Repair of massive rotator cuff tears in patients older than 70 years

Worland, Richard L.; Arredondo, Jorge; Angles, Francesc; Lopez‐Jimenez, Francisco

doi:10.1016/s1058-2746(99)90050-2

Cited by 105 publications

(64 citation statements)

References 28 publications

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“…Tendon rerupture has attracted preferential attention and has been extensively assessed by means of arthrography [2][3][4][5], ultrasound [6][7][8][9][10][11][12][13][14][15], arthrography combined with computed tomography (CT) [16][17][18], magnetic resonance (MR) imaging [13,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], and MR arthrography [34].…”

Section: Introductionmentioning

confidence: 99%

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

et al. 2006

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The objectives of this study were to use magnetic resonance (MR) imaging to evaluate the prevalence, size, location, and clinical relevance of tendon rerupture following complete repair of full-thickness rotator cuff tear (RCT). A total of 78 surgically proven full-thickness rotator cuff tears in 74 patients were retrospectively included in the study. Clinical assessment was performed using the University of California at Los Angeles score. Postoperative MR imaging was evaluated to determine prevalence, size, and location of tendon rerupture. At a mean 48.4 months' follow-up, 62 shoulders (79.5%) had favorable outcomes and 45 shoulders (57.6%) showed rerupture on MR imaging studies. Reruptures were significantly more prevalent among patients with intermediate-to-bad outcomes (81.3%), with surgically demonstrated two-tendon tears (78.9%) or three-tendon tears (100%), and with preoperative fatty degeneration of the supraspinatus muscle greater than 1 (91.6%). Reruptures were also significantly larger in those subgroups. Complete repair of RCT of all sizes may have favorable outcomes in a significant proportion of patients in spite of a high prevalence of reruptures. Preoperative tear size and degree of muscle fatty degeneration influence the prevalence and rerupture size. After repair of supraspinatus tears, reruptures tend to invade the posterior aspect of the tendon.

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Section: Introductionmentioning

confidence: 99%

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

et al. 2006

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“…Some studies included all tear sizes according to the Cofield classification. 19,36,38,40,42 Lam et al 40 intra-operatively encountered > 5 cm full thickness RCT in all patients (postoperative CSS = 63%). Some studies excluded massive tears (> 5 cm).…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 90%

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review

Silva¹,

Cartucho²,

Sarmento³

et al. 2017

Acta Med Port

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RESUMOIntrodução: O objetivo deste estudo, é o de analisar a evidência atual no que respeita ao tratamento cirúrgico de roturas da coifa dos rotadores, em doentes com mais de 65 anos de idade. A hipótese proposta foi que o tratamento cirúrgico de roturas da coifa dos rotadores, em doentes com 65 anos ou mais, acarreta bons resultados funcionais. Não existe, na literatura atual, uma revisão sistemática com os mesmos parâmetros que esta. Material e Métodos: Recorremos à Medline ® , PubMed, Scopus, e Cochrane Register of Controlled Trials, na procura de estudos entre janeiro de 1999 e dezembro de 2015, independentemente da língua, que incluíssem as palavras: 'rotator cuff' e '65 years' ou '70 years'. Como critérios de inclusão estipulámos, estudos (nível I a IV) que reportassem os resultados funcionais de doentes com 65 anos ou mais, submetidos à reparação cirúrgica de uma rotura da coifa dos rotadores sintomática. Foram incluídas técnicas artroscópicas, mini-invasivas e abertas. Os critérios de exclusão estipulados foram, estudos que incluíssem doentes com menos de 65 anos, estudos que não recorressem a escalas de avaliação funcional validadas, como ferramenta de aferição primária, e aqueles com tempo de seguimento inferior a um ano. Este trabalho seguiu as orientações da Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA. A informação colhida incluiu dados demográficos, padrões de rotura, procedimentos cirúrgicos realizados e resultados, clínicos e das reparações efectuadas. Os resultados funcionais foram convertidos em percentagens, permitindo a comparação de dados entre os estudos. Resultados: Quatorze estudos cumpriram os critérios de inclusão: 11 estudos nível IV, um estudo nível III e dois estudos nível II. Sete estudos reportaram melhorias com significado estatístico entra as avaliações funcionais pré e pós operatórias. Todos os estudos reportaram resultados funcionais bons ou excelentes. Discussão: É provável que seriam obtidos resultados mais consistentes, se todos os estudos incluídos tivessem critérios de selecção mais homogéneos e rigorosos. Apesar de tal não se ter verificado, os resultados clínicos foram, todavia, favoráveis. Isto traduziu-se numa melhoria dos resultados funcionais, com significado estatístico, em todos os estudos prospectivos incluídos. Conclusão: Com base na literatura atual, a reparação de roturas da coifa dos rotadores em doentes com 65 anos ou mais, está associada à melhoria dos resultados funcionais e a um bom grau de satisfação com o procedimento. Palavras-chave: Artroscopia; Idoso; Revisão Sistemática; Rotura da Coifa dos Rotadores ABSTRACTIntroduction: The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature. Material and Methods: Medline ® , PubMed, Scopus, and the ...

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“…It often results in an improved functional outcome and a reduction of pain symptoms. Reported success following rotator cuff repair (RCR) range between 38% to 95% (1)(2)(3)(4)(5)(6). Current literature reports a multitude of studies looking at variables which may impact surgical outcomes.…”

Section: Contextmentioning

confidence: 99%

Large/Massive Tears, Fatty Infiltration, and Rotator Cuff Muscle Atrophy: A Review Article With Management Options Specific to These Types of Cuff Deficiencies

et al. 2016

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Context: There are many studies in the literature looking into factors affecting outcomes in rotator cuff surgery. The aetiology of rotator cuff deficiency is often multi-factorial and there are many facets towards successful management in this often debilitating condition. Evidence Acquisition: We performed a literature search of MEDLINE and Embase databases using the terms large rotator cuff tears, fatty infiltration rotator cuff, rotator cuff atrophy, rotator cuff augmentation, rotator cuff tendon transfers, allografts rotator cuff repair, xenograft rotator cuff repair and synthetic grafts rotator cuff repair. Results: In this article, we focus particularly on the aetiology, pathology and prognosis of large tears, fatty infiltration and muscle atrophy of the rotator cuff. An overview of the various treatment strategies and current/future concepts are also discussed in managing patients with these types of rotator cuff deficiencies. Conclusions: Large tears, fatty infiltration and muscle atrophy of the cuff are challenging. An in-depth understanding of these elements may prove vital for the practising orthopedician in determining the right course of management. Techniques in strengthening the repair construct using augmentation play an important role in the treatment of this condition.

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Repair of massive rotator cuff tears in patients older than 70 years

Cited by 105 publications

References 28 publications

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

MR assessment of the repaired rotator cuff: prevalence, size, location, and clinical relevance of tendon rerupture

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review

Large/Massive Tears, Fatty Infiltration, and Rotator Cuff Muscle Atrophy: A Review Article With Management Options Specific to These Types of Cuff Deficiencies

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