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Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity.
J Bone Joint Surg Am. 2013 Aug 21; 95(16):1482-8.JB

Abstract

BACKGROUND

Few studies of large-to-massive contracted rotator cuff tears have examined the arthroscopic complete repair obtained by a posterior interval slide and whether the clinical outcomes or structural integrity achieved are better than those after partial repair without the posterior interval slide.

METHOD

The study included forty-one patients with large-to-massive contracted rotator cuff tears, not amenable to complete repair with margin convergence alone. The patients underwent either arthroscopic complete repair with a posterior interval slide and side-to-side repair of the interval slide edge (twenty-two patients; Group P) or partial repair with margin convergence (nineteen patients; Group M). The patient assignment was not randomized. The Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and range of motion were used to compare the functional outcomes. Preoperative and six-month postoperative magnetic resonance arthrography (MRA) images were compared within or between groups.

RESULTS

At the two-year follow-up evaluation, the SST, ASES score, UCLA score, and range of motion had significantly improved (p < 0.001 for all) in both groups. However, no significant differences were detected between groups. Even though the difference in preoperative tear size on MRA images was not significant, follow-up MRA images identified a retear in twenty patients (91%) in Group P and a significant difference in tear size between groups (p = 0.007).

CONCLUSIONS

The complete repair group with an aggressive release had no better clinical or structural outcomes compared with the partial repair group with margin convergence alone for large-to-massive contracted rotator cuff tears. In addition, the complete repair group had a 91% retear rate and a greater defect on follow-up MRA images. Even though this study had a relatively short-term follow-up, a complete repair of large-to-massive contracted rotator cuff tears, with an aggressive release such as posterior interval slide, may not have an increased benefit compared with partial repair without posterior interval slide.

Authors+Show Affiliations

Arthroscopy and Joint Research Institute, Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23965698

Citation

Kim, Sung-Jae, et al. "Arthroscopic Repair of Massive Contracted Rotator Cuff Tears: Aggressive Release With Anterior and Posterior Interval Slides Do Not Improve Cuff Healing and Integrity." The Journal of Bone and Joint Surgery. American Volume, vol. 95, no. 16, 2013, pp. 1482-8.
Kim SJ, Kim SH, Lee SK, et al. Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity. J Bone Joint Surg Am. 2013;95(16):1482-8.
Kim, S. J., Kim, S. H., Lee, S. K., Seo, J. W., & Chun, Y. M. (2013). Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity. The Journal of Bone and Joint Surgery. American Volume, 95(16), 1482-8. https://doi.org/10.2106/JBJS.L.01193
Kim SJ, et al. Arthroscopic Repair of Massive Contracted Rotator Cuff Tears: Aggressive Release With Anterior and Posterior Interval Slides Do Not Improve Cuff Healing and Integrity. J Bone Joint Surg Am. 2013 Aug 21;95(16):1482-8. PubMed PMID: 23965698.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic repair of massive contracted rotator cuff tears: aggressive release with anterior and posterior interval slides do not improve cuff healing and integrity. AU - Kim,Sung-Jae, AU - Kim,Sung-Hwan, AU - Lee,Su-Keon, AU - Seo,Jae-Wan, AU - Chun,Yong-Min, PY - 2013/8/23/entrez PY - 2013/8/24/pubmed PY - 2013/11/10/medline SP - 1482 EP - 8 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 95 IS - 16 N2 - BACKGROUND: Few studies of large-to-massive contracted rotator cuff tears have examined the arthroscopic complete repair obtained by a posterior interval slide and whether the clinical outcomes or structural integrity achieved are better than those after partial repair without the posterior interval slide. METHOD: The study included forty-one patients with large-to-massive contracted rotator cuff tears, not amenable to complete repair with margin convergence alone. The patients underwent either arthroscopic complete repair with a posterior interval slide and side-to-side repair of the interval slide edge (twenty-two patients; Group P) or partial repair with margin convergence (nineteen patients; Group M). The patient assignment was not randomized. The Simple Shoulder Test (SST), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and range of motion were used to compare the functional outcomes. Preoperative and six-month postoperative magnetic resonance arthrography (MRA) images were compared within or between groups. RESULTS: At the two-year follow-up evaluation, the SST, ASES score, UCLA score, and range of motion had significantly improved (p < 0.001 for all) in both groups. However, no significant differences were detected between groups. Even though the difference in preoperative tear size on MRA images was not significant, follow-up MRA images identified a retear in twenty patients (91%) in Group P and a significant difference in tear size between groups (p = 0.007). CONCLUSIONS: The complete repair group with an aggressive release had no better clinical or structural outcomes compared with the partial repair group with margin convergence alone for large-to-massive contracted rotator cuff tears. In addition, the complete repair group had a 91% retear rate and a greater defect on follow-up MRA images. Even though this study had a relatively short-term follow-up, a complete repair of large-to-massive contracted rotator cuff tears, with an aggressive release such as posterior interval slide, may not have an increased benefit compared with partial repair without posterior interval slide. SN - 1535-1386 UR - https://www.unboundmedicine.com/medline/citation/23965698/Arthroscopic_repair_of_massive_contracted_rotator_cuff_tears:_aggressive_release_with_anterior_and_posterior_interval_slides_do_not_improve_cuff_healing_and_integrity_ L2 - http://dx.doi.org/10.2106/JBJS.L.01193 DB - PRIME DP - Unbound Medicine ER -