Is Arthroscopic Debridement an Effective Treatment Option for Rotator Cuff Arthropathy? (original) (raw)
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Evaluate the Results at Minimum 2-Years of Treating Rotator Cuff Tear by Arthroscopic Surgery
Open Access Macedonian Journal of Medical Sciences, 2019
BACKGROUND: Rotator cuff tear (RCT) is a common injury of the shoulder, especially middle-aged people. Nonoperative treatment, cortisone injections are only effective at an early stage. Open surgery causes postoperative atrophy of the deltoid muscle, so results are limited. Arthroscopic rotator cuff repair surgery has been performed in Vietnam for about ten years, with many advantages such as the ability to accurately assess the lesions and less invasive procedure. In order to have a clearer view, we performed a mid-term assessment of the effectiveness of this surgery. AIM: Evaluate results over 2 years of patients with rotator cuff tears treated with arthroscopic surgery and their quality of life. METHOD: A group of 30 patients were diagnosed with RCT and surgery by arthroscopy to treat at Hanoi Medical University Hospital and Saint Paul Hospital between Jun 2015 and April 2017. The results of the surgeries were assessed by the degree of pain, muscle power, motion of the shoulder j...
The Clinical journal of pain, 2015
Study the influence of concomitant arthroscopic procedures and rotator cuff tear (RCT) severity on daily pain intensity and disability following shoulder arthroscopy. 145 patients (mean age: 42.66±17.6; n of males=96) completed daily pain intensity and disability measures prior to shoulder arthroscopy. RCT severity was assessed on a 7-point scale based on operative report. Operative procedures were categorized based on anatomical location and invasiveness to calculate a weighted concomitant procedure estimate. Postoperative daily pain and disability were assessed 3 months, 6 months, and 1 year status-post surgery. Only concomitant procedures was associated with 3 month daily pain intensity after adjusting for age, sex, pain duration, and baseline daily pain intensity (R=0.03; St. Beta=0.203; P=0.036). Moreover, post-hoc analysis revealed concomitant procedures remained predictive of 3 month daily pain intensity when the estimate was calculated independent of RCT procedures (R=0.05; ...
Outcomes of Arthroscopic Treatment for Rotator Cuff Tears
2010
The rotator cuff (RC), formed posteriorly by the tendons of the supraspinatus (Ss), infraspinatus (Is) and teres minor (Tm) and, anteriorly by the tendon of the subscapularis (Sc), has an important contribution in the shoulder mobility and stability functions. Lesions of this structure represent one of the main causes of incapacity in the shoulder.1,2 Satisfactory results of the conservative treatment vary in literature between 40 and 82%, whereas factors such as: age, comorbidities, activity levels and degree of shoulder dysfunction interfere therein. With the increase of functional demand such as practice of sports, work and/or daily activities, etc., in some patients the conservative treatment might not be successful. This situation has occurred more frequently due to the increase in life expectancy and quality.2-4 In these cases, surgical repair has proven efficient, attaining a high level of satisfaction, with pain relief and function improvement, ranging between 70 and 95%.5-9...
Open Versus Arthroscopic Rotator Cuff Repair: A Comparative View of 96 Cases
Arthroscopy: The Journal of Arthroscopic & Related Surgery, 2005
This study was performed to review and compare the outcome of a consecutive series of 96 rotator cuff repairs performed with an open versus arthroscopic technique. The arthroscopic repairs include the beginning of the learning curve. Type of Study: Case series. Methods: In a 24-month period from 1999 to 2001, 95 patients underwent a cuff repair with bony reattachment by 1 surgeon; 4 patients had surgery on both shoulders. We present subjective outcome data from 96 of 99 operated shoulders by the use of a visual analog scale (VAS), the Simple Shoulder Test (SST), and the question of overall patient satisfaction. Thirty shoulders undergoing surgery before February 2000 had open cuff repair (12 classic open, 18 mini-open) and 66 shoulders undergoing surgery after February 2000 had an arthroscopic cuff repair with suture anchors. All but 3 shoulders had the supraspinatus/infraspinatus tendon refixed, 32% had a subscapularis reattachment, and 21% an additional SLAP repair. Results: Groups A (30 shoulders, open repair) and B (66 shoulders, arthroscopic repair) were comparable concerning tear size, cause of the tear, professional shoulder strain, and preoperative pain intensity. At follow-up evaluation (15-40 months after surgery), group B had significantly better pain relief on the VAS (P Ͻ .05), more yes answers in the SST (9.7 vs. 8.7, not significant), and a higher patient satisfaction rate of 92.4% versus 80% (not significant). From the 12 questions of the SST, all but 1 showed a higher percentage of yes answers in group B; for 3 questions concerning mobility the difference was significant (P Ͻ .07). There was no correlation between tear size and outcome in the SST. Conclusions: Arthroscopic cuff repair yielded equal or better results than open repair, even at the beginning of the learning curve. Patients with an arthroscopic repair had a significantly better decrease in pain and a better functional result concerning mobility. Arthroscopic repair is successful for large and small tears. Biomechanically, large tears might even benefit more than small ones. Level of Evidence: Level IV.
