Mohamed Imam1, Asser Sallam2, Lukas Ernstbrunner3, Glenn Boyce4, Nikolaos Bardakos5, Ashraf Abdelkafy6, Moussa Moussa6, Mohamed-Adel Ghazal6. 1. Norfolk and Norwich University Hospitals, Norfolk, England; Department of Orthopaedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt. 2. Department of Orthopaedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt. Electronic address: assersallam@hotmail.com. 3. Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland. 4. Bendigo Orthopaedic and Sports Medicine, and University Hospital Geelong, Ryrie and Bellarine Street Geelong, Geelong, VIC, Australia. 5. South West London Elective Orthopaedic Centre, Epsom, UK. 6. Department of Orthopaedic Surgery and Trauma, Suez Canal University Hospitals, Ismailia, Egypt.
Abstract
BACKGROUND: The trial aimed to prospectively compare the functional outcomes of patients undergoingarthroscopic rotator cuff repair using transosseous-equivalent double-row (TEDR) or single-row (SR) suture anchor techniques at 3 years postoperatively for both large (>3 cm) and small (<3 cm) tears. METHODS:Eighty patients with a symptomatic and magnetic resonance imaging (MRI)-proven full-thickness rotator cuff tear, who had failed conservative management of at least 6 months' duration and who had a complete passive range of motion of the affected shoulder, were enrolled in the trial. Patients were randomized to TEDR repair (n = 40) or SR repair (n = 40). Subgroup analysis was conducted for tears <3 cm (TEDR n = 17, SR n = 19) and tears >3 cm (TEDR n = 23, SR n = 21). Primary outcomes included the Oxford Shoulder Score (OSS), the University of California, Los Angeles (UCLA) score, and the Constant-Murley score (CMS). The secondary outcomes included a 0-100-mm visual analog scale (VAS) score for pain, range of motion (ROM), and EQ-5D scores. All patients completed a follow-up of 3 years. RESULTS: There was a significant difference in the mean OSS postoperative score for tears >3 cm (P = .01) and mean improvement from baseline in the TEDR group (P = .001). For tears >3 cm, mean postoperative scores were also significantly higher in the TEDR group for UCLA (P = .015) and CMS (P = .001). Post hoc testing showed that the differences between these groups was statistically significant (P < .05). For tears <3 cm, a significant postoperative difference in favor of SR repair was seen in the mean CMSs (P = .011), and post hoc testing showed that the difference was statistically significant (P = .015). No significant difference was seen with mean postoperative OSS or UCLA, and post hoc testing did not show a statistically significant difference between groups. CONCLUSIONS:TEDR repair showed improved functional outcomes for tears >3 cm compared with SR repair. For tears <3 cm, no clear benefit was seen with either technique.
RCT Entities:
BACKGROUND: The trial aimed to prospectively compare the functional outcomes of patients undergoing arthroscopic rotator cuff repair using transosseous-equivalent double-row (TEDR) or single-row (SR) suture anchor techniques at 3 years postoperatively for both large (>3 cm) and small (<3 cm) tears. METHODS: Eighty patients with a symptomatic and magnetic resonance imaging (MRI)-proven full-thickness rotator cuff tear, who had failed conservative management of at least 6 months' duration and who had a complete passive range of motion of the affected shoulder, were enrolled in the trial. Patients were randomized to TEDR repair (n = 40) or SR repair (n = 40). Subgroup analysis was conducted for tears <3 cm (TEDR n = 17, SR n = 19) and tears >3 cm (TEDR n = 23, SR n = 21). Primary outcomes included the Oxford Shoulder Score (OSS), the University of California, Los Angeles (UCLA) score, and the Constant-Murley score (CMS). The secondary outcomes included a 0-100-mm visual analog scale (VAS) score for pain, range of motion (ROM), and EQ-5D scores. All patients completed a follow-up of 3 years. RESULTS: There was a significant difference in the mean OSS postoperative score for tears >3 cm (P = .01) and mean improvement from baseline in the TEDR group (P = .001). For tears >3 cm, mean postoperative scores were also significantly higher in the TEDR group for UCLA (P = .015) and CMS (P = .001). Post hoc testing showed that the differences between these groups was statistically significant (P < .05). For tears <3 cm, a significant postoperative difference in favor of SR repair was seen in the mean CMSs (P = .011), and post hoc testing showed that the difference was statistically significant (P = .015). No significant difference was seen with mean postoperative OSS or UCLA, and post hoc testing did not show a statistically significant difference between groups. CONCLUSIONS: TEDR repair showed improved functional outcomes for tears >3 cm compared with SR repair. For tears <3 cm, no clear benefit was seen with either technique.
Authors: Nathan P Fackler; Cooper B Ehlers; Kylie T Callan; Arya Amirhekmat; Eric J Smith; Robert L Parisien; Dean Wang Journal: Orthop J Sports Med Date: 2022-05-10