Wednesday, February 1, 2017

Rotator cuff repair - does repair integrity matter?

Rotator cuff surgery in patients older than 75 years with large and massive tears

These authors reviewed 121 patients aged ≥75 years who underwent rotator cuff repair for large and massive rotator cuff tears. However, only 64 patients were enrolled in this study.

Open cuff repairs were performed by an individual surgeon. The mobilized, the mobilized rotator cuff was repaired with multiple tendon-totendon repair sutures and tendon-to-bone repair to the prepared greater tuberosity using transosseous rotator cuff repair with a double mattress suture technique.

After surgery, a shoulder abduction brace was applied for 7 to 8 weeks. The patients started passive forward elevation on the first postoperative day. On the third postoperative day, stretching exercises including pendulum exercises and passive external rotation were started. The average hospital stay was 4.6 days. After 4 weeks, pulley exercises to gain full forward elevation were started. Strengthening of the rotator cuff and periscapular muscle and wall pushups were started immediately after removal of the shoulder abduction brace at postoperative week 8. Posteriocapsular stretching exercises and internal rotation stretching were initiated after approximately 3 months of strengthening exercise.

MRI revealed retears at or before one year in 26% of patients.

While the scores and motion of the patients were improved for those patients without and with retears, there was no difference in functional outcomes between the retear and the non-retear groups as shown in the chart below.

Comment: This is one of a growing number of papers showing that cuff integrity after surgery may not have a major influence on the patient's perception of the outcome: failed repairs have similar patient-reported results to successful repairs.

Here are some related posts:

What happens if a rotator cuff tear is not repaired?
Rotator cuff repair, does integrity matter?


Check out the new Shoulder Arthritis Book - click here.

Use the "Search" box to the right to find other topics of interest to you.

You may be interested in some of our most visited web pages including:shoulder arthritis, total shoulder, ream and runreverse total shoulderCTA arthroplasty, and rotator cuff surgery as well as the 'ream and run essentials'