Clinical outcomes following arthroscopic repair of articular vs. bursal partial-thickness rotator cuff tears with follow-up of 2 years or more

Fukushi, Ryunosuke; Horigome, Keiko; Yamashita, Toshihiko

doi:10.1016/j.jseint.2019.12.002

Cited by 8 publications

(15 citation statements)

References 13 publications

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“…The arthroscopic repair can rebuild the anatomical structure by sutured tendons, and hence the shoulder joint can obtain a more stable structure. Numerous studies have reported impressive results of arthroscopic repair for tear thickness of less than 50% of PTRCTs 19,23 . Zafra et al 24 compared two suture techniques for treating PTRCTs, both of which could relieve the patient's pain and improve the function.…”

Section: Treatment Options For Ellman Grade II Bptrctsmentioning

confidence: 99%

“…Zafra et al 24 compared two suture techniques for treating PTRCTs, both of which could relieve the patient's pain and improve the function. Fukushi et al 23 found that arthroscopic repair significantly improved the prognosis of BPTRCTs and APTRCTs. However, arthroscopic repair also had some disadvantages, such as increased postoperative pain, longer immobilization time, higher risk of postoperative shoulder stiffness, and so forth.…”

Section: Treatment Options For Ellman Grade II Bptrctsmentioning

confidence: 99%

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Comparison of Arthroscopic Debridement and Repair in the Treatment of Ellman Grade II Bursal‐side Partial‐thickness Rotator Cuff Tears: A Prospective Randomized Controlled Trial

Wang

Ren

Zhang

et al. 2021

Orthopaedic Surgery

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Objective: To compare the effects of arthroscopic debridement and repair in treating Ellman grade II bursal-side partial-thickness rotator cuff tears.Methods: This is a single-center, prospective, randomized controlled trial. From September 2017 to April 2019, 78 patients underwent arthroscopic debridement (35 patients) or repair (43 patients) due to Ellman grade II bursal-side partial-thickness rotator cuff tears. Twenty-six men and 52 women were included in the study, with an average age of 56.31 years (range, 42 to 74 years). After the acromioplasty was formed, the debridement group only performed stump refreshing and surrounding soft tissue cleaning, while the repair group converted the partial tears into full-thickness tears and then sutured them by single row or suture bridge technique. The visual analogue scale (VAS), Constant-Murley shoulder (CMS), American Shoulder and Elbow Surgeons (ASES), and University of California, Los Angeles (UCLA) scores were used to evaluate clinical results preoperatively and at 6, 12, and 18 months postoperatively. Magnetic resonance imaging was used to assess the integrity of the rotator cuff, muscle atrophy, and fat infiltration.Results: A total of 85 patients met the inclusion criteria and were randomly divided into the debridement group (41 patients) and the repair group (43 patients). During the 18-month follow-up period, a total of seven patients were lost to follow-up. The functional scores of both groups were significantly improved: the VAS score decreased 5.06 and 4.63 in the debridement group (5.77 preoperative to 0.71 postoperative) and the repair group (5.49 to 0.86) (P < 0.05).

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Section: Treatment Options For Ellman Grade II Bptrctsmentioning

confidence: 99%

Section: Treatment Options For Ellman Grade II Bptrctsmentioning

confidence: 99%

Comparison of Arthroscopic Debridement and Repair in the Treatment of Ellman Grade II Bursal‐side Partial‐thickness Rotator Cuff Tears: A Prospective Randomized Controlled Trial

Wang

Ren

Zhang

et al. 2021

Orthopaedic Surgery

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“…In our study, the improvements of arm/hand motor function and SWB of the patient were collected over time in all stages, even though the long-term period in our study was relatively short compared to other studies over a 6-, 12- or 48- month follow-up period [ 10 , 26 ]. Although the results were sustained over time, after 6 or 12 months, residual events and dysfunction persisted [ 14 , 15 , 16 ]. Therefore, it is very clear that patient recovery rates need to be monitored and evaluated for a longer period of time.…”

Section: Discussionmentioning

confidence: 99%

“…However, it has been observed that patient satisfaction with their condition and how it affects their lives after RC surgery starts to significantly improve after 2.5 months, ranging to six months. Meanwhile, clinically relevant functional status results for patients are usually achieved only after a median postoperative period of two years [ 14 , 15 , 16 ]. Every patient who undergoes shoulder surgery for the treatment of RC tear is commonly assessed pre- and postoperatively with general and shoulder-specific measures of pain and function.…”

Section: Introductionmentioning

confidence: 99%

“…Both protective and accelerated rehabilitation protocols must be utilised based on individual patient risk for developing postoperative hand muscle stiffness (muscle strengthening exercises are delayed and applied after arthroscopic repair of RC tears greater than 5 cm or involving more than two tendons, poor tissue quality or repairs with greater tension). Arm position during immobilisation (four to five weeks after surgery) is also of importance during the early healing phase of tendon repair [ 14 , 16 ]. Continuous passive motion, cryotherapy or joint mobilization post-surgically is used to minimise postoperative pain, swelling, muscle spasm, inflammatory response while maintaining ROM following articular cartilage treatments and joint arthroplasty.…”

