Intratendinous Rotator Cuff Tears

Park, Sang-Eun; Panchal, Karnav; Jeong, Jong Ju; Kim, Young‐Yul; Kim, Jong-Ho; Lee, Juyeob; Ji, Jong‐Hun

doi:10.1177/0363546514556741

Cited by 29 publications

(20 citation statements)

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“…Rotator cuff tears occur as a result of normal ageing, excessive loading, and microtrauma. They are common in the general population and can have serious effects on a person’s work and life [36–38]. Several therapies have been reported; however, the problem can be difficult to manage.…”

Section: Discussionmentioning

confidence: 99%

Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials

Han

Zhu

et al. 2019

J Orthop Surg Res

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Background Recently, many authors have reported the effects of platelet-rich plasma (PRP) on rotator cuff repair. Whether PRP treatment during arthroscopic rotator cuff repair improves tendon healing rates or restores full function remains unknown. The purpose of this meta-analysis was to evaluate the clinical improvement and radiological outcomes of PRP treatment in patients undergoing arthroscopic rotator cuff repair. Methods PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched. The study included only level 1 or 2 randomized controlled trials (RCTs) that compared the injection of platelet-rich plasma or platelet-rich fibrin matrix. The methodological quality of the trials was assessed using the Cochrane Handbook for Systematic Reviews of Interventions, 5.3. Continuous variables were analysed using the weighted mean difference, and categorical variables were assessed using relative risks. P < 0.05 was considered statistically significant. Results The meta-analysis revealed a lower retear rate following PRP treatment than that following the control method (mean difference, 1.10; 95% CI, 1.03 to 1.18; P = 0.004). Constant shoulder scores improved with PRP (mean difference, 2.31; 95% CI, 1.02 to 3.61; P = 0.0005). PRP treatment also resulted in higher UCLA scores (mean difference, 0.98; 95% CI, 0.27 to 1.69; P = 0.007), and simple shoulder test scores were improved (mean difference, 0.43; 95% CI, 0.11 to 0.75; P = 0.008). Finally, lower visual analogue scale scores were observed with PRP augmentation (mean difference, − 0.35; 95% CI, − 0.57 to − 0.13; P = 0.002). Conclusions The current systematic review and meta-analysis reveals that PRP treatment with arthroscopic repair of rotator cuff tears decreases the retear rate and improves the clinical outcomes. Systematic review registration PROSPERO CRD42016048416

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Section: Discussionmentioning

confidence: 99%

Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials

Han

Zhu

et al. 2019

J Orthop Surg Res

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“…Good clinical outcomes have also been reported with TT repair in intratendinous PRCTs. 37 Park et al 37 reported clinical and radiographic outcomes in 33 patients (age 53.4 ± 9.1 years) with arthroscopically confirmed intratendinous PRCTs who underwent TT suture-bridge repair. At 4.6-year follow-up, 6.1% (N = 2) demonstrated Sugaya type III healing (ie, <50% normal tendon thickness without discontinuity).…”

Section: Surgical Treatmentmentioning

confidence: 99%

Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review

Plancher

Shanmugam

Briggs

et al. 2021

J Am Acad Orthop Surg

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Partial thickness rotator cuff tears (PRCTs) are a challenging disease entity. Optimal management of PRCTs continues to be controversial. Although advances in magnetic resonance imaging and ultrasonography have aided in early diagnosis, arthroscopic evaluation remains the benchmark for diagnosis. Conservative treatment is often the first line of management for most patients; however, evidence suggests that surgical intervention may limit tear progression and the long-term sequelae. Surgical decision making is driven by factors such as age, arm dominance, etiology, activity level, tear thickness, and tear location. Many surgical options have been described in the literature to treat PRCTs including arthroscopic débridement, transosseous, in situ repair techniques, and tear completion and repair. Biologic supplements have also become an attractive alternative to aid in healing; however, the long-term efficacy of these modalities is largely unknown. This article will provide a detailed review of the etiology and natural history of PRCTs, as well as diagnosis, and current management to guide clinical decision-making and formulate an algorithm for management of PRCTs for the orthopaedic surgeon.

