The relationship between rotator cuff integrity and acromiohumeral distance following open and arthroscopic rotator cuff repair

Abstract

Background: Acromiohumeral distance (AHD) has become both a diagnostic and prognostic parameter related to rotator cuff pathology which is always measured in a 2-dimensional plane. The purposes of this study were (1) to evaluate the regional AHD with MRI following open and arthroscopic rotator cuff repair and, (2) to investigate its association to the rotator cuff integrity following medium to large size rotator cuff repair with open and arthroscopic manner. Methods: A retrospective review of 112 patients who were treated for full-thickness medium to large size rotator cuff tears either by open repair (open group) or arthroscopic repair (arthroscopic group) was done. All patients included in the study are those with at least 12 and 18 months for the post-operative MRI and clinical follow-up. Propensity score matching was used to select controls matched for age, sex, body mass index, tear size, and affected site. There were 56 patients in each group with a mean age of 63.3 years (range, 50 to 77 years). The post-operative functional and radiologic outcomes for both groups were compared. AHD was measured at three regions of interest (ROI) with MRI and compared pre-and post-operatively. Results: AHD was significantly greater in the open group when measured at the anterior third of the lateral acromion border compare to the arthroscopic group (p = 0.005). The re-tear rate was affected by AHD at the anterior third of the lateral border of the acromion for the arthroscopic and open group (p = 0.021, p = 0.029). The AHD measured at the anterior and middle third of lateral acromion border were significantly greater in healed compared to the re-tear rotator cuff group (p = 0.019, p = 0.022). Conclusions: Open rotator cuff repair showed greater AHD at the anterior third of the lateral border of the acromion. Regional AHD measured at anterior third of the lateral border of acromion significantly associated with rotator cuff integrity following repair. Level of evidence: propensity-matched case-control (Level II)

Supraspinatus Muscle and Tendon Characteristics 1 Year After Surgical Rotator Cuff Repair Compared With Contralateral Shoulder: Data From the CUT-N-MOVE Trial

“…This is irreversible and increases in the case of tendon retear. 38 We found smaller AHD on the repaired side compared with the healthy side regardless of whether there was an intact or retorn tendon, in contrast to another study that found a significantly greater AHD, measured by MRI, in healed tears compared with retears, 25 as well as studies indicating that the retear led to superior migration of the humeral head and a reduced AHD. 54 However, comparison between 2 different imaging modalities must always be made with caution because while US is conducted with the patient in the functional upright position, standard MRI is carried out with the patient in the supine position.…”

Single-row and double-row shoulder suture techniques, combined with dynamic-static modeling, were employed for finite element analysis of the three-dimensional mechanics of the shoulder joint

“…Currently, double-row surgery is generally considered superior to single-row surgery in various studies [18] . The data also indicate that compared to single-row suturing, double-row suturing has a more pronounced effect on reducing the torque values of the shoulder joint, demonstrating that double-row suturing can more effectively restore the biomechanical function of the shoulder joint [19][20][21] . However, since the choice of surgery is not solely determined by the doctor and the cost of surgical materials has consistently constituted a signi cant portion of the surgical expenses, there are still many individuals opting for the less costly single-row suturing due to nancial constraints.…”

Comparison of clinical outcomes and repair integrity after arthroscopic versus mini-open rotator cuff repair: An observational study

“…Our study did not compare this measuring method for both treatments, but Kholinne et al found that a larger AHD was observed in open repair. [25][26][27] Literature on the current tendency of operating RCRs via full ART versus MO techniques has reported conflicting results. ART RCR has recently emerged as the gold standard of treatment for patients with rotator cuff tears that require surgical intervention.…”

“…Our study did not compare this measuring method for both treatments, but Kholinne et al found that a larger AHD was observed in open repair. [25–27]…”