Jin Hwa Jeong1, Eun Ji Yoon2, Bo Seoung Kim2, Jong-Hun Ji3. 1. Joint Center, Department of Orthopedic Surgery, Shinsegae Seoul Hospital, 841, Gyeongin-ro, Yeongdeungpo-gu, Seoul, 07305, Republic of Korea. 2. Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64, Daeheung-ro, Jung-gu, Daejeon, 34943, Republic of Korea. 3. Department of Orthopedic Surgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 64, Daeheung-ro, Jung-gu, Daejeon, 34943, Republic of Korea. jijh87@gmail.com.
Abstract
PURPOSE: In large-to-massive rotator cuff tears (MRCTs), incorporating the long head of the biceps tendon (LHBT) with arthroscopic partial rotator cuff and margin convergence can improve clinical outcomes and preserve the acromio-humeral interval (AHI) during mid-term follow-up. The purpose of this study was to evaluate mid-term clinical and radiological outcomes of arthroscopic biceps-incorporating rotator cuff repair with partial release of the LHBT and footprint medialization through the Neviaser portal in MRCTs. METHODS: This study enrolled 107 patients (38 males and 69 females, mean age: 64.9 ± 8.6 years) with MRCTs. A novel arthroscopic biceps-incorporating repair was performed by footprint medialization, with a partially released biceps tendon covering central defects. Clinical outcomes such as pain VAS, KSS, ASES, UCLA, SST and CS scores and ROM were evaluated at a mean follow-up time of 35 months (range 12-132 months). Serial radiographs with a mean postoperative MRI follow-up duration of 33 months were used to evaluate AHI, tendon integrity, fatty infiltration (FI) and muscle hypotrophy. RESULTS: Postoperative pain VAS, KSS, ASES, UCLA, SST, and CS scores and ROM (except external rotation) were improved significantly. AHI also improved significantly from 8.6 to 9.3 mm. According to Sugaya's classification, type I, II, III, IV, or V healing status was found in 30 (28.0%), 29 (27.1%), 26 (24.3%), 14 (13.1%), and 8 (7.5%) patients, respectively. The retear rate was 22 (20.6%). CONCLUSIONS: Novel biceps-incorporating cuff repair with footprint medialization yielded satisfactory outcomes in MRCT patients at the 3-year follow-up. A partially released, repaired biceps tendon provided superior stability with preserved AHI similar to that of anterior cable reconstruction. LEVEL OF EVIDENCE: IV.
PURPOSE: In large-to-massive rotator cuff tears (MRCTs), incorporating the long head of the biceps tendon (LHBT) with arthroscopic partial rotator cuff and margin convergence can improve clinical outcomes and preserve the acromio-humeral interval (AHI) during mid-term follow-up. The purpose of this study was to evaluate mid-term clinical and radiological outcomes of arthroscopic biceps-incorporating rotator cuff repair with partial release of the LHBT and footprint medialization through the Neviaser portal in MRCTs. METHODS: This study enrolled 107 patients (38 males and 69 females, mean age: 64.9 ± 8.6 years) with MRCTs. A novel arthroscopic biceps-incorporating repair was performed by footprint medialization, with a partially released biceps tendon covering central defects. Clinical outcomes such as pain VAS, KSS, ASES, UCLA, SST and CS scores and ROM were evaluated at a mean follow-up time of 35 months (range 12-132 months). Serial radiographs with a mean postoperative MRI follow-up duration of 33 months were used to evaluate AHI, tendon integrity, fatty infiltration (FI) and muscle hypotrophy. RESULTS: Postoperative pain VAS, KSS, ASES, UCLA, SST, and CS scores and ROM (except external rotation) were improved significantly. AHI also improved significantly from 8.6 to 9.3 mm. According to Sugaya's classification, type I, II, III, IV, or V healing status was found in 30 (28.0%), 29 (27.1%), 26 (24.3%), 14 (13.1%), and 8 (7.5%) patients, respectively. The retear rate was 22 (20.6%). CONCLUSIONS: Novel biceps-incorporating cuff repair with footprint medialization yielded satisfactory outcomes in MRCT patients at the 3-year follow-up. A partially released, repaired biceps tendon provided superior stability with preserved AHI similar to that of anterior cable reconstruction. LEVEL OF EVIDENCE: IV.
Authors: Maxwell C Park; Yasuo Itami; Charles C Lin; Adam Kantor; Michelle H McGarry; Chong J Park; Thay Q Lee Journal: Arthroscopy Date: 2018-08-02 Impact factor: 4.772
Authors: David Kovacevic; Robert J Suriani; Brian M Grawe; Edward H Yian; Mohit N Gilotra; S Ashfaq Hasan; Umasuthan Srikumaran; Samer S Hasan; Frances Cuomo; Robert T Burks; Andrew G Green; Wesley M Nottage; Sai Theja; Hafiz F Kassam; Maarouf A Saad; Miguel A Ramirez; Rodney J Stanley; Matthew D Williams; Vidushan Nadarajah; Alexis C Konja; Jason L Koh; Andrew S Rokito; Charles M Jobin; William N Levine; Christopher C Schmidt Journal: J Shoulder Elbow Surg Date: 2020-08-04 Impact factor: 3.019
Authors: Tim Vogler; Dimosthenis Andreou; Georg Gosheger; Nico Kurpiers; Clara Velmans; Yacine Ameziane; Kristian Schneider; Carolin Rickert; Dennis Liem; Dominik Schorn Journal: PLoS One Date: 2020-11-12 Impact factor: 3.240