Outcome analysis of surgery for disorders of the rotator cuff
The Journal of Bone and Joint Surgery. British volume, 2009
A consecutive series of 372 patients who underwent surgery for disorders of the rotator cuff involving arthroscopic subacromial decompression and open or arthroscopic repairs of the cuff were prospectively investigated as to the comparability of subjective and objective assessment scores of shoulder function. Assessments were made before operation and at 3, 6, 12, 18 and 24 months after surgery using the Disabilities of the Arm, Shoulder, and Hand score, the Oxford shoulder score and the Constant-Murley score, which was used as a reference. All scores were standardised to a scale of 0 to 100 for comparison. Statistical analysis compared the post-operative course and the mean score for the subjective Disabilities to the Arm, Shoulder and Hand score and Oxford shoulder score, with the objective Constant score at each interval. A strong correlation was evident between both subjective scores and the Constant score. We concluded that both the subjective scores would be useful substitutes...
Arthroscopic vs mini-open rotator cuff repair. A quality of life impairment study
International Orthopaedics, 2010
We compared the clinical and quality of life related outcome of rotator cuff repair performed using either a mini-open or an arthroscopic technique for rotator cuff tears of less than 3 cm. The records of 64 patients who underwent rotator cuff repair between September 2003 and September 2005 were evaluated. Thirty-two patients underwent a mini-open rotator cuff repair, and 32 patients underwent an arthroscopic rotator cuff repair. The mean follow-up period was 31 months in the mini-open group and 30.6 months in the arthroscopic group (P>0.05). The UCLA rating system, range of motion examination and the self-administered SF-36 used for postoperative evaluation showed a statistically significant improvement from the preoperative to the final score for both groups (P<0.05).
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 2016
To evaluate the minimum 2-year results and possible outcomes of arthroscopic partial repair in different patterns of irreparable rotator cuff tears (RCTs). Patients suffering from an irreparable supraspinatus and a reparable infraspinatus tendons who underwent arthroscopic partial repair with a minimum 24-month follow-up were included in this study. The Constant and Murley score (CMS) was used to assess patients' functionality pre- and postoperatively. Postoperative patient assessment included the Simple Shoulder Test (SST) and the Short Form Health Survey questionnaire (SF-36). A postoperative range of motion, CMS, and strength were compared with the contralateral side. Postoperative SF-36 was compared with age- and sex-matched norms. Ninety patients (95 shoulders) were reviewed after a mean follow-up of 7 (range 2-12) years. The subscapularis tendon was intact in 80 shoulders and torn but completely reparable in the remaining 15 shoulders. The CMS improved from 39.1 ± 8.4 (10-...
2012
The purpose of this dissertation was to systematically review the prognostic evidence for factors that may predict clinical outcome in individuals undergoing rotator cuff repair, determine preoperative factors that can accurately predict outcome in individuals having arthroscopic subacromial decompression with or without rotator cuff repair, and calculate responsiveness for the Western Ontario Rotator Cuff Index and the Disabilities of the Arm, Shoulder and Hand Questionnaire in these individuals. A preoperative evaluation collected demographic information, history of the shoulder condition, measures of shoulder impairment, shoulder activity level, fear-avoidance levels, depressive symptomatology, and anxiety. Patient-reported outcomes (PROs) included a disease-specific PRO, the Western Ontario Rotator Cuff Index (WORC), and a region-specific PRO, the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH). Six months postoperatively, the WORC, DASH and global rating of chan...
Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.], 2015
Good clinical results have been reported for both surgical and conservative treatment of rotator cuff tears. The primary aim of this randomized controlled trial was to compare functional and radiologic improvement after surgical and conservative treatment of degenerative rotator cuff tears. We conducted a randomized controlled trial that included 56 patients with a degenerative full-thickness rotator cuff tear between January 2009 and December 2012; 31 patients were treated conservatively, and rotator cuff repair was performed in 25 patients. Outcome measures, including the Constant-Murley score (CMS), visual analog scale (VAS) pain and VAS disability scores, were assessed preoperatively and after 6 weeks and 3, 6, and 12 months. Magnetic resonance imaging was performed preoperatively and at 12 months postoperatively. At 12 months postoperatively, the mean CMS was 81.9 (standard deviation [SD], 15.6) in the surgery group vs 73.7 (SD, 18.4) in the conservative group (P = .08). VAS pa...