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Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome: surgical technique.
J Bone Joint Surg Am. 2011 Mar; 93 Suppl 1:62-74.JB

Abstract

BACKGROUND

Literature regarding the outcomes of revision rotator cuff repair is limited. The purposes of the present study were to report the tendon repair integrity and clinical outcomes for a cohort of patients following revision arthroscopic rotator cuff repair and to examine factors related to tendon healing and the influence of healing on clinical outcomes.

METHODS

Twenty-one of twenty-nine consecutive revision arthroscopic rotator cuff repairs with a minimum of two years of postoperative follow-up were retrospectively reviewed. Outcomes were evaluated on the basis of a visual analog pain scale, the range of motion of the shoulder, the Simple Shoulder Test, the American Shoulder and Elbow Surgeons score, and the Constant score. Ultrasonography was used to examine repair integrity at a minimum of one year following surgery. Ten shoulders underwent arthroscopic repair of a recurrent single-tendon posterior rotator cuff tear, whereas eleven shoulders had repair of both the supraspinatus and infraspinatus.

RESULTS

The mean age of the twenty-one subjects was 55.6 years; thirteen subjects were male and eight were female. Complete preoperative and postoperative clinical data were available for nineteen subjects after an average duration of follow-up of thirty-three months. Significant improvements were seen in terms of postoperative pain (p < 0.05), the Simple Shoulder Test score (p < 0.05), the American Shoulder and Elbow Surgeons function (p < 0.05) and total scores (p < 0.05), active forward elevation (p < 0.05), and active external rotation (p < 0.05). Postoperative ultrasound data were available for all twenty-one shoulders after a mean duration of follow-up of twenty-five months. Ten (48%) of the twenty-one shoulders had an intact repair. Seven (70%) of the ten single-tendon repairs were intact, compared with three (27%) of the eleven supraspinatus/infraspinatus repairs (p = 0.05). Patient age (p < 0.05) and the number of torn tendons (p = 0.05) had significant effects on postoperative tendon repair integrity. Shoulders with an intact repair had better postoperative Constant scores (p < 0.05) and scapular plane elevation strength (p < 0.05) in comparison with those with a recurrent tear.

CONCLUSIONS

Revision arthroscopic rotator cuff repair results in reliable pain relief and improvement in shoulder function in selected cases. Approximately half of the revision repairs can be expected to be intact at a minimum of one year following surgery. Patient age and the number of torn tendons are related to postoperative tendon integrity. The postoperative integrity of the rotator cuff can have a significant influence on shoulder abduction strength and the Constant score.

Authors+Show Affiliations

Shoulder and Elbow Service, Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri 63110, USA.No affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21411687

Citation

Kowalsky, Marc S., and Jay D. Keener. "Revision Arthroscopic Rotator Cuff Repair: Repair Integrity and Clinical Outcome: Surgical Technique." The Journal of Bone and Joint Surgery. American Volume, vol. 93 Suppl 1, 2011, pp. 62-74.
Kowalsky MS, Keener JD. Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome: surgical technique. J Bone Joint Surg Am. 2011;93 Suppl 1:62-74.
Kowalsky, M. S., & Keener, J. D. (2011). Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome: surgical technique. The Journal of Bone and Joint Surgery. American Volume, 93 Suppl 1, 62-74. https://doi.org/10.2106/JBJS.J.01173
Kowalsky MS, Keener JD. Revision Arthroscopic Rotator Cuff Repair: Repair Integrity and Clinical Outcome: Surgical Technique. J Bone Joint Surg Am. 2011;93 Suppl 1:62-74. PubMed PMID: 21411687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome: surgical technique. AU - Kowalsky,Marc S, AU - Keener,Jay D, PY - 2011/3/18/entrez PY - 2011/3/29/pubmed PY - 2011/6/1/medline SP - 62 EP - 74 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 93 Suppl 1 N2 - BACKGROUND: Literature regarding the outcomes of revision rotator cuff repair is limited. The purposes of the present study were to report the tendon repair integrity and clinical outcomes for a cohort of patients following revision arthroscopic rotator cuff repair and to examine factors related to tendon healing and the influence of healing on clinical outcomes. METHODS: Twenty-one of twenty-nine consecutive revision arthroscopic rotator cuff repairs with a minimum of two years of postoperative follow-up were retrospectively reviewed. Outcomes were evaluated on the basis of a visual analog pain scale, the range of motion of the shoulder, the Simple Shoulder Test, the American Shoulder and Elbow Surgeons score, and the Constant score. Ultrasonography was used to examine repair integrity at a minimum of one year following surgery. Ten shoulders underwent arthroscopic repair of a recurrent single-tendon posterior rotator cuff tear, whereas eleven shoulders had repair of both the supraspinatus and infraspinatus. RESULTS: The mean age of the twenty-one subjects was 55.6 years; thirteen subjects were male and eight were female. Complete preoperative and postoperative clinical data were available for nineteen subjects after an average duration of follow-up of thirty-three months. Significant improvements were seen in terms of postoperative pain (p < 0.05), the Simple Shoulder Test score (p < 0.05), the American Shoulder and Elbow Surgeons function (p < 0.05) and total scores (p < 0.05), active forward elevation (p < 0.05), and active external rotation (p < 0.05). Postoperative ultrasound data were available for all twenty-one shoulders after a mean duration of follow-up of twenty-five months. Ten (48%) of the twenty-one shoulders had an intact repair. Seven (70%) of the ten single-tendon repairs were intact, compared with three (27%) of the eleven supraspinatus/infraspinatus repairs (p = 0.05). Patient age (p < 0.05) and the number of torn tendons (p = 0.05) had significant effects on postoperative tendon repair integrity. Shoulders with an intact repair had better postoperative Constant scores (p < 0.05) and scapular plane elevation strength (p < 0.05) in comparison with those with a recurrent tear. CONCLUSIONS: Revision arthroscopic rotator cuff repair results in reliable pain relief and improvement in shoulder function in selected cases. Approximately half of the revision repairs can be expected to be intact at a minimum of one year following surgery. Patient age and the number of torn tendons are related to postoperative tendon integrity. The postoperative integrity of the rotator cuff can have a significant influence on shoulder abduction strength and the Constant score. SN - 1535-1386 UR - https://www.unboundmedicine.com/medline/citation/21411687/Revision_arthroscopic_rotator_cuff_repair:_repair_integrity_and_clinical_outcome:_surgical_technique_ L2 - http://dx.doi.org/10.2106/JBJS.J.01173 DB - PRIME DP - Unbound Medicine ER -