulders (15%) and progressed of 3 stages in 2 (4%), whereas the other 32 shoulders remained stable. No intra- or postoperative complications were found except for 1 patient who required a revision for spacer migration. CONCLUSIONS: Arthroscopic implantation of a subacromial spacer for irreparable rotator cuff tear leads to significant improvement in shoulder function at a minimum of 1 year postoperatively. LEVEL OF EVIDENCE: Level IV, therapeutic case series; treatment study.
Authors: Philippe Valenti; Felipe Reinares; Charbel Maroun; James Choueiry; Jean-David Werthel Journal: Int Orthop Date: 2018-06-15 Impact factor: 3.075
Authors: Felipe Reinares; Andres Calvo; Nazira Bernal; Pedro Lizama; Philippe Valenti; Felipe Toro Journal: Eur J Orthop Surg Traumatol Date: 2021-06-03