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Arthroscopic Repair of Anterosuperior Massive Rotator Cuff Tears: Does Repair Integrity Affect Outcomes?
Am J Sports Med. 2017 Jul; 45(8):1762-1768.AJ

Abstract

BACKGROUND

The purpose of this study was to investigate clinical outcomes and structural integrity after arthroscopic repair of anterosuperior massive rotator cuff tears (RCTs) and to compare clinical outcomes between healed and retear groups.

HYPOTHESIS

The authors hypothesized that although both groups would exhibit improved clinical outcomes compared with their preoperative status, the healed group would have better clinical outcomes than the retear group, and in the retear group, the subscapularis retear subgroup would have inferior outcomes compared with the intact subscapularis repair subgroup.

STUDY DESIGN

Case-control study; Level of evidence, 3.

METHODS

This study included 73 of 90 eligible patients who underwent arthroscopic repair of an anterosuperior massive RCT. Functional outcomes after 2-year follow-up were assessed using the visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) shoulder score, and active range of motion. Patients were assigned to the healed group (group H, n = 34) or retear group (group R, n = 39) based on magnetic resonance arthrography results at 6 months postoperatively. Group R was composed of subgroup R1 (subscapularis retear) and subgroup R2 (intact subscapularis repair).

RESULTS

Retearing occurred in 53% of patients. At 2-year follow-up, group H exhibited better outcomes for all functional scores versus group R, respectively ( P < .001): VAS pain score (1.0 vs 2.1), SSV (90.2 vs 77.4), ASES score (90.8 vs 76.6), and UCLA shoulder score (31.0 vs 24.9). Within both groups, all scores improved significantly compared with preoperative values ( P < .001). At follow-up, group H had significantly better forward flexion ( P = .018) and internal rotation ( P = .002) than group R; within both groups, active range of motion improved in all planes compared with the preoperative condition ( P < .001). Subgroup R1 exhibited inferior outcomes versus subgroup R2, respectively: VAS pain score (2.6 vs 1.5; P = .012), ASES score (70.9 vs 83.6; P = .013), SSV (70.9 vs 85.4; P = .005), and UCLA shoulder score (22.0 vs 28.5; P = .001).

CONCLUSION

After arthroscopic repair of anterosuperior massive RCTs, 53% of patients exhibited retearing. The healed group had better functional outcomes than the retear group. The subscapularis retear subgroup exhibited significantly inferior outcomes compared with the intact subscapularis repair subgroup.

Authors+Show Affiliations

Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.Department of Orthopaedic Surgery, Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28298061

Citation

Kim, Sung-Jae, et al. "Arthroscopic Repair of Anterosuperior Massive Rotator Cuff Tears: Does Repair Integrity Affect Outcomes?" The American Journal of Sports Medicine, vol. 45, no. 8, 2017, pp. 1762-1768.
Kim SJ, Choi YR, Jung M, et al. Arthroscopic Repair of Anterosuperior Massive Rotator Cuff Tears: Does Repair Integrity Affect Outcomes? Am J Sports Med. 2017;45(8):1762-1768.
Kim, S. J., Choi, Y. R., Jung, M., Lee, W., & Chun, Y. M. (2017). Arthroscopic Repair of Anterosuperior Massive Rotator Cuff Tears: Does Repair Integrity Affect Outcomes? The American Journal of Sports Medicine, 45(8), 1762-1768. https://doi.org/10.1177/0363546517694028
Kim SJ, et al. Arthroscopic Repair of Anterosuperior Massive Rotator Cuff Tears: Does Repair Integrity Affect Outcomes. Am J Sports Med. 2017;45(8):1762-1768. PubMed PMID: 28298061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic Repair of Anterosuperior Massive Rotator Cuff Tears: Does Repair Integrity Affect Outcomes? AU - Kim,Sung-Jae, AU - Choi,Yun-Rak, AU - Jung,Min, AU - Lee,Wonyong, AU - Chun,Yong-Min, Y1 - 2017/02/01/ PY - 2017/3/17/pubmed PY - 2017/12/9/medline PY - 2017/3/17/entrez KW - anterosuperior massive rotator cuff tear KW - arthroscopic repair KW - retear KW - shoulder SP - 1762 EP - 1768 JF - The American journal of sports medicine JO - Am J Sports Med VL - 45 IS - 8 N2 - BACKGROUND: The purpose of this study was to investigate clinical outcomes and structural integrity after arthroscopic repair of anterosuperior massive rotator cuff tears (RCTs) and to compare clinical outcomes between healed and retear groups. HYPOTHESIS: The authors hypothesized that although both groups would exhibit improved clinical outcomes compared with their preoperative status, the healed group would have better clinical outcomes than the retear group, and in the retear group, the subscapularis retear subgroup would have inferior outcomes compared with the intact subscapularis repair subgroup. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: This study included 73 of 90 eligible patients who underwent arthroscopic repair of an anterosuperior massive RCT. Functional outcomes after 2-year follow-up were assessed using the visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) shoulder score, and active range of motion. Patients were assigned to the healed group (group H, n = 34) or retear group (group R, n = 39) based on magnetic resonance arthrography results at 6 months postoperatively. Group R was composed of subgroup R1 (subscapularis retear) and subgroup R2 (intact subscapularis repair). RESULTS: Retearing occurred in 53% of patients. At 2-year follow-up, group H exhibited better outcomes for all functional scores versus group R, respectively ( P < .001): VAS pain score (1.0 vs 2.1), SSV (90.2 vs 77.4), ASES score (90.8 vs 76.6), and UCLA shoulder score (31.0 vs 24.9). Within both groups, all scores improved significantly compared with preoperative values ( P < .001). At follow-up, group H had significantly better forward flexion ( P = .018) and internal rotation ( P = .002) than group R; within both groups, active range of motion improved in all planes compared with the preoperative condition ( P < .001). Subgroup R1 exhibited inferior outcomes versus subgroup R2, respectively: VAS pain score (2.6 vs 1.5; P = .012), ASES score (70.9 vs 83.6; P = .013), SSV (70.9 vs 85.4; P = .005), and UCLA shoulder score (22.0 vs 28.5; P = .001). CONCLUSION: After arthroscopic repair of anterosuperior massive RCTs, 53% of patients exhibited retearing. The healed group had better functional outcomes than the retear group. The subscapularis retear subgroup exhibited significantly inferior outcomes compared with the intact subscapularis repair subgroup. SN - 1552-3365 UR - https://www.unboundmedicine.com/medline/citation/28298061/Arthroscopic_Repair_of_Anterosuperior_Massive_Rotator_Cuff_Tears:_Does_Repair_Integrity_Affect_Outcomes L2 - https://journals.sagepub.com/doi/10.1177/0363546517694028?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -