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Arthroscopic Incomplete Repair Using a "Hybrid Technique" for Large to Massive Rotator Cuff Tears: Clinical Results and Structural Integrity.
Arthroscopy. 2018 07; 34(7):2063-2073.A

Abstract

PURPOSE

The first aim of this study was to introduce the concept of hybrid repair (incomplete repair) for large to massive rotator cuff tears and to report clinical results and structural integrity of patients with a minimum 2-year follow-up. The second aim was to compare arthroscopic hybrid repair with partial repair for large to massive rotator cuff tears.

METHODS

We retrospectively evaluated 65 patients who underwent arthroscopic incomplete (hybrid) repair (45 patients) or partial repair (20 patients) for large to massive cuff tears from March 2011 to January 2015. The pain visual analog scale, function visual analog scale, American Shoulder and Elbow Surgeons, and Constant scores and range of motion (ROM) (active flexion, elevation, abduction, external rotation, and internal rotation) were assessed preoperatively, at first follow-up (approximately 6 months postoperatively), at second follow-up (1 year postoperatively), and at final follow-up (2 years postoperatively). The healing status of the repaired tendon was evaluated with postoperative magnetic resonance imaging, with a focus on tendon integrity.

RESULTS

Comparisons of the preoperative values and final follow-up results of hybrid repair showed significant improvement in the mean pain visual analog scale score (5.56 and 0.93, respectively), mean function visual analog scale score (4.77 and 8.59, respectively), and questionnaire results (American Shoulder and Elbow Surgeons score, 44.89 and 84.67, respectively; Constant score, 44.27 and 73.46, respectively) (all P ≤ .001). Most shoulder ROM measures showed some improvement compared with presurgical ROM at last follow-up (≥2 years). However, there was no statistical significance. Retears occurred in 9 patients (20%) in the hybrid-repair group. Most of the postoperative clinical outcomes showed excellent results with hybrid repair compared with partial repair.

CONCLUSIONS

Arthroscopic incomplete repair (hybrid technique) showed more satisfactory clinical trial outcomes than partial repair of large to massive rotator cuff tears. Therefore, we propose the use of incomplete repair, which provides improvements in both pain and functional outcomes, as another repair option for large to massive rotator cuff tears.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

Authors+Show Affiliations

Department of Radiology, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea.Division of Sports Medicine, Department of Physical Medicine and Rehabilitation, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea.Department of Orthopedic Surgery, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea.Department of Orthopedic Surgery, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea. Electronic address: shoulderyoo@gmail.com.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

29730212

Citation

Jeong, Jeung Yeol, et al. "Arthroscopic Incomplete Repair Using a "Hybrid Technique" for Large to Massive Rotator Cuff Tears: Clinical Results and Structural Integrity." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 34, no. 7, 2018, pp. 2063-2073.
Jeong JY, Yoon YC, Lee SM, et al. Arthroscopic Incomplete Repair Using a "Hybrid Technique" for Large to Massive Rotator Cuff Tears: Clinical Results and Structural Integrity. Arthroscopy. 2018;34(7):2063-2073.
Jeong, J. Y., Yoon, Y. C., Lee, S. M., & Yoo, J. C. (2018). Arthroscopic Incomplete Repair Using a "Hybrid Technique" for Large to Massive Rotator Cuff Tears: Clinical Results and Structural Integrity. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 34(7), 2063-2073. https://doi.org/10.1016/j.arthro.2018.02.013
Jeong JY, et al. Arthroscopic Incomplete Repair Using a "Hybrid Technique" for Large to Massive Rotator Cuff Tears: Clinical Results and Structural Integrity. Arthroscopy. 2018;34(7):2063-2073. PubMed PMID: 29730212.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Arthroscopic Incomplete Repair Using a "Hybrid Technique" for Large to Massive Rotator Cuff Tears: Clinical Results and Structural Integrity. AU - Jeong,Jeung Yeol, AU - Yoon,Young Cheol, AU - Lee,Sang Min, AU - Yoo,Jae Chul, Y1 - 2018/05/02/ PY - 2017/08/03/received PY - 2018/02/03/revised PY - 2018/02/04/accepted PY - 2018/5/8/pubmed PY - 2019/9/26/medline PY - 2018/5/7/entrez SP - 2063 EP - 2073 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 34 IS - 7 N2 - PURPOSE: The first aim of this study was to introduce the concept of hybrid repair (incomplete repair) for large to massive rotator cuff tears and to report clinical results and structural integrity of patients with a minimum 2-year follow-up. The second aim was to compare arthroscopic hybrid repair with partial repair for large to massive rotator cuff tears. METHODS: We retrospectively evaluated 65 patients who underwent arthroscopic incomplete (hybrid) repair (45 patients) or partial repair (20 patients) for large to massive cuff tears from March 2011 to January 2015. The pain visual analog scale, function visual analog scale, American Shoulder and Elbow Surgeons, and Constant scores and range of motion (ROM) (active flexion, elevation, abduction, external rotation, and internal rotation) were assessed preoperatively, at first follow-up (approximately 6 months postoperatively), at second follow-up (1 year postoperatively), and at final follow-up (2 years postoperatively). The healing status of the repaired tendon was evaluated with postoperative magnetic resonance imaging, with a focus on tendon integrity. RESULTS: Comparisons of the preoperative values and final follow-up results of hybrid repair showed significant improvement in the mean pain visual analog scale score (5.56 and 0.93, respectively), mean function visual analog scale score (4.77 and 8.59, respectively), and questionnaire results (American Shoulder and Elbow Surgeons score, 44.89 and 84.67, respectively; Constant score, 44.27 and 73.46, respectively) (all P ≤ .001). Most shoulder ROM measures showed some improvement compared with presurgical ROM at last follow-up (≥2 years). However, there was no statistical significance. Retears occurred in 9 patients (20%) in the hybrid-repair group. Most of the postoperative clinical outcomes showed excellent results with hybrid repair compared with partial repair. CONCLUSIONS: Arthroscopic incomplete repair (hybrid technique) showed more satisfactory clinical trial outcomes than partial repair of large to massive rotator cuff tears. Therefore, we propose the use of incomplete repair, which provides improvements in both pain and functional outcomes, as another repair option for large to massive rotator cuff tears. LEVEL OF EVIDENCE: Level III, retrospective comparative study. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/29730212/Arthroscopic_Incomplete_Repair_Using_a_"Hybrid_Technique"_for_Large_to_Massive_Rotator_Cuff_Tears:_Clinical_Results_and_Structural_Integrity_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(18)30139-7 DB - PRIME DP - Unbound Medicine ER -