Anatomic restoration of the articular deep layer is a definitive factor for repair status in delaminated rotator cuff tear

Yoshimura, Hideya; Kanehiro, Hiromichi; Uomizu, Mari; Ueki, Hiroko

doi:10.1016/j.jse.2022.09.025

Cited by 2 publications

(2 citation statements)

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“…Biomechanical studies have emphasized the importance of the superior capsule in maintaining normal glenohumeral joint biomechanics, highlighting the significance of achieving accurate anatomical restoration of the superior capsular layer [ 19 , 41 , 42 , 43 ]. Similarly, in the context of delaminated cuff tear repair, it has been revealed that the anatomical reduction of the articular layer, specifically the superior capsule, plays a crucial role in determining clinical outcomes [ 44 ]. Therefore, several SDLR techniques that separately suture the superior capsular layer and the bursal tendon layer have been proposed to address the benefits of anatomically restoring the superior capsular layer and minimizing tension mismatch between the tendon layers [ 9 , 17 , 18 , 45 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of En Masse Repair versus Separate Double-Layer Repair for Delaminated Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Shin,

Jang,

Han

2024

JCM

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Background: Delamination of cuff tendons has a negative impact on outcomes following arthroscopic rotator cuff repair (RCR). The purpose of this study is to compare en masse repair (EMR) and separate double-layer repair (SDLR) for delaminated rotator cuff tears. Methods: A systematic literature search was conducted on major databases (MEDLINE/PubMed, EMBASE, Cochrane Library, and Scopus) until 1 June 2023. Comparative studies with a minimum 24-month follow-up of patients undergoing arthroscopic RCR for delaminated tears were included. The outcomes assessed retear rates and functional outcomes. Results: Five eligible studies involving 325 cases were analyzed. The meta-analysis showed no significant difference in retear rates between SDLR and EMR for delaminated tears (OR = 0.73, 95% CI: 0.35–1.49). However, the meta-analysis demonstrated a significant intergroup difference in favor of the SDLR for the total Constant score (SMD = 0.68, 95% CI: 0.35 to 1.02), SST score (SMD = 0.37, 95% CI: 0.02 to 0.71), and postoperative range of abduction (SMD = 0.34, 95% CI: 0.03 to 0.64). Conclusion: The evidence suggests that the SDLR in arthroscopic RCR for delaminated rotator cuff tears leads to improved short-term functional outcomes and range of motion compared to EMR. However, there is no significant difference in retear risk between the two approaches.

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Section: Discussionmentioning

confidence: 99%

Comparison of En Masse Repair versus Separate Double-Layer Repair for Delaminated Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Shin,

Jang,

Han

2024

JCM

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“…In cases of delaminated tears, a dual-layer repair was conducted using suture anchors (HEALIX ADVANCE BR anchor; DePuy Synthes and SwiveLoc anchor; Arthrex, Inc) and suture bridging technique. Non-delaminated tears were treated with en masse bridging sutures [38].…”

Section: Surgical Proceduresmentioning

confidence: 99%

Long‐lasting decreased pain threshold negatively affects functional recovery after arthroscopic rotator cuff repair

Ueki,

Yoshimura

2023

Knee surg. sports traumatol. arthrosc.

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Purpose The relationship between sensitization and postoperative function in patients undergoing arthroscopic rotator cuff repair (ARCR). The purpose of this study was to evaluate the effect of pre-and postoperative reductions in the pressure pain threshold (PPT) on postoperative clinical outcomes in patients with ARCR and investigate changes in PPT and clinical outcomes resulting from postoperative administration of weak opioids activating the central inhibitory system. Methods This retrospective study included patients who underwent primary ARCR, categorized into Group A (excellent/ good Constant scores) and B (fair/poor Constant scores). In a complementary study, patients were randomized to the Control or Tramadol groups. Both studies evaluated the PPT, visual analog scale, active range of motion (ROM), Constant score, and retear rates pre-and postoperatively. ResultsIn the primary study with 158 patients, those with poor clinical outcomes exhibited significantly lower PPT at the affected shoulder preoperatively at 3 months postoperatively compared to those with good outcomes. The PPT of the affected side was lower than that of the uninvolved side not only at 1 and 3 months but also preoperatively and at 6 months in the poor outcome group. In the secondary study involving 96 patients, weak opioid administration was associated with increased PPT for 3 months, improved ROM at 3 months postoperatively, and reduced postoperative pain 1 year postoperatively. Conclusion Patients experiencing poor postoperative clinical outcomes exhibited prolonged lowered PPT. Lowered PPT due to sensitization may adversely affect functional recovery and pain perception. Elevating PPT using weak opioids improved clinical outcomes during the acute perioperative period after ARCR. Level of evidence III.

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Anatomic restoration of the articular deep layer is a definitive factor for repair status in delaminated rotator cuff tear

Cited by 2 publications

References 40 publications

Comparison of En Masse Repair versus Separate Double-Layer Repair for Delaminated Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Comparison of En Masse Repair versus Separate Double-Layer Repair for Delaminated Rotator Cuff Tears: A Systematic Review and Meta-Analysis

Long‐lasting decreased pain threshold negatively affects functional recovery after arthroscopic rotator cuff repair

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