Arthroscopic Supraspinatus Tendon Repair with Suture-Bridging Technique

Voigt, C.; Bosse, Christin; Vosshenrich, R.; Schulz, Arndt P.; Lill, Helmut

doi:10.1177/0363546509359063

Cited by 135 publications

(153 citation statements)

References 31 publications

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“…Data are conflicting on which, if any, of these programs provides superior results. Early aggressive rehabilitation programs have been shown to result in better early outcomes, pain relief, and range of motion however most studies show no difference with regard to these parameters with longer-term followup [60][61][62][63][64][65][66] . One concern with early aggressive rehabilitation programs is that they may be associated with a higher incidence of tendon re-tear.…”

Section: Rehabilitationmentioning

confidence: 99%

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

162

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Rotator cuff repair has been shown to have good longterm results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair. Core tip: Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscletendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing after rotator cuff repair. Smoking cessation and blood glucose and cholesterol control are methods to potentially improve healing rates. Slower, less aggressive rehabilitation programs may improve healing rates with no negative effect on final range of motion and are therefore recommended after arthroscopic repair of most full thickness tears. Finally, no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates after rotator cuff repair. Routine use of these adjuvants is therefore not currently recommended.

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Section: Rehabilitationmentioning

confidence: 99%

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

162

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“…Nach der Weiterentwicklung von der Single-row zur Double-row Technik konnten zwei Studien zeigen, dass die Double-row Technik signifikant bessere Einheilungsergebnisse erlangte jedoch bei identischen klinischen Ergebnissen [77,90]. Die Untersuchung der suture-bridge gegenüber der Double-row Technik zeigte keine weitere Verbesserung des Outcomes [94]. Ein weiterer Kritikpunkt der arthroskopischen Technik besteht in der Wirtschaftlichkeit.…”

Section: Ergebnisse Nach Alterunclassified

Mittelfristige Ergebnisse nach offener Rotatorenmanschettenrekonstruktion in Double-Row-Technik mit Titanankerschraube

et al. 2015

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Zusammenfassung Hintergrund: Die Double-Row-Rotatorenmanschettenrekonstruktion wird kontrovers diskutiert, da trotz besserer biomechanischer Eigenschaften, einer verminderten Rerupturrate und h?herer Kosten bisher keine eindeutigen Unterschiede zur Single-Row-Fixation im klinischen Ergebnis nachgewiesen wurden. Es werden mittelfristige Ergebnisse einer offenen Double-Row-Fixationstechnik mit Titanankerschrauben vorgestellt. Material und Methoden: 237 Patienten (m?=?142; w?=?95; Alter: 56,3 Jahre) wurden 2007 von einem Operateur (M.?G.) in dieser Technik operiert. Pr?operativ, 2 und 4,5 Jahre postoperativ wurde mit Follow-up-Raten von 86, 87 und 83?% ein subjektiver Schulterfragebogen (SSG) erhoben. 5,1 Jahre postoperativ erfolgte bei 131 Patienten eine objektive Nachuntersuchung mit standardisierter Kraft- und Beweglichkeitsmessung sowie die Erhebung des Constant-Murley-Scores (CS), des Simple-Shoulder-Tests (SST), der Patientenzufriedenheit in Schulnoten und des subjektiven Schulterwerts nach Gerber. Die Sehnenintegrit?t wurde sonografisch ?berpr?ft. Dabei wurde die absolute Rerupturrate (Teil- und Redefekte) sowie die relative Rerupturrate (Teil- und Redefekte, Ausd?nnung und Verdickung der Sehne) bestimmt. Ergebnisse: F?nf Jahre nach Operation zeigt sich im SSG eine h?chst signifikante Steigerung von 51 auf 83 Punkte (p?

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“…Although the severity of fatty muscle 2,3 infiltration has important implications on the success of rotator cuff repairs, little longitudinal information regarding the risks for progression of muscle degenerative changes is available. Currently, surgical indications for rotator cuff treatment vary widely.…”

mentioning

confidence: 99%

“…Several studies have examined the factors associated with decreased healing rates following cuff repair surgery. Among these, patient age, tear size, and fatty infiltration have consistently been shown to negatively impact healing 2,[4][5][6] . While previous studies have examined the progression of tear size over time as well as the association of fatty muscle infiltration in relation to tear size, to our knowledge none have looked specifically at the temporal progression of muscle degeneration 1,7,8 .…”

mentioning

confidence: 99%

“…Fatty infiltration is associated with decreased healing and worse functional outcome following rotator cuff repair 15,16 . Multiple studies have suggested that muscle infiltration beyond grade 2, according to the Goutallier classification 17 , represents an inflection point at which healing becomes less consistent 2,4 . Determining factors related to the development and timing of muscle degeneration is potentially important for counseling patients with regard to optimal surgical timing.…”

mentioning

confidence: 99%

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