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Factors affecting healing rates after arthroscopic double-row rotator cuff repair.
Am J Sports Med. 2010 Dec; 38(12):2435-42.AJ

Abstract

BACKGROUND

Double-row arthroscopic rotator cuff repairs were developed to improve initial biomechanical strength of repairs to improve healing rates. Despite biomechanical improvements, failure of healing remains a clinical problem.

PURPOSE

To evaluate the anatomical results after double-row arthroscopic rotator cuff repair with ultrasound to determine postoperative repair integrity and the effect of various factors on tendon healing.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Forty-eight patients (49 shoulders) who had a complete arthroscopic rotator cuff repair (double-row technique) were evaluated with ultrasound at a minimum of 6 months after surgery. Outcome was evaluated at a minimum of 1-year follow-up with standardized history and physical examination, visual analog scale for pain, active forward elevation, and preoperative and postoperative shoulder scores according to the system of the American Shoulder and Elbow Surgeons and the Simple Shoulder Test. Quantitative strength was measured postoperatively.

RESULTS

Ultrasound and physical examinations were performed at a minimum of 6 months after surgery (mean, 16 months; range, 6 to 36 months) and outcome questionnaire evaluations at a minimum of 12 months after surgery (mean, 29 months; range, 12 to 55 months). Of 49 repairs, 25 (51%) were healed. Healing rates were 67% in single-tendon tears (16 of 24 shoulders) and 36% in multitendon tears (9 of 25 shoulders). Older age and longer duration of follow-up were correlated with poorer tendon healing (P < .03). Visual analog scale for pain, active forward elevation, American Shoulder and Elbow Surgeons scores, and Simple Shoulder Test scores all had significant improvement from baseline after repair (P < .0001).

CONCLUSION

Increased age and longer duration of follow-up were associated with lower healing rates after double-row rotator cuff repair. The biological limitation at the repair site, as reflected by the effects of age on healing, appears to be the most important factor influencing tendon healing, even after maximizing repair biomechanical strength with a double-row construct.

Authors+Show Affiliations

Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, 84108, USA. Robert.Tashjian@hsc.utah.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21030564

Citation

Tashjian, Robert Z., et al. "Factors Affecting Healing Rates After Arthroscopic Double-row Rotator Cuff Repair." The American Journal of Sports Medicine, vol. 38, no. 12, 2010, pp. 2435-42.
Tashjian RZ, Hollins AM, Kim HM, et al. Factors affecting healing rates after arthroscopic double-row rotator cuff repair. Am J Sports Med. 2010;38(12):2435-42.
Tashjian, R. Z., Hollins, A. M., Kim, H. M., Teefey, S. A., Middleton, W. D., Steger-May, K., Galatz, L. M., & Yamaguchi, K. (2010). Factors affecting healing rates after arthroscopic double-row rotator cuff repair. The American Journal of Sports Medicine, 38(12), 2435-42. https://doi.org/10.1177/0363546510382835
Tashjian RZ, et al. Factors Affecting Healing Rates After Arthroscopic Double-row Rotator Cuff Repair. Am J Sports Med. 2010;38(12):2435-42. PubMed PMID: 21030564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors affecting healing rates after arthroscopic double-row rotator cuff repair. AU - Tashjian,Robert Z, AU - Hollins,Anthony M, AU - Kim,Hyun-Min, AU - Teefey,Sharlene A, AU - Middleton,William D, AU - Steger-May,Karen, AU - Galatz,Leesa M, AU - Yamaguchi,Ken, Y1 - 2010/10/28/ PY - 2010/10/30/entrez PY - 2010/10/30/pubmed PY - 2011/4/2/medline SP - 2435 EP - 42 JF - The American journal of sports medicine JO - Am J Sports Med VL - 38 IS - 12 N2 - BACKGROUND: Double-row arthroscopic rotator cuff repairs were developed to improve initial biomechanical strength of repairs to improve healing rates. Despite biomechanical improvements, failure of healing remains a clinical problem. PURPOSE: To evaluate the anatomical results after double-row arthroscopic rotator cuff repair with ultrasound to determine postoperative repair integrity and the effect of various factors on tendon healing. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Forty-eight patients (49 shoulders) who had a complete arthroscopic rotator cuff repair (double-row technique) were evaluated with ultrasound at a minimum of 6 months after surgery. Outcome was evaluated at a minimum of 1-year follow-up with standardized history and physical examination, visual analog scale for pain, active forward elevation, and preoperative and postoperative shoulder scores according to the system of the American Shoulder and Elbow Surgeons and the Simple Shoulder Test. Quantitative strength was measured postoperatively. RESULTS: Ultrasound and physical examinations were performed at a minimum of 6 months after surgery (mean, 16 months; range, 6 to 36 months) and outcome questionnaire evaluations at a minimum of 12 months after surgery (mean, 29 months; range, 12 to 55 months). Of 49 repairs, 25 (51%) were healed. Healing rates were 67% in single-tendon tears (16 of 24 shoulders) and 36% in multitendon tears (9 of 25 shoulders). Older age and longer duration of follow-up were correlated with poorer tendon healing (P < .03). Visual analog scale for pain, active forward elevation, American Shoulder and Elbow Surgeons scores, and Simple Shoulder Test scores all had significant improvement from baseline after repair (P < .0001). CONCLUSION: Increased age and longer duration of follow-up were associated with lower healing rates after double-row rotator cuff repair. The biological limitation at the repair site, as reflected by the effects of age on healing, appears to be the most important factor influencing tendon healing, even after maximizing repair biomechanical strength with a double-row construct. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/21030564/Factors_affecting_healing_rates_after_arthroscopic_double_row_rotator_cuff_repair_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546510382835?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -