Surgical repair of massive rotator cuff tendon tears: Autologous quadriceps tendon graft versus arthroscopic repair
| Autor: | Nicolas Pujol, F. Lespagnol, J. Pierrart, Christine Tempelaere, Pierre Desmoineaux, P. Beaufils |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Shoulder medicine.medical_specialty Shoulders Osteoarthritis Transplantation Autologous Rotator Cuff Injuries Tendons Arthroscopy 03 medical and health sciences Postoperative Complications 0302 clinical medicine Shoulder Pain medicine Humans Orthopedics and Sports Medicine Rotator cuff Muscle Strength Aged Pain Measurement Retrospective Studies Surgical repair 030222 orthopedics Sutures Shoulder Joint business.industry Retrospective cohort study 030229 sport sciences Middle Aged medicine.disease Tendon Surgery Treatment Outcome medicine.anatomical_structure Female Quadriceps tendon Tendon tears business Follow-Up Studies |
| Zdroj: | Orthopaedics & Traumatology: Surgery & Research. 103:435-440 |
| ISSN: | 1877-0568 |
| DOI: | 10.1016/j.otsr.2016.12.020 |
| Popis: | Introduction Massive rotator cuff tear repair results are variable. The main purpose of this study was to compare functional outcome between two procedures: open repair by autologous quadriceps-patella tendon patch, and arthroscopic suture. The study hypothesis was that there is no significant difference in results between the two techniques. Material and methods A retrospective study included all patients younger than 70 years operated on from 1995 to 2013 for massive rotator cuff tear. Exclusion criteria comprised history of dislocation, fracture or surgery or osteoarthritis in the affected shoulder, and infra- and supra-spinatus fatty degeneration equal to or greater than stage 3. Two consecutive groups were distinguished: group 1, from 1995 to 2003, comprised 23 patients (24 shoulders; mean age, 55.8 years) treated by open repair using quadriceps tendon autograft; group 2, from 2003 to 2013, comprised 27 patients (29 shoulders: mean age, 60.3 years) treated by arthroscopic repair. Results Preoperatively, mean Constant score was 42.9 in group 1 and 45.7 in group 2 (P = 0.36), pain score 5.5/15 and 7.6/15 (P = 0.08), strength 3.0 kg and 2.4 kg (P = 0.30), and subacromial space 6.3 and 6.7 mm (P = 0.05), respectively. At respectively 58 and 55 months’ mean follow-up, Constant score was 71.1 in group 1 and 71.8 in group 2 (P = 0.086), pain 11.9/15 and 12.7/15 (P = 0.76), gain in strength 1.4 kg and 2.3 kg (P = 0.0006), and subacromial space 7.1 mm and 6.3 mm (P = 0.29), respectively. The complications rate was 70% in group 1 and there were no specific complications in group 2. Conclusion Functional improvement was significant and comparable between the 2 groups. Quadriceps tendon harvesting was associated with high morbidity, but the technique increased subacromial space. Level of evidence IV, retrospective, single-center. |
| Databáze: | OpenAIRE |
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