Saturday, April 16, 2016

Rotator cuff repair - results by tear size

Is the arthroscopic modified tension band suturetechnique suitable for all full-thickness rotatorcuff tears?

These authors reviewed 47 of 63 patients who underwent arthroscopic rotator cuff repair for a full-thickness rotator cuff tear using the modified tension band suture technique at a single hospital between July 2011 and March 2013 with a mean follow-up of 29 months.

Postoperative clinical outcomes at the final follow-up showed significant improvements compared with those seen during preoperative evaluations. However, shoulders with large and massive tears (Group B) showed worse clinical results than those with small and medium tears (Group A) . Evaluation with magnetic resonance imaging performed 6 months postoperatively and ultrasonography taken at the final follow-up revealed that group B showed a significantly higher retear rate than did group A (69% vs. 6%, respectively; P < .001).

It is of interest that preoperatively there was little difference between the scores and motion of the small/medium tears and the large/massive tears.

Comment: This work shows again that the quantity and quality of the cuff tissue is the major determinant of the results of cuff repair. Over two-thirds of the repairs of large/massive tears failed to restore integrity to the cuff.


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