EVALUATION OF ANATOMICAL INTEGRITY USING ULTRASOUND EXAMINATION, AND FUNCTIONAL INTEGRITY USING THE CONSTANT & MURLEY SCORE, OF THE ROTATOR CUFF FOLLOWING ARTHROSCOPIC REPAIR

Abstract

Objective: To evaluate the functional and anatomical results from surgical treatment via arthroscopy in cases of complete rupture of the rotator cuff, using ultrasound images and the Constant and Murley functional index to investigate the correlation between them. Methods: 100 patients (110 shoulders) were evaluated. The mean follow-up was 48.8 ± 33.28 months (12 to 141 months). The mean age was 60.25 ± 10.09 (36 to 81 years). Rupture of the supraspinal tendon alone occurred in 85 cases (77%), and in association with the infraspinatus in 20 cases (18%) and subscapularis in four shoulders (4%). An association of supraspinatus, infraspinatus and subscapularis lesions was found in one shoulder (1%). The lesions were classified according to DeOrio and Cofield scores as small/medium in 85 shoulders (77%) and large/extensive in 25 (23%). The clinical results were assessed in accordance with the Constant and Murley criteria. The ultrasound results relate to reports issued by different radiologists. Statistical analysis was carried out using the chi-square test, Fisher's exact test, Student's t test, Pearson's correlation, Kruskal-Wallis correlation and logistic regression (significance: p < 0.05). Results: The mean Constant evaluation was 85.3 ± 10.06 in the normal shoulders and 83.96 ± 8.67 in the operated shoulders (p = 0.224). Excellent and good results were found in 74 shoulders (67%), satisfactory and moderate results in 32 (29%) and poor results in four (4%). The ultrasound evaluation showed 38 shoulders with re-rupture (35%) and absence of rupture in 71 (65%). Among the 74 shoulders (67%) with excellent/good results, 22 (30%) presented re-rupture in the ultrasound report (p = 0.294). Among the four shoulders (4%) with poor results, two (50%) presented reports of intact tendons (p = 0.294). Conclusion: There was no statistically valid correlation between the ultrasound diagnosis and the clinical evaluation of results among the patients who underwent arthroscopic repair to treat full tear lesions of the rotator cuff. The clinical results from the complete rotator cuff repairs via arthroscopy presented a high level of functional recovery (Constant 83.96), compared with the contralateral shoulder. The postoperative ultrasound reports presented a high percentage of re-rupture (35%). Postoperative strength was greater among the patients aged under 60 years (p = 0.002) and in cases of lesions less than or equal to 3 cm (p = 0.003).

Evaluation of the functional results after rotator cuff arthroscopic repair with the suture bridge technique

“…The increased degree of fatty degeneration led to the recurrence of rotator cuff rupture after arthroscopic repair in 31.8% of the patients in the study by Ozbaydar et al, 24 in 2005, and in 30% of those in the study by Godinho et al, 25 in 2010. Most cases were asymptomatic, as patients had no pain or functional loss 26 .…”

Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears

“…Twelve months postoperatively, a standardized ultrasonogram of the operated shoulder was obtained by an independent, experienced musculoskeletal ultrasonographer to evaluate the integrity of the repaired tendons. [26] As no ultrasound-based classification system for rotator cuff repairs is available, the repairs were scored as intact or retear. As a result of the obvious incision pattern, the patient and the examiner could not be blinded postoperatively.…”

Manguito capturado: Um fator de mau prognóstico no reparo do manguito rotador

“…65 years old, using the UCLA score, obtained 96.4% of good and excellent results, as well as 2.45% of retear. Godinho et al, 23 analyzing 86 shoulders after RC repair for nontraumatic (51 shoulders) and traumatic (35 shoulders) injuries, the mean modified UCLA was 33.7 points in the first group, and 32.8 points in the second. In the present study, we obtained a mean Constant & Murley score of 74.7 points, a mean UCLA of 20 points, and a retear ratio (Sugaya 5) of 62.5%.…”