Literature DB >> 33811525

Early versus delayed repair of traumatic rotator cuff tears. Does timing matter on outcomes?

Vishal Patel1, Christopher Thomas2, Helen Fort2, Richard Wood2, Amit Modi2, Radhakant Pandey2, Harvinder Singh2, Alison Armstrong2.   

Abstract

INTRODUCTION: The purpose of this study was to determine if delay (before or after 4 months) in repairing a symptomatic traumatic rotator cuff tear affected clinical outcome, re-rupture rates and use of interpositional dermal grafts.
METHODS: This was a case matched (age + tear size) series of patients who underwent an early (≤ 4 months) or delayed (> 4 months) rotator cuff repair following a traumatic tear. If a direct repair could not be achieved a dermal interposition graft was used. Outcomes were collected at a median time of 30 months post-operatively using the Oxford, Constant and EQ5D scores.
RESULTS: Twenty patients underwent rotator cuff repair within 4 months (1-4) of injury. Twenty age and cuff tear size-matched patients were identified who had undergone a delayed repair (4.1-24 months) after injury. We found no significant difference (p > 0.05) in patient reported outcomes scores between the early and delayed repair. [Oxford scores; Early 43(13-48), Delayed 45 (31-48); Constant scores; Early 73 (21-94), Delayed 73.5 (44-87); EQ5D; Early 0.75 (0.25-1), Delayed 0.77 (0.4-1)]. Time to full recovery was significantly longer (14 vs 33.8 months) for the delayed repair group (P > 0.05). When cuff tears were subdivided into < 3 cm tears or ≥ 3 cm tears, no significant difference outcome scores were founds. However, use of dermal interposition graft was 44% in delayed group for tears ≥ 3 cm. No grafts were used in early repair group. There was one symptomatic re-tear in our series which was in the early repair group.
CONCLUSION: When compared to the delayed repair group, patients that underwent early repair of traumatic rotator cuff tears had shorter time of recovery, and less need for allograft augmentation for tears 3 cm or greater. However, at mid-term follow-up, this study found no difference in patient reported outcomes following early versus delayed repair of traumatic rotator cuff tears. LEVEL OF EVIDENCE: 3.
© 2021. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.

Entities:  

Keywords:  Delayed repair; Early repair; Graft jacket; Rotator cuff repair; Shoulder outcomes; Traumatic rotator cuff tear

Mesh:

Year:  2021        PMID: 33811525     DOI: 10.1007/s00590-021-02962-w

Source DB:  PubMed          Journal:  Eur J Orthop Surg Traumatol        ISSN: 1633-8065


  17 in total

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Authors:  H Fukuda
Journal:  J Shoulder Elbow Surg       Date:  2000 Mar-Apr       Impact factor: 3.019

2.  Acute rotator cuff tear: do we miss the early diagnosis? A prospective study showing a high incidence of rotator cuff tears after shoulder trauma.

Authors:  Anne K B Sørensen; Klaus Bak; Annabel L Krarup; Charlotte H Thune; Marianne Nygaard; Uffe Jørgensen; Carsten Sloth; Søren Torp-Pedersen
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3.  Results of early operative treatment of rotator cuff tears with acute symptoms.

Authors:  Hannu E Lähteenmäki; Petri Virolainen; Ari Hiltunen; Jouni Heikkilä; Olavi I Nelimarkka
Journal:  J Shoulder Elbow Surg       Date:  2006 Mar-Apr       Impact factor: 3.019

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Authors:  Steve A Petersen; Todd P Murphy
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6.  Investigating minimal clinically important difference for Constant score in patients undergoing rotator cuff surgery.

Authors:  Juha Kukkonen; Tommi Kauko; Tero Vahlberg; Antti Joukainen; Ville Aärimaa
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7.  Function of the rabbit supraspinatus muscle after large detachment of its tendon: 6-week, 3-month, and 6-month observation.

Authors:  J Fabiś; P Kordek; A Bogucki; J Mazanowska-Gajdowicz
Journal:  J Shoulder Elbow Surg       Date:  2000 May-Jun       Impact factor: 3.019

8.  Traumatic tears of the subscapularis tendon. Clinical diagnosis, magnetic resonance imaging findings, and operative treatment.

Authors:  A Deutsch; D W Altchek; D M Veltri; H G Potter; R F Warren
Journal:  Am J Sports Med       Date:  1997 Jan-Feb       Impact factor: 6.202

9.  The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders.

Authors:  Hanna C Björnsson; Rolf Norlin; Kajsa Johansson; Lars E Adolfsson
Journal:  Acta Orthop       Date:  2011-03-24       Impact factor: 3.717

10.  Determination and comparison of the smallest detectable change (SDC) and the minimal important change (MIC) of four-shoulder patient-reported outcome measures (PROMs).

Authors:  Derk A van Kampen; W Jaap Willems; Loes W A H van Beers; Rene M Castelein; Vanessa A B Scholtes; Caroline B Terwee
Journal:  J Orthop Surg Res       Date:  2013-11-14       Impact factor: 2.359

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