Section: Introductionmentioning

confidence: 99%

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Analysis of Functional Recovery and Subjective Well-Being after Arthroscopic Rotator Cuff Repair

et al. 2021

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Background: Rotator cuff tears are common causes of functional shoulder instability and often lead to arthroscopic rotator cuff repair. A well-programmed rehabilitation leads to successful tendon healing, positive functional recovery and subjective well-being (SWB). Objective: To evaluate the changes in shoulder functioning and SWB pre-, post-outpatient rehabilitation and after one-month follow-up. Materials and Methods: A total of 44 patients were assessed three times: at the beginning (six weeks’ post-surgery), at the end of outpatient rehabilitation (2–3 weeks) and one month after rehabilitation. The outcome measures were the Disabilities of the Arm, Shoulder and Hand score (DASH), active range of motion (ROM), manual muscle testing (MMT), hand dynamometry (HD) and pain level by a Visual Analogue Scale (VAS). SWB was assessed by Rosenberg self-esteem scale (RSES), Positive and Negative Affect Schedule (PANAS) and the Lithuanian Psychological Well-Being Scale (LPWBS). Results are presented as a difference between periods. Results: Affected shoulder motor function (MMT, HD and ROM) significantly improved in three periods (p < 0.05); however, major recovery was observed in the follow-up period. VAS scores meaningfully decreased over all stages and negatively correlated with motor function recovery (p < 0.05). DASH rates exhibited significant retrieval in all phases, especially in follow-up. SWB results demonstrated the larger effects of self-evaluation in follow-up, improved daily functions and psychological wellness, then negative emotions significantly decreased (p < 0.05). Conclusions: The experienced pain and psychosocial factors significantly influence functional recovery of the shoulder during rehabilitation. The improvement in motor function, ability and pain relief during rehabilitation increases level of SWB, psychological wellness and positive emotional affect in long-term context.

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Arthroscopic management of isolated partial‐thickness rotator cuff tears

Longo,

Marino,

Lalli

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of the present study is to provide a comprehensive review on the surgical outcomes following arthroscopic treatments of partial‐thickness rotator cuff tears (PT‐RCTs) and to compare the postoperative American Shoulder and Elbow Surgeons (ASES) score following in situ transtendon repair and tear completion, followed by repair.MethodsMedline, EMBASE, Scopus, CINAHL and CENTRAL bibliographic databases were searched. Papers including patients with PT‐RCTs of any grade who underwent treatment using debridement, in situ transtendon repair, tear completion and repair or bioinductive collagen implants were reviewed. Primary PT‐RCTs were the sole indication for surgery. Primary postoperative outcomes assessed included the ASES score, the Absolute Constant–Murley score, the Simple Shoulder Test, the Visual Analogue Scale, the University of California‐Los Angeles Shoulder Scale, the Western Ontario Rotator Cuff Score, range of motion, complications and revisions. A meta‐analysis of comparative studies compared the postoperative ASES score between patients treated with in situ transtendon repair versus tear completion repair.ResultsTwenty‐eight studies were included. The ASES score was reported by four comparative studies with contrasting results. The heterogeneity was high (I2 = 86%), and effect sizes ranged from −0.49 in favour of the tear completion and repair technique to an effect size of +1.07 favouring in situ transtendon repair. The overall effect size of 0.02 suggests an equivalence between the two techniques in terms of the ASES score. Two studies with a total sample size of 111 patients reported on debridement, and four studies with a total sample size of 155 patients reported on bioinductive collagen implants.ConclusionDebridement alone is suitable for Ellman grades I‐II PT‐RCTs. In situ transtendon and tear completion repair techniques yield similar postoperative outcomes. Bioinductive collagen implants hold promise but lack long‐term efficacy data. High‐quality comparative studies are needed to determine the best treatment for PT‐RCTs.Level of EvidenceLevel IV.

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Clinical outcomes following arthroscopic repair of articular vs. bursal partial-thickness rotator cuff tears with follow-up of 2 years or more

Cited by 8 publications

References 13 publications

Comparison of Arthroscopic Debridement and Repair in the Treatment of Ellman Grade II Bursal‐side Partial‐thickness Rotator Cuff Tears: A Prospective Randomized Controlled Trial

Comparison of Arthroscopic Debridement and Repair in the Treatment of Ellman Grade II Bursal‐side Partial‐thickness Rotator Cuff Tears: A Prospective Randomized Controlled Trial

Analysis of Functional Recovery and Subjective Well-Being after Arthroscopic Rotator Cuff Repair

Arthroscopic management of isolated partial‐thickness rotator cuff tears

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