The administration of IV iron sucrose seems to reduce ABT requirements in patients with PHF and is associated to lower postoperative morbidity. The possible mechanisms involved in these effects are discussed.
Purpose The purpose of this study was to compare arthroscopic rotator cuff repair with single-row and double-row techniques because research has demonstrated the superiority of double-row repair from a biological and mechanical point of view but there is no evidence of clinical superiority. Methods A total of 160 patients with a full-thickness rotator cuff tear underwent arthroscopic repair with suture anchors. They were randomised into two groups of 80 patients according to the repair technique: single-row (group 1) and double-row (group 2). Results were evaluated by use of the University of California, Los Angeles (UCLA), American Shoulder and Elbow Surgeons (ASES) and Constant questionnaires, the Shoulder Strength Index (SSI) and range of motion. Follow-up time was two years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and two years after repair. Results One hundred per cent of the patients were followed up. All measurements showed significant improvement compared with the preoperative status. The UCLA score showed significant improvement in group 2. In over 30-mm tears UCLA and ASES showed significant differences. SSI showed significant improvement in group 2. Range of motion showed significant improvements in flexion and abduction in group 2. In under 30-mm tears group 2 showed also significant improvement in internal and external rotation. In MRI studies there were no significant differences.Conclusions At two years follow-up the double-row repair technique showed a significant difference in clinical outcome compared with single-row repair and this was even more significative in over 30-mm tears. No MRI differences were observed.
Preoperative parenteral iron administration could be a safe and effective way to reduce the ABT requirements in DSHF patients. This reduction in the ABT requirements is accompanied by a reduction in the morbid-mortality rate and LOS. A large, randomised, controlled trial to confirm these results is warranted.
The blood-saving protocol implemented seems to reduce ABT requirements in patients with HF, and is associated with a lower postoperative morbidity. The possible mechanisms involved in these effects are discussed.
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