Clinical outcome and prognostic factors of revision arthroscopic rotator cuff tear repair

Mora, Maria Valencia; Barrenechea, Diana Morcillo; Ríos, María Dolores Martín; Foruria, Antonio M.; Calvo, Emílio

doi:10.1007/s00167-016-4392-7

Cited by 28 publications

(15 citation statements)

References 27 publications

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“…Despite the heterogeneity of these studies, improvement in postoperative shoulder function has been reported by many authors. 24,27,32,36,39,42 In previous reports, patients achieved active forward flexion between 136° and 153°, which is supported by our mean result of 145.4°. 24,27,32,36 Clinical outcomes at short-term follow-up were good to moderate with respect to the ASES.…”

Section: Discussionsupporting

confidence: 90%

“…In the past decade, arthroscopic revision RCR has become more popular, and several articles have focused on this topic. 6,24,27,32,36,39,42 Overall, these studies reported on heterogeneous cohorts and different surgical techniques, including suture anchors, margin convergence, single row, and double row. Standardized methods are sparse mostly because of different tear sizes and different preoperative conditions after primary RCR.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical outcomes and shoulder function have improved through surgical intervention. 6,24,27,36,42 Despite good clinical outcomes, tendon integrity seems to be a concern after revision surgery. Ultrasound controlled examinations reported only 48% to 60% success rates in short-term follow-up studies.…”

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confidence: 99%

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Clinical Outcomes, Tendon Integrity, and Shoulder Strength After Revision Rotator Cuff Reconstruction: A Minimum 2 Years’ Follow-up

et al. 2018

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Clinical Outcomes, Tendon Integrity, and Shoulder Strength After Revision Rotator Cuff Reconstruction: A Minimum 2 Years’ Follow-up

et al. 2018

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“…22-24 Previous studies examining revision rotator cuff repair have only focused on the clinical outcomes and retear rates of the posterosuperior rotator cuff after revision. 14,30,36,39,40 However, to our knowledge, no study has yet focused on concomitant subscapularis full-thickness tears that are neglected during posterosuperior rotator cuff repair.…”

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confidence: 99%

Arthroscopic Revision Rotator Cuff Repair: The Role of Previously Neglected Subscapularis Tears

et al. 2021

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Background: Concomitant full-thickness tear of the subscapularis tendon is often neglected during primary posterosuperior rotator cuff repair, and its significance has not been investigated by any previous clinical study. Purpose: To investigate (1) the clinical and radiological outcomes of revision arthroscopic rotator cuff repair and (2) the number of neglected concomitant subscapularis full-thickness tears in the revision of posterosuperior rotator cuff retears and their structural integrity after repair. Study Design: Case series, Level of evidence, 4. Methods: This study retrospectively examined 58 patients who underwent arthroscopic rotator cuff revision for a retear of a previously repaired posterosuperior rotator cuff. Preoperative and postoperative functional scores and active range of motion (ROM) were assessed. The initial and most recent follow-up magnetic resonance imaging scans before revision and arthroscopic findings at the time of primary repair were reviewed to determine whether the concomitant subscapularis tear was newly developed or preexisting. Final confirmation of the tendon’s full-thickness tear was made during the revision procedure. Results: At final follow-up, mean functional shoulder scores and ROM improved significantly compared with the preoperative values ( P < .001). Among the 58 revision cases, 25 (43.1%) had a neglected full-thickness tear of the subscapularis tendon. The fatty infiltration grade of the neglected subscapularis tear progressed from a mean of 1.1 before primary repair to a mean of 1.6 before revision, and the change indicated statistically significant deterioration ( P < .001). Despite clinical improvement after revision surgery, the retear rate was considerable in the re-repaired cuff tendons (37.9%) as well as for the repaired concomitant subscapularis tears (24%). Conclusion: Among revision rotator cuff repairs, 43.1% had neglected subscapularis tears, and fatty infiltration of these initially neglected subscapularis tendons showed further progression at the time of revision. The retear rate after the repair of neglected subscapularis tears was higher than expected. Thus, detecting and treating subscapularis tear via meticulous preoperative evaluation and thorough inspection during primary arthroscopy are essential.

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“…18,27 Revision rotator cuff repair can be considered in patients with a retear. 23 However, symptoms related to rotator cuff retears are not easy to predict, and making the decision for a reoperation is difficult. 6 Nonoperative treatment has been shown to be effective for some primary rotator cuff tears, 5,17,27 and it has also been prescribed in cases of retears after rotator cuff repair.…”

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confidence: 99%

Clinical Outcomes of Nonoperative Treatment for Rotator Cuff Retears and Analysis of Factors That Affect Outcomes

Shim

Lee

Yoo

2020

Orthopaedic Journal of Sports Medicine

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Background: Patients who sustain a rotator cuff retear after arthroscopic rotator cuff repair are generally considered to have worse clinical outcomes compared with patients with an intact rotator cuff. However, some patients have good clinical outcomes, even with a retorn rotator cuff. Purpose: To report the clinical outcomes of nonoperative treatment for rotator cuff retears and analyze the factors affecting clinical outcomes after a retear. Study Design: Cohort study; Level of evidence, 3. Methods: Patients who underwent arthroscopic rotator cuff repair between 2011 and 2017 were reviewed, and those with a full-thickness retear on postoperative magnetic resonance imaging (MRI) were included in this study. According to their pre- and postoperative scores on the pain visual analog scale (pVAS) and functional visual analog scale (fVAS), the patients were divided into 3 groups: (1) mild group (pVAS ≤ 1 and fVAS ≥ 8), (2) moderate group (pVAS ≤ 1 and fVAS ≤ 7 or pVAS 2-3 and fVAS ≥ 8), and (3) severe group (pVAS ≥ 3 and fVAS ≤ 7). Preoperative data (dominant hand involvement, heavy labor) and tear size on 6-month postoperative MRI were analyzed as factors affecting clinical outcomes. Results: A total of 712 patients were reviewed, and a retear was observed in 62 patients (8.7%). Of the patients with retears, 52 were included in this study: 25 men and 27 women with a mean age of 62.6 years (range, 49-80 years) and mean follow-up period of 40 months (range, 24-88 months). According to the pVAS and fVAS scores, 25 patients (48.1%) were classified into the mild group, 9 (17.3%) into the moderate group, and 18 (34.6%) into the severe group. There were no significant differences in preoperative data among the 3 groups. The tear size in the coronal and sagittal planes decreased by 5.1 and 6.6 mm, respectively, in the mild group but increased by 2.8 and 1.4 mm, respectively, in the severe group. Conclusion: In patients with retears, 48.1% had only mild symptoms at a mean of 40 months postoperatively. Patients with severe symptoms tended to have an increased tear size on postoperative MRI.

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Clinical outcome and prognostic factors of revision arthroscopic rotator cuff tear repair

Abstract: IV.

Cited by 28 publications

References 27 publications

Clinical Outcomes, Tendon Integrity, and Shoulder Strength After Revision Rotator Cuff Reconstruction: A Minimum 2 Years’ Follow-up

Clinical Outcomes, Tendon Integrity, and Shoulder Strength After Revision Rotator Cuff Reconstruction: A Minimum 2 Years’ Follow-up

Arthroscopic Revision Rotator Cuff Repair: The Role of Previously Neglected Subscapularis Tears

Clinical Outcomes of Nonoperative Treatment for Rotator Cuff Retears and Analysis of Factors That Affect Outcomes

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