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Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique.
Arch Orthop Trauma Surg. 2016 Dec; 136(12):1701-1708.AO

Abstract

INTRODUCTION

The purpose of this study was to introduce a novel arthroscopic transtendon anatomic repair technique that spares the intact bursal-sided tendon in articular-sided partial-thickness rotator cuff tears (PTRCT) and to present shoulder functional outcomes in patients with symptomatic articular-sided PCRCT that involves more than 50 % of its thickness after arthroscopic repair using a novel technique.

MATERIALS AND METHODS

Eighteen patients with symptomatic articular-sided PCRCT involving more than 50 % of the tendon's thickness underwent arthroscopic repair using a devised technique. The devised technique restores only the torn articular portion of the rotator cuff at the anatomical footprint using a suture anchor, and preserves the integrity of the corresponding bursal-sided tendon by tying knots at the most lateral bursal side on the subacromial space. Clinical and functional outcome using ASES and Constant scores were evaluated. The structural integrity of the rotator cuff was evaluated by MRI at 6 months postoperatively.

RESULTS

Pain relief and shoulder functional outcomes were encouraging during the recovery phase after operation. ASES (preoperative 54.0 ± 10.3 to postoperative 92.6 ± 8.0), Constant score (61.2 ± 8.5-88.0 ± 5.3), VAS for pain (4.9 ± 2.6-0.6 ± 0.7) improved significantly after arthroscopic transtendon anatomic repair (p < 0.001). No patients had rotator cuff retears on 6-month MRI. No complications related to surgical procedures had occurred.

CONCLUSION

The devised technique of arthroscopic transtendon repair provided satisfactory functional outcomes without postoperative discomforts. This technique minimizes over-tightening of the articular layer and reduces tension mismatches between the articular and bursal layers, which are considered as important factors for improvement of postoperative shoulder motion.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, Korea. sjshin622@ewha.ac.kr.Department of Orthopaedic Surgery, Ansan Yes Hospital, Ansan, Kyunggi-do, Korea.Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, Korea.Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul, 158-710, Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27498108

Citation

Shin, Sang-Jin, et al. "Preservation of Bursal-sided Tendon in Partial-thickness Articular-sided Rotator Cuff Tears: a Novel Arthroscopic Transtendon Anatomic Repair Technique." Archives of Orthopaedic and Trauma Surgery, vol. 136, no. 12, 2016, pp. 1701-1708.
Shin SJ, Jeong JH, Jeon YS, et al. Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique. Arch Orthop Trauma Surg. 2016;136(12):1701-1708.
Shin, S. J., Jeong, J. H., Jeon, Y. S., & Kim, R. G. (2016). Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique. Archives of Orthopaedic and Trauma Surgery, 136(12), 1701-1708.
Shin SJ, et al. Preservation of Bursal-sided Tendon in Partial-thickness Articular-sided Rotator Cuff Tears: a Novel Arthroscopic Transtendon Anatomic Repair Technique. Arch Orthop Trauma Surg. 2016;136(12):1701-1708. PubMed PMID: 27498108.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique. AU - Shin,Sang-Jin, AU - Jeong,Jae-Hoon, AU - Jeon,Yoon Sang, AU - Kim,Rag Gyu, Y1 - 2016/08/06/ PY - 2016/03/05/received PY - 2016/8/9/pubmed PY - 2017/1/10/medline PY - 2016/8/8/entrez KW - Arthroscopic transtendon anatomic repair technique KW - Articular-sided KW - Partial-thickness rotator cuff tears SP - 1701 EP - 1708 JF - Archives of orthopaedic and trauma surgery JO - Arch Orthop Trauma Surg VL - 136 IS - 12 N2 - INTRODUCTION: The purpose of this study was to introduce a novel arthroscopic transtendon anatomic repair technique that spares the intact bursal-sided tendon in articular-sided partial-thickness rotator cuff tears (PTRCT) and to present shoulder functional outcomes in patients with symptomatic articular-sided PCRCT that involves more than 50 % of its thickness after arthroscopic repair using a novel technique. MATERIALS AND METHODS: Eighteen patients with symptomatic articular-sided PCRCT involving more than 50 % of the tendon's thickness underwent arthroscopic repair using a devised technique. The devised technique restores only the torn articular portion of the rotator cuff at the anatomical footprint using a suture anchor, and preserves the integrity of the corresponding bursal-sided tendon by tying knots at the most lateral bursal side on the subacromial space. Clinical and functional outcome using ASES and Constant scores were evaluated. The structural integrity of the rotator cuff was evaluated by MRI at 6 months postoperatively. RESULTS: Pain relief and shoulder functional outcomes were encouraging during the recovery phase after operation. ASES (preoperative 54.0 ± 10.3 to postoperative 92.6 ± 8.0), Constant score (61.2 ± 8.5-88.0 ± 5.3), VAS for pain (4.9 ± 2.6-0.6 ± 0.7) improved significantly after arthroscopic transtendon anatomic repair (p < 0.001). No patients had rotator cuff retears on 6-month MRI. No complications related to surgical procedures had occurred. CONCLUSION: The devised technique of arthroscopic transtendon repair provided satisfactory functional outcomes without postoperative discomforts. This technique minimizes over-tightening of the articular layer and reduces tension mismatches between the articular and bursal layers, which are considered as important factors for improvement of postoperative shoulder motion. SN - 1434-3916 UR - https://www.unboundmedicine.com/medline/citation/27498108/Preservation_of_bursal_sided_tendon_in_partial_thickness_articular_sided_rotator_cuff_tears:_a_novel_arthroscopic_transtendon_anatomic_repair_technique_ L2 - https://dx.doi.org/10.1007/s00402-016-2546-1 DB - PRIME DP - Unbound Medicine ER -