Tags

Type your tag names separated by a space and hit enter

Arthroscopic repair of anterosuperior rotator cuff tears: in-continuity technique vs. disruption of subscapularis-supraspinatus tear margin: comparison of clinical outcomes and structural integrity between the two techniques.
J Bone Joint Surg Am. 2014 Dec 17; 96(24):2056-61.JB

Abstract

BACKGROUND

The purpose of this study was to compare the clinical outcomes and structural integrity after two techniques of arthroscopic anterosuperior rotator cuff repair: in continuity and disruption of the tear margin.

METHODS

This study included fifty-nine patients who underwent arthroscopic repair of an anterosuperior rotator cuff tear that was done either by disrupting the margin between the subscapularis and supraspinatus tears (Group A) or by performing the repair in continuity without disrupting the margin (Group B). Clinical outcomes were assessed on the basis of a visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and active range of motion of the shoulder. Subscapularis strength was assessed with use of the modified belly-press test. Magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed at six months after surgery to assess the structural integrity of the repair.

RESULTS

At the two-year follow-up evaluation, VAS pain scores, SSVs, ASES scores, UCLA shoulder scores, subscapularis strength, and active range of motion improved significantly in both groups compared with preoperatively (p < 0.001). There were no significant differences between groups for any of these follow-up measurements. On follow-up MRA or CTA, the overall retear rate did not differ significantly different between Group A (22%; five of twenty-three) and Group B (19%; six of thirty-two).

CONCLUSIONS

In conclusion, in patients treated with arthroscopic repair of anterosuperior full-thickness subscapularis and supraspinatus tears of the rotator cuff, the technique of in-continuity repair did not produce better clinical outcomes or structural integrity than the technique involving disruption of the tear margin. If the muscle in an anterosuperior rotator cuff tear is of good quality, it does not appear to matter whether the tear margin between the subscapularis and supraspinatus is preserved or disrupted.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-M. Chun: min1201@hanmail.net.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-M. Chun: min1201@hanmail.net.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-M. Chun: min1201@hanmail.net.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-M. Chun: min1201@hanmail.net.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, CPO Box 8044, 134, Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea. E-mail address for Y.-M. Chun: min1201@hanmail.net.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25520339

Citation

Kim, Sung-Jae, et al. "Arthroscopic Repair of Anterosuperior Rotator Cuff Tears: In-continuity Technique Vs. Disruption of Subscapularis-supraspinatus Tear Margin: Comparison of Clinical Outcomes and Structural Integrity Between the Two Techniques." The Journal of Bone and Joint Surgery. American Volume, vol. 96, no. 24, 2014, pp. 2056-61.
Kim SJ, Jung M, Lee JH, et al. Arthroscopic repair of anterosuperior rotator cuff tears: in-continuity technique vs. disruption of subscapularis-supraspinatus tear margin: comparison of clinical outcomes and structural integrity between the two techniques. J Bone Joint Surg Am. 2014;96(24):2056-61.
Kim, S. J., Jung, M., Lee, J. H., Kim, C., & Chun, Y. M. (2014). Arthroscopic repair of anterosuperior rotator cuff tears: in-continuity technique vs. disruption of subscapularis-supraspinatus tear margin: comparison of clinical outcomes and structural integrity between the two techniques. The Journal of Bone and Joint Surgery. American Volume, 96(24), 2056-61. https://doi.org/10.2106/JBJS.N.00293
Kim SJ, et al. Arthroscopic Repair of Anterosuperior Rotator Cuff Tears: In-continuity Technique Vs. Disruption of Subscapularis-supraspinatus Tear Margin: Comparison of Clinical Outcomes and Structural Integrity Between the Two Techniques. J Bone Joint Surg Am. 2014 Dec 17;96(24):2056-61. PubMed PMID: 25520339.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic repair of anterosuperior rotator cuff tears: in-continuity technique vs. disruption of subscapularis-supraspinatus tear margin: comparison of clinical outcomes and structural integrity between the two techniques. AU - Kim,Sung-Jae, AU - Jung,Min, AU - Lee,Jae-Hoo, AU - Kim,Chul, AU - Chun,Yong-Min, PY - 2014/12/19/entrez PY - 2014/12/19/pubmed PY - 2015/2/20/medline SP - 2056 EP - 61 JF - The Journal of bone and joint surgery. American volume JO - J Bone Joint Surg Am VL - 96 IS - 24 N2 - BACKGROUND: The purpose of this study was to compare the clinical outcomes and structural integrity after two techniques of arthroscopic anterosuperior rotator cuff repair: in continuity and disruption of the tear margin. METHODS: This study included fifty-nine patients who underwent arthroscopic repair of an anterosuperior rotator cuff tear that was done either by disrupting the margin between the subscapularis and supraspinatus tears (Group A) or by performing the repair in continuity without disrupting the margin (Group B). Clinical outcomes were assessed on the basis of a visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and active range of motion of the shoulder. Subscapularis strength was assessed with use of the modified belly-press test. Magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed at six months after surgery to assess the structural integrity of the repair. RESULTS: At the two-year follow-up evaluation, VAS pain scores, SSVs, ASES scores, UCLA shoulder scores, subscapularis strength, and active range of motion improved significantly in both groups compared with preoperatively (p < 0.001). There were no significant differences between groups for any of these follow-up measurements. On follow-up MRA or CTA, the overall retear rate did not differ significantly different between Group A (22%; five of twenty-three) and Group B (19%; six of thirty-two). CONCLUSIONS: In conclusion, in patients treated with arthroscopic repair of anterosuperior full-thickness subscapularis and supraspinatus tears of the rotator cuff, the technique of in-continuity repair did not produce better clinical outcomes or structural integrity than the technique involving disruption of the tear margin. If the muscle in an anterosuperior rotator cuff tear is of good quality, it does not appear to matter whether the tear margin between the subscapularis and supraspinatus is preserved or disrupted. SN - 1535-1386 UR - https://www.unboundmedicine.com/medline/citation/25520339/Arthroscopic_repair_of_anterosuperior_rotator_cuff_tears:_in_continuity_technique_vs__disruption_of_subscapularis_supraspinatus_tear_margin:_comparison_of_clinical_outcomes_and_structural_integrity_between_the_two_techniques_ L2 - http://dx.doi.org/10.2106/JBJS.N.00293 DB - PRIME DP - Unbound Medicine ER -