Rotator cuff integrity is correlated to superior functional results and slower osteoarthritis progression ten years after arthroscopic repair - 14/11/18
Relation entre intégrité structurelle d’une réparation de coiffe et résultats cliniques et radiologiques après 10 ans postopératoires
, Alessandra Menon 2, Francesca Maria Feroldi 2, Manuel Mazzoleni 2, Gianvito Santarsiero 2, Elisabetta Nocerino 3, Alberto Aliprandi 4, Max Friedrich 1, Dieter Wirtz 1, Pietro Randelli 2Riassunto |
Aim |
The aim of this study was to evaluate survivorship and functional results of arthroscopic rotator cuff (RC) repairs at a minimum follow-up of ten years. Secondary goals were to compare outcomes in patients with and without re-tears and to relate lesions’ characteristics with clinical, functional and radiological results.
Background |
Arthroscopic repair is considered the gold standard treatment for RC tears, but studies describing long-term results after arthroscopic RC repair are still scarce.
Methods |
Patients were prospectively re-evaluated at least ten years after arthroscopic RC repair. American Shoulder and Elbow Surgeons Shoulder Score (ASES), range of motion (ROM), Constant Murley Score (CMS), isometric strength in forward flexion (fl) and abduction (ab) were measured. Shoulder radiographs were used to measure the acromion-humeral distance (AHD) and classify shoulder osteoarthritis (OA) according to Samilson-Prieto. Ultrasound examination was performed to assess supraspinatus (SSp) re-rupture as a dichotomous variable.
Results |
One hundred and two patients were available for functional and radiological evaluation. In 47 of them (46.5%), a discontinuity of the SSp was diagnosed echographically. Two groups of patients were created and compared depending on echographic tendon integrity: significant differences in favour of patients with intact SSp were detected in ASES (P=0.0086), ROM (ab: P=0.0143, fl : P=0.0069), CMS (P>0.0001), strength (ab and fl: P>0.0001), and AHD (P>0.0001). Patients with smaller (C1-C2) lesions (62.4%) developed significantly greater ROM (ab : P=0.0174, fl: P=0.0164), CMS (P=0.0007), strength in ab (P>0.0006), strength in fl (P>0.0001), and showed higher AHD (P>0.0001). Larger (C3-C4) lesions (37.6 %) were significantly more prone to re-tear (P=0.0002) and progression of OA (P=0.0003) than smaller ones.
Conclusions |
These long-term results of arthroscopic RC repair indicate that RC integrity is important to maintain functional results and prevent OA progression. Independently from RC integrity, patients with smaller lesions maintain a superior functional level and a slower rate of OA progression.
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Vol 104 - N° 8S
P. S77 - dicembre 2018 Ritorno al numero
Articolo precedente
- Postoperative mobilization after Rotator Cuff Repair: Sling versus nothing. A randomized prospective study
- Jérome Tirefort, Philippe Collin, Adrien Schwitzguébel, Alexandre Lädermann
- Ossifications hétérotopiques après réparation de la coiffe des rotateurs
- Philippe Teissier, Jacques Teissier, Haroun Bouhali, Samih Kacem
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