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“…Partial-thickness rotator cuff tears (PTRCTs) are detected in 13% to 40% of the adult population and in 70% of arthroscopically treated rotator cuff tears. 3,7,12 First-line treatment focuses on nonoperative therapy, including physical therapy, anti-inflammatory medication such as nonsteroidal anti-inflammatory drugs, and activity modification. 5,7,19,20 Even though nonoperative management is highly successful, approximately 29% to 40% of nonoperatively treated PTRCTs will increase to full-thickness rotator cuff tears.…”

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confidence: 99%

Minimum 10-Year Outcomes After Arthroscopic Repair of Partial-Thickness Supraspinatus Rotator Cuff Tears

Hazra

Hanson

et al. 2023

Am J Sports Med

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Background: The prevalence of partial-thickness rotator cuff tears (PTRCTs) has been reported to be 13% to 40% within the adult population, accounting for 70% of all rotator cuff tears. Approximately 29% of PTRCTs will progress to full-thickness tears if left untreated. The long-term clinical course after arthroscopic repair of PTRCTs is not well known. Purpose: To investigate minimum 10-year patient-reported outcomes (PROs) after arthroscopic rotator cuff repair (RCR) of the supraspinatus tendon and to report reoperation and complication rates. Study Design: Case series; Level of evidence, 4. Methods: Patients were included who underwent arthroscopic RCR of a PTRCT performed by a single surgeon between October 2005 and October 2011. Arthroscopic RCR was performed with a transtendon repair of partial, articular-sided supraspinatus tendon avulsions, bursal-sided repair, or conversion into a full-thickness tear and repair. PRO data were collected preoperatively and at a minimum 10 years postoperatively. PRO measures included the American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation score, the shortened version of Disabilities of the Arm, Shoulder and Hand score (QuickDASH), the 12-Item Short Form Health Survey Physical Component Summary, and patient satisfaction. Subanalyses were performed to determine if tear location or age was associated with outcomes. Retears, revision surgery, and surgical complications were recorded. Results: In total, 33 patients (21 men, 12 women) at a mean age of 50 years (range, 23-68) met criteria for inclusion. Follow-up was obtained in 28 (87.5%) of the 32 eligible patients ≥10 years out from surgery (mean, 12 years; range, 10-15 years). Of the 33 PTCRTs, 21 were articular sided and 12 were bursal sided. Of the 33 patients, 26 underwent concomitant biceps tenodesis. At follow-up, the mean PROs were significantly improved when compared with preoperative levels: American Shoulder and Elbow Surgeons score from 67.3 to 93.7 ( P < .001), Single Assessment Numeric Evaluation from 70.9 to 91.2 ( P = .004), QuickDASH from 22.3 to 6.6 ( P < .004), and 12-Item Short Form Health Survey Physical Component Summary from 44.8 to 54.2 ( P < .001). Median postoperative satisfaction was 10 (range, 5-10). No patient underwent revision surgery. Conclusion: Arthroscopic repair of PTRCTs results in excellent clinical outcomes and high patient satisfaction at minimum 10-year follow-up. Furthermore, the procedure is highly durable, with a clinical survivorship rate of 100% at 10 years.

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Intratendinous Rotator Cuff Tears

Abstract: Transtendon suture bridge repair yielded satisfactory clinical and radiological outcomes in patients with intratendinous rotator cuff tears.

Cited by 29 publications

References 50 publications

Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials

Is platelet-rich plasma an ideal biomaterial for arthroscopic rotator cuff repair? A systematic review and meta-analysis of randomized controlled trials

Diagnosis and Management of Partial Thickness Rotator Cuff Tears: A Comprehensive Review

Minimum 10-Year Outcomes After Arthroscopic Repair of Partial-Thickness Supraspinatus Rotator Cuff Tears

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