Structural factors affecting the outcome of rotator cuff repair

Sonnabend, David H.; Watson, Elizabeth M.

doi:10.1067/mse.2002.122272

Cited by 81 publications

(92 citation statements)

References 13 publications

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“…Although a matter of debate, a poorer prognosis may be expected with a larger rotator cuff tear even where surgery was performed. 21,22 This pilot study included all 24 patients who had completed a questionnaire and had undergone surgery to repair a rotator cuff tear between May 2002 and October 2003. Patients attended clinics at various time points during their care and, therefore, the sample included patients who had been followed prospectively.…”

Section: Methodsmentioning

confidence: 99%

The Use of a Patient-Based Questionnaire (The Oxford Shoulder Score) to Assess Outcome After Rotator Cuff Repair

Olley

Carr

2008

annals

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INTRODUCTION It is increasingly important for surgeons to monitor the outcome of their practice for the purpose of audit. The main difficulty has been the lack of appropriate methods of assessing outcome. Outcome has traditionally been assessed by clinical means which can be inaccurate, irreproducible and subject to surgeon bias. In addition, the perspective of the patient and surgeon may differ with respect to outcome and interest has grown in patient-based scoring systems. The Oxford Shoulder Score (OSS) is one such patient-based scoring system. The main aim of this study was to assess whether a patient-based questionnaire, in this case the OSS, could be effectively used to audit outcome from shoulder surgery. A secondary aim was to assess the value of gathering outcome information by post.PATIENTS AND METHODS A total of 24 patients (14 male; median age 59 years; age range, 43-73 years) who had completed a pre-operative OSS questionnaire and had undergone rotator cuff repair were included in the study. Participants were assessed postoperatively at regular intervals using the OSS at hospital visits and by postal questionnaire. RESULTS The completion level for the OSS was 97% and the response rate to the postal questionnaire was 96%. At 3 months' post-surgery, 21 of 24 patients had improved; at final review (16-37 months), 23 patients had improved following surgery. The OSS was observed to be a robust tool for the quantitative assessment and tracking of patient outcomes after surgery. CONCLUSIONS This study shows the value of using a postal questionnaire to follow-up patients after surgery and demonstrates the successful use of a patient-based questionnaire to audit the outcome from shoulder surgery.OLLEY CARR

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Section: Methodsmentioning

confidence: 99%

The Use of a Patient-Based Questionnaire (The Oxford Shoulder Score) to Assess Outcome After Rotator Cuff Repair

Olley

Carr

2008

annals

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“…Clark and Harryman 19 described 5 distinct histologic layers of the rotator cuff tendons. Sonnabend and Watson 20 noted that articular-sided delamination tears retracted more significantly than bursal-sided tears. These layers may separate from the humerus as well as each other; when this delamination occurs, the success of arthroscopic repair declines.…”

Section: Discussionmentioning

confidence: 99%

Dual-Camera Technique for Arthroscopic Rotator Cuff Repair

Tuttle

Ramos

DaSilva

2014

Arthroscopy Techniques

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An all-arthroscopic rotator cuff repair demands a high level of technical skill and is associated with a steep learning curve. It is well accepted that small rotator cuff tears or partial tears can be more difficult than large or even massive tears to repair. Part of the reason is the difficulty in visualizing the tear, as well as important surrounding structures, during repair. To improve visibility during the repair process, we have introduced a second arthroscopic camera. Two cameras allow the surgeon to observe the rotator cuff from both the articular and bursal sides. We find this technique has merit in small or partial-thickness rotator cuff tears; however, there may be other applications.

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“…Some authors have reported it as negative effects on outcome, 16) whereas some have showed no significant difference. 10,11) Thus, despite commonly reported findings, little is known about delamination, and only one study has carried out a histological assessment.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8] Delamination is defined as a horizontal split of the torn tendon end and is a common finding during arthroscopic shoulder surgery with a reported prevalence of 31% to 71%. [9][10][11] Whereas the exact mechanism of delamination is not known, it can occur between layers 2 and 3 due to different histological properties such as varying collagen direction and degeneration degree as well as biomechanical properties of the two layers. Therefore, delamination can be considered as a form of degeneration within the tendon.…”

Section: Introductionmentioning

confidence: 99%

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Similar Degree of Degeneration in the Articular and Bursal Layers of Delaminated Rotator Cuff Tear

Lee

Shin

et al. 2016

Clinics in Shoulder and Elbow

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Background: The purpose of the study was to compare the degree of degeneration of the articular and bursal layers of delaminated supraspinatus tendons based on histological examination. Methods: Fifty-four patients with a full-thickness rotator cuff tear were included in the study. Tendon specimens were harvested during arthroscopic rotator cuff repair from the lateral torn edges of the articular and bursal layers of the delaminated tear. Harvested samples were stained with H&E dye and evaluated based on a semi-quantitative grading scale. Results: There were no significant differences in the seven histological characteristics of tendon degeneration: fiber structure, fiber arrangement, round nuclei, regional variations in cellularity, vascularity, collagen stainability, and hyalinization between the articular and bursal layers of the delaminated rotator cuff tear (all p>0.05). Total degeneration scores of articular and bursal sides were 13.1 ± 3.85 points and 13.2 ± 3.42 points, respectively, and were not significantly different (p=0.958). Conclusions: The study demonstrates that tendon degeneration was similar in the articular and bursal sides of the delaminated fullthickness rotator cuff tear, suggesting that degeneration would be a main etiology for the rotator cuff tear not only in the articular side but also in the bursal side. Considering potential disadvantages of subacromial decompression, this study tentatively suggests routine use of subacromial decompression as well as the need for halting or recovery from rotator cuff degeneration for better rotator cuff repair.

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Structural factors affecting the outcome of rotator cuff repair

Cited by 81 publications

References 13 publications

The Use of a Patient-Based Questionnaire (The Oxford Shoulder Score) to Assess Outcome After Rotator Cuff Repair

The Use of a Patient-Based Questionnaire (The Oxford Shoulder Score) to Assess Outcome After Rotator Cuff Repair

Dual-Camera Technique for Arthroscopic Rotator Cuff Repair

Similar Degree of Degeneration in the Articular and Bursal Layers of Delaminated Rotator Cuff Tear

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