Massive rotator cuff tears: The result of partial rotator cuff repair

Duralde, Xavier A.; Bair, Brant

doi:10.1016/j.jse.2004.06.015

Cited by 183 publications

(113 citation statements)

References 15 publications

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“…Some authors suggest degeneration is a major cause of rerupture after surgical repair [20]. Some authors have reported high rates of rerupture (range, 20%-54%) [2,8,18] with a much shorter followup than ours, with some showing a correlation between rerupture and poorer outcome [11] and some less so [7,17]. We believe, in large retracted tears with poor tendon material, a free tendon graft may play a beneficial role.…”

Section: Discussionmentioning

confidence: 57%

Pain Relief, Motion, and Function after Rotator Cuff Repair or Reconstruction May Not Persist after 16 Years

Borgmästars

Paavola

Remes

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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Background Short-to medium-term rotator cuff repair reportedly relieves pain in 82% to 97% of patients and provides normal or almost normal shoulder function in 82% to 92%. However, it is unknown whether pain relief and function persist long term. Questions/purposes We asked whether, after rotator cuff repair or reconstruction, pain relief, ROM, shoulder strength, and function remained over the long term. Patients and MethodsWe retrospectively reviewed 75 patients who underwent rotator cuff repair between 1980 and 1989. There were 55 men and 20 women. Their mean age at surgery was 52 years. The minimum followup was 16 years (mean, 20 years; range 16-25 years). Results Twenty-eight of the 75 patients (37%) had persistent relief of pain lasting for 20 years. In the remaining 47 patients, alleviation of pain lasted, on average, 14 years (range, 0-24 years). Mean flexion and abduction strength increased postoperatively but during long-term followup decreased to less than preoperative levels. External rotation also decreased. At the last followup, the Constant-Murley score averaged 66 (range, 10-98) in men and 60 (range, 29-89) in women. In the Simple Shoulder Test questionnaire, the mean number of yes answers was eight of 12. Of the 75 patients, 32 (43%) reported impairment in activities of daily living owing to an index shoulder complaint. Severe degenerative changes of the glenohumeral joint were evident in 14 patients (19%). Conclusions The early high functional scores after primary rotator cuff repair or reconstruction of the types we performed in the 1980s did not persist. The function achieved postoperatively was lost, as ROM and strength decreased to less than preoperative values. However, alleviation of pain was long-standing in most patients. Based on our data, we should warn patients to expect less than permanent relief with those repairs. We cannot say whether the same will apply to currently performed types of repairs.

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Section: Discussionmentioning

confidence: 57%

Pain Relief, Motion, and Function after Rotator Cuff Repair or Reconstruction May Not Persist after 16 Years

Borgmästars

Paavola

Remes

et al. 2010

Clinical Orthopaedics &Amp; Related Research

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“…Partial repair is a logical intervention, especially when restoring the anchor points of the FE. [91][92][93] If weakness remains a function-limiting problem in a RCT too large or inelastic to repair, then intrinsic or extrinsic musculotendinous transfers (local rotator cuff flap or pectoralis major, latissimus dorsi and teres major flaps) are considered. [94][95][96][97][98][99] If painful articular surface roughness persists, causing articular surface impingement, then replacement of the articular surfaces is indicated.…”

Section: Treatment Specified By Patho-biomechanicsmentioning

confidence: 99%

Assessment and treatment strategies for rotator cuff tears

2014

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Tears of the rotator cuff are common and becoming an increasingly frequent problem. There is a vast amount of literature on the merits and limitations of the various methods of clinical and radiological assessment of rotator cuff tears. This is also the case with regard to treatment strategies. Certain popular beliefs and principles practiced widely and the basis upon which they are derived may be prone to inaccuracy. We provide an overview of the historical management of rotator cuff tears, as well as an explanation for how and why rotator cuff tears should be managed, and propose a structured methodology for their assessment and treatment.

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“…광범위 파열에 대한 개방적 및 관절경적 일차 복 원술시 근에 가해지는 장력이 증가하게 되고 이로 인한 재파열의 빈도가 소파열 및 중파열에 비하여 높게 보고 되는 경향이다. 회전근 개를 충분히 유리한 후 가동성을 증가시켜 파열부에 대한 일차 복원술을 통해 회전근 개 와 상완골 간의 해부학적 복원을 얻는 것이 장기적인 결 과에 있어서 좋지만 7,24,28,29) , 퇴축이 심해 제자리로 장력 이 없는 해부학적 복원이 힘든 경우 건-건 봉합을 통한 부분 복원술을 시행하거나 6,11,41) , 내측 전이술 26,27) 등을 고 려해 볼 수도 있다. 물론 간격 활주 (interval slide) 방 식을 통한 봉합이나 10,25) 건 이전술 9,16,22,39,40) , 혹은 인공관 절 치환술 32) 을 시행할 수도 있지만 어느 방법 하나 결과 를 예측하기가 힘들고 수술 또한 부담이 되는 것이 사실 이다.…”

Section: 서 론unclassified

Debridement or Tuberoplasty for Massive Rotator Cuff Tear

Cho

Oh²,

Rhee

2010

The Journal of the Korean Shoulder and Elbow Society

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Purpose: The purpose of this article was to review the effectiveness of arthroscopic debridement and tuberoplasty, and to evaluate the clinical and radiologic results of our series for irreparable massive rotator cuff tears in the elderly. Materials and Methods:We reviewed articles that focused on the treatment options and decision making for irreparable massive rotator cuff tears. In particular, we summarized the reported results of arthroscopic debridement and tuberoplasty for irreparable massive rotator cuff tears in the elderly. Among consecutive patients who had arthroscopic tuberoplasty for irreparable massive rotator cuff tears in our series, thirty-two patients available for clinical and radiological evaluation at a mean follow-up of 29 months (range, 13-52 months) were enrolled and reviewed for the analysis. Results: At the last follow-up, the range of active forward flexion increased significantly with excellent pain relief and improvement in the ability to perform the activities of daily living. However, the group with less than 2 mm in preoperative acromiohumeral distance showed inferior postoperative results. Conclusion: Arthroscopic tuberoplasty may be an alternative option in irreparable massive rotator cuff tears for pain relief and improvement of range of motion. However, good results can not be expected if the acromiohumeral distance is less than 2 mm preoperatively and decreases postoperatively, or when the preoperative range of motion is less than 90 on flexion and abduction.

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Massive rotator cuff tears: The result of partial rotator cuff repair

Cited by 183 publications

References 15 publications

Pain Relief, Motion, and Function after Rotator Cuff Repair or Reconstruction May Not Persist after 16 Years

Pain Relief, Motion, and Function after Rotator Cuff Repair or Reconstruction May Not Persist after 16 Years

Assessment and treatment strategies for rotator cuff tears

Debridement or Tuberoplasty for Massive Rotator Cuff Tear

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