OUTCOME OF ARTHROSCOPIC NON-ANATOMIC REPAIR OF MASSIVE ROTATOR CUFF TEAR: A RETROSPECTIVE ANALYSIS
DOI:
https://doi.org/10.55519/JAMC-04-13574Keywords:
Rotator cuff tear, Anatomic repair, Constant score, University of California at Los shoulder score.Abstract
Background: The aim was to assess the clinical outcome of non-anatomic rotator-cuff repair in large tears not amenable to anatomic repair and to assess the preoperative factors that affect the result of such repairs. Study design: A retrospective case-series at GTTH, Lahore. Place and duration: Twenty-seven cases that underwent non-anatomic rotator-cuff repair at Ghurki Trust Teaching Hospital over the last 5 years and met inclusion criteria were assessed over a three-month study period (from 01/10/2023 to 31/12/2023). Study methodology: Outcome was assessed in terms of improvement in pain as per visual-analog-scale (VAS), UCLA, as well as Constant score. Furthermore, patients' satisfaction was also assessed to measure subjective efficacy of the procedure. Results: Most commonly cases of rotator cuff tear present with pain, weakness, and restriction of shoulder range of motion. Pain improved significantly (p<0.001) from preoperative score of 3.68 to 1.45. Analysis of the objective assessment showed statistically significant (p=001) improvement in Constant score from a preoperative average score of 63.63 to a postoperative average of 77.27, with significant improvement (p=0.05) in each individual scoring criteria as well. The other scoring studied: UCLA also improved significantly (p=0.001) from 25.36 to 30.18. Despite this, on subjective assessment 40.9% of the sample was very satisfied and 27.3% were satisfied with the outcome. Conclusion: Non-anatomic repair is very effective at treating the presenting complaints of the rotator cuff tear patients. Thus, alongside good clinical outcome, patient satisfaction can be predicted after the procedure.
References
van der Windt DA, Koes BW, de Jong BA, Bouter LM. Shoulder disorders in general practice: incidence, patient characteristics, and management. Ann Rheum Dis. 1995 Dec;54(12):959-64. doi: 10.1136/ard.54.12.959. PMID: 8546527; PMCID: PMC1010060.
Malavolta EA, Martinez L, Gracitelli MEC, Assunção JH, Andrade-Silva FB, Ferreira Neto AA. Clinical Outcome of Partial Repair of IrreparableRotator Cuff Tears. Rev Bras Ortop (Sao Paulo). 2020 Oct 29;57(1):136-143. doi: 10.1055/s-0040-1716763. PMID: 35198121; PMCID: PMC8856861.
Jain NB, Higgins LD, Losina E, Collins J, Blazar PE, Katz JN. Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. BMC Musculoskelet Disord. 2014 Jan 8;15:4. doi: 10.1186/1471-2474-15-4. PMID: 24397703; PMCID: PMC3893587.
Miyazaki AN, Santos PD, da Silva LA, do Val Sella G, Checchia SL, Yonamine AM. Are the good functional results from arthroscopic repair of massive rotator cuff injuries maintained over the long term? Rev Bras Ortop. 2015 Dec 30;51(1):40-4. doi: 10.1016/j.rboe.2015.12.009. PMID: 26962491; PMCID: PMC4767841.
DeOrio JK, Cofield RH. Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am. 1984 Apr;66(4):563-7. PMID: 6707035.
Miyazaki AN, Fregoneze M, Santos PD, da Silva LA, do Val Sella G, Neto DL, Muchiuti Junior M, Checchia SL. Functional evaluation of arthroscopic repair of rotator cuff injuries in patients with pseudoparalysis. Rev Bras Ortop. 2014 Apr 13;49(2):178-82. doi: 10.1016/j.rboe.2014.03.025. PMID: 26229796; PMCID: PMC4511652.
