Long-term outcome of arthroscopic massive rotator cuff repair: the importance of double-row fixation
| Autor: | Stephen S. Burkhart, Patrick J. Denard, Alexandre Lädermann, Alisha Z. Jiwani |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male medicine.medical_specialty Elbow Rotator Cuff/injuries/surgery law.invention Rotator Cuff Injuries Cohort Studies Arthroscopy/methods Arthroscopy Rotator Cuff Randomized controlled trial law Tendon Injuries medicine Humans Orthopedics and Sports Medicine Rotator cuff Range of Motion Articular Aged Retrospective Studies Aged 80 and over ddc:617 business.industry Rotator cuff injury Suture Techniques Tendon Injuries/surgery Retrospective cohort study Recovery of Function Middle Aged medicine.disease musculoskeletal system Surgery Tendon medicine.anatomical_structure Logistic Models Treatment Outcome Multivariate Analysis Female business Range of motion Cohort study Follow-Up Studies |
| Zdroj: | Arthroscopy, Vol. 28, No 7 (2012) pp. 909-15 |
| ISSN: | 1526-3231 0749-8063 |
| Popis: | Purpose The purpose of this study was to (1) evaluate the long-term functional outcome of arthroscopic rotator cuff repair of massive rotator cuff tears (RCTs) and (2) compare double-row (DR) and single-row (SR) repairs. Methods This was a retrospective review of massive RCTs treated with an arthroscopic rotator cuff repair over an 8-year period. Minimum 5-year follow-up was available for 126 repairs at a mean of 99 months. Among 107 complete repairs, there were 62 SR and 45 DR repairs. Functional outcome was determined by University of California, Los Angeles (UCLA) and American Shoulder and Elbow Surgeons scores. A multivariate analysis was performed to examine the role of a DR repair. Results For all repairs combined, improvements were observed in forward flexion (132° v 168°), pain (6.3 v 1.3), UCLA score (15.7 v 30.7), and American Shoulder and Elbow Surgeons score (41.7 v 85.7) ( P P = .035) and a DR repair ( P = .008). When we excluded partial repairs, postoperative UCLA gain was greater after a DR repair ( P = .007). Patients reported their shoulder as feeling closer to normal after a DR repair compared with an SR repair (93.5% v 84.4%, P = .006). A DR repair was 4.9 times more likely to lead to a good or excellent outcome ( P = .021). Conclusions When a DR repair of a massive RCT is possible, on the basis of the ability to mobilize the tendons, a better long-term functional outcome can be expected compared with an SR repair. Given the known high risk of recurrence after repair of massive RCTs and the knowledge that functional outcome is related to recurrence, a DR repair of massive RCTs should be performed when there is sufficient tendon mobility. Level of Evidence Level III, retrospective comparative study. |
| Databáze: | OpenAIRE |
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