All-Arthroscopic versus Mini-Open Repair of Small to Large Sized Rotator Cuff Tears: A Meta-Analysis of Clinical Outcomes

Shan, Liancheng; Fu, Dong; Chen, Kai; Cai, Zhengdong; Li, Guodong

doi:10.1371/journal.pone.0094421

Cited by 36 publications

(33 citation statements)

References 29 publications

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“…While the current study provides support for the use of this collagen implant in preventing retears in this population, additional studies are needed to further document the ability of the implant to limit re-tearing in medium, as well as in larger (> 3 cm) rotator cuff lesions. In addition, although patients in the current study underwent either arthroscopic or miniopen repair, studies have shown no difference in clinical outcomes or re-tear rates 29,30 . Similar results have also been reported for outcomes and re-tear rates using single-or double-row suture repair techniques 15 .…”

mentioning

confidence: 67%

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Bokor

Sonnabend

Deady³

et al. 2015

MLTJ

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tissue matured over time and became indistinguishable from the underlying tendon. At 24 months all repairs remained intact and normal footprint anatomy of the tendon was restored in all patients. All clinical scores improved significantly over time. Conclusion: the ability of a collagen implant to induce new host tissue formation and restore the normal footprint anatomy may represent a significant advancement in the biological augmentation and ultimate durability of rotator cuff repairs. KEY WORDS: collagen implant, cuff repair, footprint, tendon. IntroductionRotator cuff repair is one of the most common orthopaedic procedures performed, with between 200,000 and 300,000 rotator cuffs being surgically repaired annually 1, 2 . Although surgical techniques for rotator cuff repair have advanced over the last decade, one of the most important postoperative complications of rotator cuff repair is re-tear of the repaired tendon 3 . Recent estimates suggest that retear rates in rotator cuff repair are in the order of 11 to 57% 3 . While studies have suggested that re-torn repairs can still provide clinical benefit to patients, subjective and objective outcome metrics in these patients are inferior to those patients with intact repairs [3][4][5] . Re-tear of a rotator cuff repair has been associated with a multitude of factors including patient age, tear dimensions, and tendon tissue quality 3 . However, a recent report of 1000 consecutive rotator cuff repairs found that no single preoperative or intra-operative factor was overwhelmingly predictive of re-tearing 3 . Several studies have suggested that the biomechanical environment of the healing tendon may also play a significant role in the ability to achieve a durable rotator cuff repair [6][7][8][9][10] . These studies have advocated restoring the normal footprint dimensions of the rotator cuff tendon attachment to bone and decreasing tissue strain in the healing tendon as techniques to improve the long-term integrity of rotator cuff repairs [6][7][8][9][10] . Biomechanical analysis of surgical techniques such as the 'double-row' fixation, which utilizes two rows of tendon fixation to bone to increase the contact area of the tendon attachment to bone, has shown improved initial tendon contact and strength 10 and also decreased tendon strain 8 . How- SummaryBackground: the inability to restore the normal tendon footprint and limit strains on the repair site are thought to contribute to re-tearing following rotator cuff repair. The purpose of this study was to use a collagen implant to augment rotator cuff repairs through the restoration of the native tendon footprint and the induction of new tissue to decrease overall tendon strain. Methods: repairs of full-thickness rotator cuff lesions in 9 adult patients were augmented with a novel collagen implant placed over the bursal surface of the repair. Tendon thickness and footprint anatomy were evaluated using MRI at 3, 6, 12, and 24 months. Clinical results were assessed using standard outcome metrics. Mean follow-up for ...

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mentioning

confidence: 67%

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Bokor

Sonnabend

Deady³

et al. 2015

MLTJ

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“…[28,29] MO repair is an alternative surgery pattern to combine the advantages of arthroscopic and open repair without taking down the deltoid origin. The arthroscopic technique is believed to cause less pain and allows for better recovery in the earlier postoperative period, which can reduce the patients’ off-work period and thereby reduce the disease-associated costs.…”

Section: Discussionmentioning

confidence: 99%

“…Some important factors exist influencing the incidence of rotator cuff retear, including tear size, preoperative duration of symptoms, degeneration of cuff, fixation technique, and the hardware used. [28] …”

Section: Discussionmentioning

confidence: 99%

Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears

et al. 2017

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“…An arthroscopic or mini-open surgical technique may be employed, with comparable outcomes. 40 Both double-row sutureanchor repair and transosseous fixation techniques have been described, but no biomechanical or clinical studies have been done that compare them in terms of strength or functional outcome for avulsion-type fractures. Arthroscopic repair can be performed by a surgeon experienced in shoulder arthroscopy.…”

Section: Avulsion-type Fracturesmentioning

confidence: 99%

Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus

Rouleau

Mutch

Laflamme

2016

Journal of the American Academy of Orthopaedic Surgeons

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Greater tuberosity fractures of the humerus can be successfully treated nonsurgically in most patients. However, as little as 3 to 5 mm of superior greater tuberosity displacement may adversely affect rotator cuff biomechanics and lead to subacromial impingement in patients who are active. In these cases, surgical treatment is recommended. Multiple surgical techniques include open and arthroscopic options tailored to fracture morphology, and strategies for repair include the use of suture anchors, transosseous sutures, tension bands, and plates/screws. Three classification systems are commonly used to describe greater tuberosity fractures: the AO, Neer, and morphologic classifications. Several hypotheses have been discussed for the mechanism of greater tuberosity fractures and the deforming forces of the rotator cuff, and the use of advanced imaging is being explored.

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All-Arthroscopic versus Mini-Open Repair of Small to Large Sized Rotator Cuff Tears: A Meta-Analysis of Clinical Outcomes

Cited by 36 publications

References 29 publications

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Preliminary investigation of a biological augmentation of rotator cuff repairs using a collagen implant: a 2-year MRI follow-up

Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears

Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus

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