In this small case study the authors compared the outcomes after 3 different treatments for large and massive rotator cuff tears: 12 in which the surgeon was able to perform an arthroscopic repair, 11 in which the surgeon elected open repair and xenograft
and 9 in which the surgeon decided that neither repair or patch was advisable and performed a debridement only.
The mean Constant-Murley scores were significantly improved for the patients in each group
Five complications occurred in 11 patients in the patch group (1 deep infection required the removal of the patch and antibiotic treatment, and postoperative stiffness developed in 4 patients. The stiffness regressed at the 1-year follow-up in 3 patients, and the remaining patient was treated with arthroscopic capsular release 9 months after the repair,
One complication occurred in the repair group (a superficial wound infection)
No complications occurred in the débridement group.
Comment: It would seem that patients in the three groups did not have comparable pathology (one group had reparable tears, one group had arthroscopically reparable tears in which the surgeon felt the need for graft supplementation at open surgery, and one group in which the surgeon could not repair the tear).
As we know, tears that can be robustly repaired do better than those that cannot.
The authors do not provide data on the postoperative integrity of the repair attempts or the patch grafts, so the anatomic effectiveness of these surgeries is unknown.
and 9 in which the surgeon decided that neither repair or patch was advisable and performed a debridement only.
The mean Constant-Murley scores were significantly improved for the patients in each group
Five complications occurred in 11 patients in the patch group (1 deep infection required the removal of the patch and antibiotic treatment, and postoperative stiffness developed in 4 patients. The stiffness regressed at the 1-year follow-up in 3 patients, and the remaining patient was treated with arthroscopic capsular release 9 months after the repair,
One complication occurred in the repair group (a superficial wound infection)
No complications occurred in the débridement group.
Comment: It would seem that patients in the three groups did not have comparable pathology (one group had reparable tears, one group had arthroscopically reparable tears in which the surgeon felt the need for graft supplementation at open surgery, and one group in which the surgeon could not repair the tear).
As we know, tears that can be robustly repaired do better than those that cannot.
The authors do not provide data on the postoperative integrity of the repair attempts or the patch grafts, so the anatomic effectiveness of these surgeries is unknown.
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