Yoshitsugu Takeda1, Koji Fujii2, Naoto Suzue2, Katsutoshi Miyatake3, Yoshiteru Kawasaki2, Kenji Yokoyama4. 1. Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, Tokushima, JAPAN. Electronic address: ytakeda@tokushima-med.jrc.or.jp. 2. Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, Tokushima, JAPAN. 3. Department of Orthopaedic Surgery, Yoshinogawa Medical Center, Tokushima, JAPAN. 4. Department of Orthopaedic Surgery, Tokushima Red Cross Hospital, Tokushima, JAPAN; Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University, Tokushima, JAPAN.
Abstract
PURPOSE: This study aimed to examine the correlation of repair tension during arthroscopic rotator cuff repair (ARCR) with preoperative factors and to evaluate whether measuring tension during ARCR is effective for predicting rotator cuff integrity after ARCR. METHODS: Patients who underwent ARCR from May 2014 to June 2017 were enrolled in this study. Inclusion criteria were patients with medium or larger-sized tears and with a minimum of 6 months follow-up. Patients with a partial repair were excluded. Intraoperative repair tension was measured according to Davidson's method. Correlation of repair tension with preoperative factors was evaluated with Pearson and Spearman correlation coefficient tests. Logistic regression analysis was performed on intraoperative factors, including repair tension, to identify independent predictors of retear after ARCR. Receiver operating characteristic (ROC) curve was used to determine the cutoff value of repair tension for retear. RESULTS: One-hundred and twenty patients met the inclusion criteria. Mean repair tension was 26.6±12.6 N, and retear was found in 29 shoulders (24.2%). Among the preoperative factors, tear size in the mediolateral (p<0.001) and anteroposterior (p<0.001) directions, DeOrio and Cofield's classification (p<0.001), geometric classification (p<0.001), and fatty infiltration of supraspinatus (p=0.006) and infraspinatus (p=0.003) were significantly correlated with repair tension. However, multivariable logistic regression analysis identified only tear size in the mediolateral direction as an independent predictor of repair tension (p=0.036). Logistic regression analysis showed that repair tension (p=0.02) and geometric classification (p<0.001) are significant factors affecting rotator cuff integrity after ARCR. ROC curve analysis showed the cutoff value of repair tension of large to massive tears for retear to be 35.6 N. CONCLUSION: This study demonstrated that intraoperative repair tension is strongly correlated with tear size in the mediolateral direction based on preoperative magnetic resonance imaging, and that measuring tension during ARCR is effective for predicting rotator cuff integrity after ARCR.
PURPOSE: This study aimed to examine the correlation of repair tension during arthroscopic rotator cuff repair (ARCR) with preoperative factors and to evaluate whether measuring tension during ARCR is effective for predicting rotator cuff integrity after ARCR. METHODS:Patients who underwent ARCR from May 2014 to June 2017 were enrolled in this study. Inclusion criteria were patients with medium or larger-sized tears and with a minimum of 6 months follow-up. Patients with a partial repair were excluded. Intraoperative repair tension was measured according to Davidson's method. Correlation of repair tension with preoperative factors was evaluated with Pearson and Spearman correlation coefficient tests. Logistic regression analysis was performed on intraoperative factors, including repair tension, to identify independent predictors of retear after ARCR. Receiver operating characteristic (ROC) curve was used to determine the cutoff value of repair tension for retear. RESULTS: One-hundred and twenty patients met the inclusion criteria. Mean repair tension was 26.6±12.6 N, and retear was found in 29 shoulders (24.2%). Among the preoperative factors, tear size in the mediolateral (p<0.001) and anteroposterior (p<0.001) directions, DeOrio and Cofield's classification (p<0.001), geometric classification (p<0.001), and fatty infiltration of supraspinatus (p=0.006) and infraspinatus (p=0.003) were significantly correlated with repair tension. However, multivariable logistic regression analysis identified only tear size in the mediolateral direction as an independent predictor of repair tension (p=0.036). Logistic regression analysis showed that repair tension (p=0.02) and geometric classification (p<0.001) are significant factors affecting rotator cuff integrity after ARCR. ROC curve analysis showed the cutoff value of repair tension of large to massive tears for retear to be 35.6 N. CONCLUSION: This study demonstrated that intraoperative repair tension is strongly correlated with tear size in the mediolateral direction based on preoperative magnetic resonance imaging, and that measuring tension during ARCR is effective for predicting rotator cuff integrity after ARCR.