Prognostic Factors Affecting Rotator Cuff Healing After Arthroscopic Repair in Small to Medium-sized Tears

Park, Ji Soon; Park, Hyung Jun; Kim, Sae Hoon; Oh, Joo Han

doi:10.1177/0363546515594449

Cited by 148 publications

(124 citation statements)

References 45 publications

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“…However, fatty infiltration of the supraspinatus does not seem to be a determinant factor in tendon healing. Park et al 55 did not find significant relationship between preoperative supraspinatus fatty infiltration and postoperative tendon healing. Contrarily, it seems that fatty infiltration of the infraspinatus and subscapularis is a highly significant factor (p<0.001).…”

Section: Resultsmentioning

confidence: 89%

Management of failed rotator cuff repair: a systematic review

Lädermann¹,

Denard²,

Burkhart

2016

Journal of ISAKOS

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ImportanceRecurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures.Aim or objectiveThe purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears.Evidence reviewA search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low.FindingsMid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis.Conclusions and relevanceThe current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing.

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Section: Resultsmentioning

confidence: 89%

Management of failed rotator cuff repair: a systematic review

Lädermann¹,

Denard²,

Burkhart

2016

Journal of ISAKOS

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“…Although elderly patients generally have a greater incidence of rotator cuff disease (10), the incidence of rotator cuff surgery declined after the age of 70. Park et al (20) reported that the failure rate for RCR was significantly higher in patients aged > 69 years compared with those aged ≤ 69 years and retears of the rotator cuff are closely associated with advanced age (2122). Initial conservative treatments can be safely undertaken in older patients (> 70 years old) with chronic tears (4).…”

Section: Discussionmentioning

confidence: 99%

National Trends in Surgery for Rotator Cuff Disease in Korea

Lee

Kim

et al. 2017

J Korean Med Sci

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The objective of this study was to investigate the national trends in rotator cuff surgery in Korea and analyze hospital type-specific trends. We analyzed a nationwide database acquired from the Korean Health Insurance Review and Assessment Service (HIRA) from 2007 to 2015. International Classification of Diseases, 10th revision (ICD-10) codes, procedure codes, and arthroscopic device code were used to identify patients who underwent surgical treatment for rotator cuff disease. A total of 383,719 cases of rotator cuff surgeries were performed from 2007 to 2015. The mean annual percentage change in the age-adjusted rate of rotator cuff surgery per population of 100,000 persons rapidly increased from 2007 to 2012 (53.3%, P < 0.001), while that between 2012 to 2015 remained steady (2.3%, P = 0.34). The proportion of arthroscopic surgery among all rotator cuff surgeries steadily rose from 89.9% in 2007 to 96.8% in 2015 (P < 0.001). In terms of hospital types, the rate of rotator cuff surgery increased to the greatest degree in hospitals with 30–100 inpatient beds, and isolated acromioplasty procedure accounted for a larger proportion of the rotator cuff surgeries in small hospitals and clinics compared to large hospitals. Overall, our findings indicate that cases of rotator cuff surgery have increased rapidly recently in Korea, of which arthroscopic surgeries account for the greatest proportion. While rotator cuff surgery is a popular procedure that is commonly performed even in small hospitals, there was a difference in the component ratio of the procedure code in accordance with hospital type.

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“…Most common system used to classify fatty degeneration of rotator cuff muscles was described by Goutallier et al [25]. Even small and medium tears are at risk for failure after repair with as little as grade 2 muscle degeneration [26]. Shoulders with more severe (grade 3 or 4) degeneration, where more than 50% of muscle volume is replaced by fat, are at a very high risk of poor outcomes, since, even if tendon repair and healing to bone is achieved, dynamic function of the rotator cuff muscle-tendon unit remains compromised.…”

Section: Outcomes Of Rotator Cuff Repairmentioning

confidence: 99%

Superior Capsule Reconstruction: Review of a Novel Operative Technique for Management of Irreparable Rotator Cuff Tears

Golant¹,

Kano²,

Quach³

et al. 2018

Advances in Shoulder Surgery

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Rotator cuff tear is a common yet functionally debilitating shoulder condition. Risk factors for failure of repair or inability to repair include advancing age of the patient, chronicity of the tear, and larger tear size. Current operative management options for tears that are considered irreparable include debridement, partial repair, biceps tenotomy, interpositional grafting, tendon transfers, and reverse shoulder arthroplasty. Recently, superior capsular reconstruction has been introduced as an alternative surgical option for these tears and has demonstrated favorable short-term outcomes. However, the literature lacks studies with large numbers of patients, consistency of results, and long-term outcomes. This article reviews the anatomy and function of the rotator cuff and shoulder capsule; patho-etiology of rotator cuff tears, particularly the irreparable ones; and rationale, techniques, outcomes, and future direction of superior capsular reconstruction in the context of this clinical indication.

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Prognostic Factors Affecting Rotator Cuff Healing After Arthroscopic Repair in Small to Medium-sized Tears

Cited by 148 publications

References 45 publications

Management of failed rotator cuff repair: a systematic review

Management of failed rotator cuff repair: a systematic review

National Trends in Surgery for Rotator Cuff Disease in Korea

Superior Capsule Reconstruction: Review of a Novel Operative Technique for Management of Irreparable Rotator Cuff Tears

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