Treatment Strategy for Irreparable Rotator Cuff Tears

Oh, Joo Han; Park, Min Suk; Rhee, Sung Min

doi:10.4055/cios.2018.10.2.119

Cited by 130 publications

(92 citation statements)

References 96 publications

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“…However, the opposite would probably not be true; that is, a longer duration of symptoms should not occur in cases of acute tears. Further, it is currently difficult to determine the chronicity of SST tears clinically or even by arthroscopy before surgery [25]. This issue is probably why several other studies have also attempted to use the duration of symptoms as a criterion for classifying acute versus chronic rotator cuff tears [26,27].…”

Section: Discussionmentioning

confidence: 99%

Elasticity of torn supraspinatus tendons measured by shear wave elastography: a potential surrogate marker of chronicity?

et al. 2020

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Purpose: This study investigated whether shear wave elastography (SWE) could be used to estimate the chronicity of supraspinatus tendon (SST) tears. Methods: A retrospective study was performed. From November 2015 to July 2016, 113 patients (52 men, 61 women; age range, 21 to 79 years) with persistent shoulder pain underwent 119 rotator cuff tendon examinations by routine B-mode ultrasonography, while SST elasticity was measured using SWE. Following the exclusion of eight suboptimal examinations, four examinations with missing SST measurements, and 27 examinations of patients with other conditions, 80 examinations were analyzed. A torn SST was found in 54 examinations (27 with a partial-thickness tear and 27 with a full-thickness tear). Elasticity values were compared in multiple ways. The results were analyzed using the Mann-Whitney U test or Kruskal-Wallis test. Results: No statistically significant difference in elasticity values (in kPa) was found between normal (median, 94.65; interquartile range [IQR], 87.43 to 105.47) and torn SSTs (median, 96.79; IQR, 86.71 to 108.56) or between full-thickness tears (median, 93.80; IQR, 82.50 to 108.33) and partial-thickness tears (median, 96.83; IQR, 90.60 to 112.20). However, there was a statistically significant difference in elasticity according to whether the duration of symptoms was 1 year or less (median, 92.20; IQR, 84.01 to 104.38) or longer than 1 year (median, 105.10; IQR, 100.41 to 116.03; P=0.032). Conclusion: Elasticity values were significantly higher in torn SSTs in patients with chronic shoulder pain that had persisted for more than 1 year. Further studies with larger samples seem warranted to determine whether elasticity values measured by SWE can be used preoperatively as a surrogate marker of the chronicity of a rotator cuff tendon tear.

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Section: Discussionmentioning

confidence: 99%

Elasticity of torn supraspinatus tendons measured by shear wave elastography: a potential surrogate marker of chronicity?

et al. 2020

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“…Läsionen der Rotatorenmanschette gehören zu den häufigsten Erkrankungen des Bewegungsapparates, die eine therapeutische Intervention, oftmals eine Operation nach sich ziehen [2,3] (▶ Abb. 1).…”

Section: Hintergrundunclassified

“…Die Behandlungen müssen oftmals mehrmals wöchentlich über mehrere Wochen erfolgen, begleitet von einem Selbstübungsprogramm, um eine hohen Therapieeffekt zu erzielen. Schmerzarmut, eine gute Gebrauchsfähigkeit im Alltag und reduzierte Ansprüche an Sportfähigkeit und Kraft (limited Goal) sind gute Indikatoren für einen Erfolg [2,3,12,13].…”

Section: Merkeunclassified

“…Der Oberarmkopf würde dem Akromionunterrand folgen und einen biomechanisch ungünstigen Humeruskopfhochstand noch verstärken. Die Implantation eines Ballonplatzhalters wird kontrovers diskutiert [3,15].…”

Section: Reverse Subakromiale Dekompressionunclassified

“…Der PMT bringt den oberen Teil des M. pectoralis major vom Humerusschaft auf das Tuberculum minus, bleibt Innenrotator und soll durch die Änderung des Kraftvektors mehr depressorische Kraft auf den Humeruskopf entfalten. Die modifizierte Variante mit Verlagerung des Muskelbauches dorsal der Conjoint Tendons erscheint biomechanisch günstiger [3].…”

Section: Pectoralis-major-transferunclassified

See 2 more Smart Citations

Gelenkerhaltende Therapie bei irreparablen Rotatorenmanschettendefekten

Kircher¹,

Junker²,

Hedtmann³

2020

Orthopädie und Unfallchirurgie up2date

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Ultrasound Findings Aid Decisions to Repair Partial Articular Supraspinatus Tendon Avulsion

Yoon

Kim

Han

et al. 2020

J of Ultrasound Medicine

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Objectives-Ultrasound (US) is useful for diagnosing full-thickness rotator cuff tears and high-grade partial-thickness bursal-side tears. However, anisotropy artifacts make it difficult to identify partial articular supraspinatus tendon avulsion (PASTA) by US. This study was performed to determine the diagnostic accuracy of US for PASTA and to uncover sensitive findings that could aid decisions to repair. Methods-Patients who underwent preoperative US examinations and supraspinatus tendon confirmation by arthroscopic examinations were enrolled. We analyzed 52 PASTA cases involving greater than 50% thickness of the tendon and 52 age-and sex-matched cases with an intact supraspinatus. Two orthopedic surgeons blinded to the diagnosis interpreted US videos of the supraspinatus tendon. Six findings (echo defect, tendon delamination, echo change, tendon thickness, tendon fiber pattern, and cartilage interface sign) were assessed. We calculated the sensitivity, specificity, and accuracy for each US finding. Results-The cases consisted of 46 men and 58 women. The US diagnosis of PASTA showed sensitivity of 64.7%, specificity of 94.1%, and accuracy of 79.4%. The echo change in the short axis showed the highest sensitivity. Thinning and delamination showed the highest specificity of 100%. In contrast to previous reports, the sensitivity of the cartilage interface sign was low in both long-axis images (17.6%) and short-axis images (29.4%). Conclusions-Preoperative diagnostic US to aid decisions regarding PASTA repair showed high specificity (94.1%) and moderate accuracy (79.4%). However, the sensitivity was only 64.7% and was affected by the examiner's experience with US.

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Treatment Strategy for Irreparable Rotator Cuff Tears

Cited by 130 publications

References 96 publications

Elasticity of torn supraspinatus tendons measured by shear wave elastography: a potential surrogate marker of chronicity?

Elasticity of torn supraspinatus tendons measured by shear wave elastography: a potential surrogate marker of chronicity?

Gelenkerhaltende Therapie bei irreparablen Rotatorenmanschettendefekten

Ultrasound Findings Aid Decisions to Repair Partial Articular Supraspinatus Tendon Avulsion

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