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Arthroscopic rotator cuff repair with double-row fixation.
J Bone Joint Surg Am. 2007 Jun; 89(6):1248-57.JB

Abstract

BACKGROUND

The treatment of rotator cuff tears has evolved from open surgical repairs to complete arthroscopic repairs over the past two decades. In this study, we reviewed the results of arthroscopic rotator cuff repairs with the so-called double-row, or footprint, reconstruction technique.

METHODS

Between 1998 and 2002, 264 patients underwent an arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty-nine years. Two hundred and thirty-eight patients (242 shoulders) were available for follow-up; 210 were evaluated with a full clinical examination and thirty-two, with a questionnaire only. Preoperative and postoperative examinations consisted of determination of a Constant score and a visual analogue score for pain as well as a full physical examination of the shoulder. Ultrasonography was done at a minimum of twelve months postoperatively to assess the integrity of the cuff.

RESULTS

The average score for pain improved from 7.4 points (range, 3 to 10 points) preoperatively to 0.7 point (range, 0 to 3 points) postoperatively. The subjective outcome was excellent or good in 220 (90.9%) of the 242 shoulders. The average increase in the Constant score after the operation was 25.4 points (range, 0 to 57 points). Ultrasonography demonstrated an intact rotator cuff in 83% (174) of the shoulders overall, 47% (fifteen) of the thirty-two with a repair of a massive tear, 78% (thirty-two) of the forty-one with a repair of a large tear, 93% (113) of the 121 with a repair of a medium tear, and 88% (fourteen) of the sixteen with a repair of a small tear. Strength and active elevation increased significantly more in the group with an intact repair at the time of follow-up than in the group with a failed repair; however, there was no difference in the pain scores.

CONCLUSIONS

Arthroscopic rotator cuff repair with double-row fixation can achieve a high percentage of excellent subjective and objective results. Integrity of the repair can be expected in the majority of shoulders treated for a large, medium, or small tear, and the strength and range of motion provided by an intact repair are significantly better than those following a failed repair.

LEVEL OF EVIDENCE

Therapeutic Level IV.

Authors+Show Affiliations

Cape Shoulder Institute, P.O. Box 15741, Panorama 7506, South Africa.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17545428

Citation

Huijsmans, Pol E., et al. "Arthroscopic Rotator Cuff Repair With Double-row Fixation." The Journal of Bone and Joint Surgery. American Volume, vol. 89, no. 6, 2007, pp. 1248-57.
Huijsmans PE, Pritchard MP, Berghs BM, et al. Arthroscopic rotator cuff repair with double-row fixation. J Bone Joint Surg Am. 2007;89(6):1248-57.
Huijsmans, P. E., Pritchard, M. P., Berghs, B. M., van Rooyen, K. S., Wallace, A. L., & de Beer, J. F. (2007). Arthroscopic rotator cuff repair with double-row fixation. The Journal of Bone and Joint Surgery. American Volume, 89(6), 1248-57.
Huijsmans PE, et al. Arthroscopic Rotator Cuff Repair With Double-row Fixation. J Bone Joint Surg Am. 2007;89(6):1248-57. PubMed PMID: 17545428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic rotator cuff repair with double-row fixation. AU - Huijsmans,Pol E, AU - Pritchard,Mark P, AU - Berghs,Bart M, AU - van Rooyen,Karin S, AU - Wallace,Andrew L, AU - de Beer,Joe F, PY - 2007/6/5/pubmed PY - 2007/7/18/medline PY - 2007/6/5/entrez SP - 1248 EP - 57 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 89 IS - 6 N2 - BACKGROUND: The treatment of rotator cuff tears has evolved from open surgical repairs to complete arthroscopic repairs over the past two decades. In this study, we reviewed the results of arthroscopic rotator cuff repairs with the so-called double-row, or footprint, reconstruction technique. METHODS: Between 1998 and 2002, 264 patients underwent an arthroscopic rotator cuff repair with double-row fixation. The average age at the time of the operation was fifty-nine years. Two hundred and thirty-eight patients (242 shoulders) were available for follow-up; 210 were evaluated with a full clinical examination and thirty-two, with a questionnaire only. Preoperative and postoperative examinations consisted of determination of a Constant score and a visual analogue score for pain as well as a full physical examination of the shoulder. Ultrasonography was done at a minimum of twelve months postoperatively to assess the integrity of the cuff. RESULTS: The average score for pain improved from 7.4 points (range, 3 to 10 points) preoperatively to 0.7 point (range, 0 to 3 points) postoperatively. The subjective outcome was excellent or good in 220 (90.9%) of the 242 shoulders. The average increase in the Constant score after the operation was 25.4 points (range, 0 to 57 points). Ultrasonography demonstrated an intact rotator cuff in 83% (174) of the shoulders overall, 47% (fifteen) of the thirty-two with a repair of a massive tear, 78% (thirty-two) of the forty-one with a repair of a large tear, 93% (113) of the 121 with a repair of a medium tear, and 88% (fourteen) of the sixteen with a repair of a small tear. Strength and active elevation increased significantly more in the group with an intact repair at the time of follow-up than in the group with a failed repair; however, there was no difference in the pain scores. CONCLUSIONS: Arthroscopic rotator cuff repair with double-row fixation can achieve a high percentage of excellent subjective and objective results. Integrity of the repair can be expected in the majority of shoulders treated for a large, medium, or small tear, and the strength and range of motion provided by an intact repair are significantly better than those following a failed repair. LEVEL OF EVIDENCE: Therapeutic Level IV. SN - 0021-9355 UR - https://www.unboundmedicine.com/medline/citation/17545428/Arthroscopic_rotator_cuff_repair_with_double_row_fixation_ L2 - http://dx.doi.org/10.2106/JBJS.E.00743 DB - PRIME DP - Unbound Medicine ER -