Berhouet J, Collin P, Benkalfate T, Le Du C, Duparc F, Courage O, Favard L; Société d'Orthopédie de l'Ouest. Massive rotator cuff tears in patients younger than 65 years. Epidemiology and characteristics. Orthop Traumatol Surg Res. 2009 Jun;95(4 Suppl 1):S13-8. doi: 10.1016/j.otsr.2009.03.006. Epub 2009 May 6. PMID: 19423421.
Iagulli ND, Field LD, Hobgood ER, Ramsey JR, Savoie FH 3rd. Comparison of partial versus complete arthroscopic repair of massive rotator cuff tears. Am J Sports Med. 2012 May;40(5):1022-6. doi: 10.1177/0363546512438763. Epub 2012 Mar 13. PMID: 22415210.
Oh JH, Kim SH, Shin SH, Chung SW, Kim JY, Kim SH, Kim SJ. Outcome of rotator cuff repair in large-to-massive tear with pseudoparalysis: a comparative study with propensity score matching. Am J Sports Med. 2011 Jul;39(7):1413-20. doi: 10.1177/0363546511399865. Epub 2011 Apr 1. PMID: 21460068.
Boileau P, Chuinard C, Roussanne Y, Bicknell RT, Rochet N, Trojani C. Reverse shoulder arthroplasty combined with a modified latissimus dorsi and teres major tendon transfer for shoulder pseudoparalysis associated with dropping arm. Clin Orthop Relat Res. 2008 Mar;466(3):584-93. doi: 10.1007/s11999-008-0114-x. Epub 2008 Jan 25. PMID: 18219547; PMCID: PMC2505202.
Hurschler C, Wülker N, Windhagen H, Hellmers N, Plumhoff P. Evaluation of the lag sign tests for external rotator function of the shoulder. J Shoulder Elbow Surg. 2004 May-Jun;13(3):298-304. doi: 10.1016/j.jse.2004.01.021. PMID: 15111900.
Farazdaghi A, Paschos NK, Kelly JD. Comparison between partial and full coverage repair in massive rotator cuff tears. A minimum five year follow-up. Orthop Traumatol Surg Res. 2021 Jun;107(4):102911. doi: 10.1016/j.otsr.2021.102911. Epub 2021 Mar 30. PMID: 33798791.
Shon MS, Koh KH, Lim TK, Kim WJ, Kim KC, Yoo JC. Arthroscopic Partial Repair of Irreparable Rotator Cuff Tears: Preoperative Factors Associated With Outcome Deterioration Over 2 Years. The American Journal of Sports Medicine. 2015;43(8):1965-1975. doi:10.1177/0363546515585122
Di Benedetto P, Mancuso F, Tosolini L, Buttironi MM, Beltrame A, Causero A. Treatment options for massive rotator cuff tears: a narrative review. Acta Biomed. 2021 Jul 26;92(S3):e2021026. doi: 10.23750/abm.v92iS3.11766. PMID: 34313657; PMCID: PMC8420830.
Kim SJ, Kim YH, Chun YM. Arthroscopic partial repair of massive contracted rotator cuff tears. Clin Shoulder Elbow. 2014;17:44-47.
Lee KW, Lee GS, Yang DS, Park SH, Chun YS, Choy WS. Clinical outcome of arthroscopic partial repair of large to massive posterosuperior rotator cuff tears: medialization of the attachment site of the rotator cuff tendon. Clinics in Orthopedic Surgery. 2020 Sep;12(3):353.
Kim SJ, Lee IS, Kim SH, Lee WY, Chun YM. Arthroscopic partial repair of irreparable large to massive rotator cuff tears. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2012 Jun 1;28(6):761-8.
Ishigaki N, Hata Y, Matsuba T, Hino M, Murakami N, Kobayashi H. Long-term results of partial repair for irreparable rotator cuff tear. JSES international. 2021 Jul 1;5(4):642-8.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Muhammad Usama, Bilal uddin, Muhammad Umer Faheem, Asad Amin, Mubashar Ahmed Bajwa, Ayesha Sohail, Shaheryar Ahmad Khan
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
