Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

Liu, Cen Tao; Ge, Heng An; Hu, Rui; Jing, Huang; Cheng, Yi; Wang, Min; Wu, Peng; Cheng, Biao

doi:10.1177/2309499018770897

Cited by 10 publications

(17 citation statements)

References 31 publications

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“…Repair of PTRCTs can either be performed with an in-situ ("trans-cuff") repair technique (leaving the intact cuff portion intact) or with a tear conversion into a full-thickness cuff tear and subsequent repair. Successful functional and structural outcome [23][24][25][26] after repair of Ellman grade 3 tears could be shown with both repair techniques. Interestingly, current literature suggests an evidence for inferior outcomes and higher failure rates after arthroscopic debridement of bursal-sided PTRCTs compared to articular-sided lesions [3] .…”

Section: Surgical Techniquesmentioning

confidence: 92%

“…Several surgical techniques of in-situ repair have been described [23][24][25][26][30][31][32] , however, with no superiority of one specific technique to the others (Figure 3). A proposed advantage of transtendinous repair techniques with preservation of the intact rotator cuff tendon integrity on the bursal side is the maintenance of the original footprint and therefore a more anatomic repair.…”

Section: In-situ Repair Versus Tear Completion Into Full-thickness Cumentioning

confidence: 99%

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Surgical Treatment Options for Partial Rotator Cuff Tears: A Review of the Literature

Borbas

Hoy

2019

International Journal of Orthopaedics

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Partial-thickness rotator cuff tears (PTRCT) can be articularsided, bursal-sided or intratendinous. New research suggests that a considerable proportion (up to 30%) of cuff thickness on the articular side is taken up histologically by the superior joint capsule conjoined to the rotator cuff tissue. This means that newer reviews of the surgical options may be required to complement the Ellman classification which grades lesions as grade 1 (less than 25% of tendon thickness involved), grade 2 (25-50%) or grade 3 (greater than 50% of tendon thickness). If primary non-operative treatment fails, many surgical options can be considered. The surgical technique chosen has been based on depth of the tear and the tear location. Surgical treatment can be distinguished between debridement and repair of PTRCT's, as well as biologically active experimental techniques showing some promise. Debridement can be successfully performed for bursal-sided Ellman grade 1 tears and articular-sided grade 1 and 2 tears. All other techniques show better results with a repair technique, which can be either performed with an in-situ or trans-cuff repair technique (leaving the intact rotator cuff portion intact) or with tear conversion to a full-thickness cuff tear and subsequent repair. Successful functional and structural outcome after repair of Ellman grade 3 tears can be shown with both repair techniques. The current literature also suggests evidence for inferior outcomes and higher failure rates after arthroscopic debridement of bursal-sided partial-thickness rotator cuff tears compared to articularsided lesions, which may reflect the contribution of capsule to the tear. Articular-sided partial cuff tears are frequently seen in overhead athletes and should be treated non-operatively whenever possible. If conservative treatment fails, debridement seems to be a better surgical choice in most cases, as only a half of professional athletes return to the same level of play after repair of partial-thickness rotator cuff tears.

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Section: Surgical Techniquesmentioning

confidence: 92%

Section: In-situ Repair Versus Tear Completion Into Full-thickness Cumentioning

confidence: 99%

Surgical Treatment Options for Partial Rotator Cuff Tears: A Review of the Literature

Borbas

Hoy

2019

International Journal of Orthopaedics

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“…Of these 17/20 were retrospective case series including single surgeon data for 1069 shoulders. 2,19,20,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Mean follow-up was 35 months (range 18-60). Two of these 17 case series compared transtendinous repair with completion repair in a single surgeon series in terms of pain and function; however, each of these papers uses completely different outcome scoring systems, with one employing the CMS and SST, the other using ASES score with a visual analogue score for pain.…”

Section: Case Series and Technical Notesmentioning

confidence: 99%

Partial articular supraspinatus tendon avulsion: Should we repair? A systematic review of the evidence

Tennent

Green

2019

Shoulder & Elbow

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Introduction Partial articular sided rotator cuff tears are described as being a common cause of shoulder pain and to have a significant impact of patient quality of life. The natural history of partial articular supraspinatus tendon avulsion lesions is not clearly defined and there is limited evidence to determine optimal management. Aims To perform a systematic review of the literature regarding the evidence for partial articular supraspinatus tendon avulsion repair and to determine whether there is any difference between operative and non-operatively managed patients. Methods Conventional and grey literature were searched with defined terms to identify studies in human adults concerning management of partial articular sided supraspinatus avulsions. Results Out of 86 papers identified by the search terms, 28 were deemed eligible for review including 1966 shoulders. 4/28 papers were of level I–II evidence but all were comparing techniques. 4/28 papers were biomechanical cadaveric studies, assessing strength of repair and effect on stability. The remaining 20 studies were level IV–V evidence and consisted of case series and technical notes identifying varying techniques of repair and their outcomes. Conclusion Current literature suggests that all techniques used to repair partial articular supraspinatus tendon avulsion lesions give increased functional scores and reduced pain. However, this represents a heterogeneous group of patients with variable degrees of tear and is not reproducible. There are limited controlled studies to determine whether partial articular supraspinatus tendon avulsion lesions require repair. Current classification systems represent a single plane and are open to user variation. No evidence exists to determine which tears are stable and which may progress.

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“…Rotator cuff tear causes pain and limited motor function of shoulder 1 , 2 . The gold standard for treatment is arthroscopic repair when conventional treatment fails 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

Effects of applying platelet-rich plasma during arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomised controlled trials

Yang

Liao

et al. 2020

Sci Rep

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Because of its healing properties, platelet-rich plasma (PRP) has been applied to the bone–tendon interface during arthroscopic rotator cuff repair to improve surgical outcomes. However, its effects remain ambiguous. Therefore, we conducted this systematic review and meta-analysis to assess the effects of PRP on retear rate and functional outcomes. Randomised control trials were identified and extracted. Data collection was completed on 15 February 2020. The results are expressed as the risk ratio (RR) for the categorical variables and weighted mean difference for the continuous variables, with 95% confidence intervals (CIs). Analyses were performed using RevMan 5.3 software. Seven randomised controlled trials published from 2013 to 2018, with 541 patients in total, were included. The results revealed a significant decrease in retear rate [RR 0.38, 95% CI (0.22, 0.68), P = 0.0009). Furthermore, a significant improvement was observed regarding short-term Constant score [mean difference = 3.28, 95% CI (1.46, 5.11), P = 0.0004), short-term University of California at Los Angeles activity score [mean difference = 1.60, 95% CI (0.79, 2.42), P = 0.0001], and short-term visual analogue scale score [mean difference = − 0.14, 95% CI (− 0.23, − 0.05), P = 0.002]. This systematic review indicates the efficacy of PRP when applied to the bone–tendon interface during arthroscopic rotator cuff repair.

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Arthroscopic knotless single-row repair preserving full footprint versus tear completion repair for partial articular-sided rotator cuff tear

Cited by 10 publications

References 31 publications

Surgical Treatment Options for Partial Rotator Cuff Tears: A Review of the Literature

Surgical Treatment Options for Partial Rotator Cuff Tears: A Review of the Literature

Partial articular supraspinatus tendon avulsion: Should we repair? A systematic review of the evidence

Effects of applying platelet-rich plasma during arthroscopic rotator cuff repair: a systematic review and meta-analysis of randomised controlled trials

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