Comparaison entre une réparation partielle et une réparation complète des ruptures massives de la coiffe des rotateurs. Un suivi de cinq ans minimum - 21/05/21
Comparison between partial and full coverage repair in massive rotator cuff tears. A minimum five year follow-up
Abstract |
Background |
Massive rotator cuff surgical management can be challenging. Controversy exists in the literature regarding the potential benefit of full head coverage for arthroscopic rotator cuff repair. The purpose of this study was to compare re-tear rate and clinical outcome of arthroscopic repair of massive rotator cuff tears in relation to the achievement of full humeral head footprint coverage or not.
Hypothesis |
We hypothesized that there will be no difference in re-tear rate and clinical outcomes between full and partial coverage rotator cuff repairs.
Patients and Methods |
A retrospective analysis of all adult patients with a massive rotator cuff tear who underwent arthroscopic repair with a minimum five years follow-up was performed. Outcomes analyzed included re-tear rate, the American Shoulder and Elbow Surgeons (ASES) Shoulder Score, and the Penn Shoulder Score. Correlation and subgroup analyses were performed in order to evaluate whether age, symptom duration, tear size, coverage percentage, and fatty infiltration had any effect in outcome.
Results |
The average ASES score was 76.3±25.2, and average Penn Shoulder Score was 75.8±23.1 at 7.9 years mean follow-up in 27 patients analyzed. Re-tear rate was similar between full and partial footprint coverage repair with 2 versus 4 failures, respectively (p=0.64). ASES and Penn Shoulder scores were 84.2 and 83.7 for full rotator cuff repair versus 70.6 and 71.1, for partial coverage repair (p=0.20 and p=0.22, respectively). The percentage of head coverage and the tear size were both found to be significantly correlated with outcome, with coefficient of determination R2 of 0.40 and 0.217, respectively, while a global fatty degeneration index GFDI <1.5 was associated with improved functional outcome.
Discussion |
No difference in failure rate and functional outcome was detected between full and partial coverage rotator cuff repair. The size of the tear and fatty infiltration were inversely correlated with functional score while the percentage of coverage achieved was positively correlated with favorable outcome.
Level of evidence |
III; retrospective comparative study.
Il testo completo di questo articolo è disponibile in PDF.Keywords : Rotator Cuff, Massive, Repair, Outcome, Coverage
| ☆ | Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus. |
Vol 107 - N° 4
P. 500 - Giugno 2021 Ritorno al numero
Articolo precedente
- Libération arthroscopique combinée à une fixation en simple rang ou double rang d’une rupture traumatique du supra-épineux associée à capsulite rétractile réfractaire au traitement conservateur - étude prospective randomisée
- Cheng Li, Heng Zhang, Xiaobo Bo, Guochun Zha, Yong Pang, Xin Zheng, Xiangyang Chen, Kaijin Guo
- L’exploration gléno-humérale systématique : facteur de risque de capsulite rétractile post exérèse arthroscopique de calcifications de la coiffe des rotateurs ? – étude rétrospective comparative sur 340 cas
- Alexandre Ecalle, Clément Julien, Samir Chaouche, Pierre-Julien Cungi, Florent Anger, Alexandre Galland, Renaud Gravier, Stéphane Airaudi
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