Repair Tension During Arthroscopic Rotator Cuff Repair is Correlated With Preoperative Tendon Retraction and Postoperative Rotator Cuff Integrity
| Autor: | Naoto Suzue, Kenji Yokoyama, Koji Fujii, Yoshiteru Kawasaki, Katsutoshi Miyatake, Yoshitsugu Takeda |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Shoulders Rotator Cuff Injuries Arthroscopy Rotator Cuff 03 medical and health sciences 0302 clinical medicine medicine Humans Orthopedics and Sports Medicine Rotator cuff Retrospective Studies 030222 orthopedics medicine.diagnostic_test Receiver operating characteristic business.industry Tension (physics) Magnetic resonance imaging Level iv 030229 sport sciences Magnetic Resonance Imaging Surgery Tendon Treatment Outcome medicine.anatomical_structure Tears business |
| Zdroj: | Arthroscopy: The Journal of Arthroscopic & Related Surgery. 37:2735-2742 |
| ISSN: | 0749-8063 |
| DOI: | 10.1016/j.arthro.2021.03.069 |
| Popis: | 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.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.One-hundred 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.001) and anteroposterior (P.001) directions, DeOrio and Cofield's classification (P0.001), geometric classification (P.001), and fatty infiltration of supraspinatus (P = .006) and infraspinatus (P = .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 = .036). Logistic regression analysis showed that repair tension (P = .02) and geometric classification (P.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.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.Level IV, prognostic study. |
| Databáze: | OpenAIRE |
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