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Intratendinous rotator cuff tears: prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears at midterm follow-up.
Am J Sports Med. 2015 Feb; 43(2):415-22.AJ

Abstract

BACKGROUND

Intratendinous tears of the rotator cuff are rare, and little has been written about them.

PURPOSE

To investigate the prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears treated with transtendon suture bridge repair.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Included in the study were 33 patients (16 male, 17 female; mean age, 53.4 years) with arthroscopically confirmed intratendinous tears treated with transtendon suture bridge repair from March 2006 to July 2012. A history of trauma was found in 10 cases (30.3%). The dominant arm was involved in 26 cases (78.8%). The mean follow-up duration was 56 months. Preoperatively, a thorough physical examination was performed; at final follow-up, shoulder range of motion (ROM) in forward flexion, abduction, external rotation (ER) at the side, and internal rotation (IR) at the back was noted, and clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score; University of California, Los Angeles [UCLA] score; visual analog scale [VAS] for pain; and Simple Shoulder Test [SST]) were recorded and compared with the preoperative data. Postoperative magnetic resonance imaging (MRI) was performed at 6 months to investigate rotator cuff healing status and repair integrity.

RESULTS

The prevalence of arthroscopically confirmed intratendinous tears was 4.7% among all arthroscopically treated partial-thickness rotator cuff tears. Impingement signs were positive in most of the patients (positive Hawkins-Kennedy test result in 78.8%, positive Neer sign in 66.7%, and either positive Hawkins-Kennedy test result or Neer sign in 84.8%). At final follow-up, mean ASES, UCLA, VAS, and SST scores improved significantly from a preoperative mean of 51.4, 18.9, 6.0, and 5.4, respectively, to a postoperative mean of 90.6, 32.9, 1.4, and 10.8, respectively (P < .001). According to the UCLA rating scale, outcomes were excellent in 17, good in 13, and fair in 3 cases. Shoulder ROM in forward flexion, abduction, ER at the side, and IR at the back improved from a preoperative mean of 135°, 129°, 25°, and L2, respectively, to a postoperative mean of 161°, 160°, 29°, and T10, respectively (P < .001 for all except ER). As per the Sugaya classification, on postoperative MRI, type I healing status was found in 10 (30.3%), type II in 18 (54.5%), and type III in 2 (6.1%) cases. None of the patients showed any evidence of retears.

CONCLUSION

Transtendon suture bridge repair yielded satisfactory clinical and radiological outcomes in patients with intratendinous rotator cuff tears.

Authors+Show Affiliations

Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea.Department of Orthopedic Surgery, Daejeon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea jijh87@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25389369

Citation

Park, Sang-Eun, et al. "Intratendinous Rotator Cuff Tears: Prevalence and Clinical and Radiological Outcomes of Arthroscopically Confirmed Intratendinous Tears at Midterm Follow-up." The American Journal of Sports Medicine, vol. 43, no. 2, 2015, pp. 415-22.
Park SE, Panchal K, Jeong JJ, et al. Intratendinous rotator cuff tears: prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears at midterm follow-up. Am J Sports Med. 2015;43(2):415-22.
Park, S. E., Panchal, K., Jeong, J. J., Kim, Y. Y., Kim, J. H., Lee, J. Y., & Ji, J. H. (2015). Intratendinous rotator cuff tears: prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears at midterm follow-up. The American Journal of Sports Medicine, 43(2), 415-22. https://doi.org/10.1177/0363546514556741
Park SE, et al. Intratendinous Rotator Cuff Tears: Prevalence and Clinical and Radiological Outcomes of Arthroscopically Confirmed Intratendinous Tears at Midterm Follow-up. Am J Sports Med. 2015;43(2):415-22. PubMed PMID: 25389369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intratendinous rotator cuff tears: prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears at midterm follow-up. AU - Park,Sang-Eun, AU - Panchal,Karnav, AU - Jeong,Jae-Jung, AU - Kim,Young-Yul, AU - Kim,Jong-Ho, AU - Lee,Ju-Yeob, AU - Ji,Jong-Hun, Y1 - 2014/11/11/ PY - 2014/11/13/entrez PY - 2014/11/13/pubmed PY - 2015/7/8/medline KW - arthroscopic surgery KW - intratendinous tears KW - prevalence KW - transtendon suture bridge repair SP - 415 EP - 22 JF - The American journal of sports medicine JO - Am J Sports Med VL - 43 IS - 2 N2 - BACKGROUND: Intratendinous tears of the rotator cuff are rare, and little has been written about them. PURPOSE: To investigate the prevalence and clinical and radiological outcomes of arthroscopically confirmed intratendinous tears treated with transtendon suture bridge repair. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Included in the study were 33 patients (16 male, 17 female; mean age, 53.4 years) with arthroscopically confirmed intratendinous tears treated with transtendon suture bridge repair from March 2006 to July 2012. A history of trauma was found in 10 cases (30.3%). The dominant arm was involved in 26 cases (78.8%). The mean follow-up duration was 56 months. Preoperatively, a thorough physical examination was performed; at final follow-up, shoulder range of motion (ROM) in forward flexion, abduction, external rotation (ER) at the side, and internal rotation (IR) at the back was noted, and clinical outcomes (American Shoulder and Elbow Surgeons [ASES] score; University of California, Los Angeles [UCLA] score; visual analog scale [VAS] for pain; and Simple Shoulder Test [SST]) were recorded and compared with the preoperative data. Postoperative magnetic resonance imaging (MRI) was performed at 6 months to investigate rotator cuff healing status and repair integrity. RESULTS: The prevalence of arthroscopically confirmed intratendinous tears was 4.7% among all arthroscopically treated partial-thickness rotator cuff tears. Impingement signs were positive in most of the patients (positive Hawkins-Kennedy test result in 78.8%, positive Neer sign in 66.7%, and either positive Hawkins-Kennedy test result or Neer sign in 84.8%). At final follow-up, mean ASES, UCLA, VAS, and SST scores improved significantly from a preoperative mean of 51.4, 18.9, 6.0, and 5.4, respectively, to a postoperative mean of 90.6, 32.9, 1.4, and 10.8, respectively (P < .001). According to the UCLA rating scale, outcomes were excellent in 17, good in 13, and fair in 3 cases. Shoulder ROM in forward flexion, abduction, ER at the side, and IR at the back improved from a preoperative mean of 135°, 129°, 25°, and L2, respectively, to a postoperative mean of 161°, 160°, 29°, and T10, respectively (P < .001 for all except ER). As per the Sugaya classification, on postoperative MRI, type I healing status was found in 10 (30.3%), type II in 18 (54.5%), and type III in 2 (6.1%) cases. None of the patients showed any evidence of retears. CONCLUSION: Transtendon suture bridge repair yielded satisfactory clinical and radiological outcomes in patients with intratendinous rotator cuff tears. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/25389369/Intratendinous_rotator_cuff_tears:_prevalence_and_clinical_and_radiological_outcomes_of_arthroscopically_confirmed_intratendinous_tears_at_midterm_follow_up_ L2 - http://journals.sagepub.com/doi/full/10.1177/0363546514556741?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -