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Results of the repair of acute rotator cuff tears is not influenced by tear retraction


1 Department of Orthopedics, Shoulder and Elbow Service, Ohio State University, Columbus, OH, USA
2 The Harvard Shoulder Service, Brigham and Women's Hospital, Boston, MA 02155, USA
3 Atlanta Sports Medicine and Orthopedic Center, Suite 500, Atlanta, GA, USA

Correspondence Address:
Laurence D Higgins
The Harvard Shoulder Service, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02155
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.118906

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Year : 2013  |  Volume : 7  |  Issue : 3  |  Page : 91-99

 

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Purpose : This study evaluated retraction in the setting of acute rotator cuff tears and determined its effects on patient outcomes and tendon repair integrity. Materials and Methods : A total of 22 patients had surgery within 6 weeks or less from the time of injury. Fifteen of these patients were prospectively followed at a minimum of 2 years; average 40.5 months (range 24-69). Pre-operative objective and subjective outcomes were compared. Tendon repair integrity was assessed with ultrasound at a minimum of 1 year from surgery. The population was stratified into Group 1 (8 patients) with minimal intra-operative medial tendon retraction to the mid-line level of the humeral head and Group 2 (7 patients) with a large medial tendon retraction to the glenohumeral joint or greater. Results : The average time to surgery from the onset of symptoms was 27 days (range, 6-42). Post-operative motion increased significantly for external rotation and forward elevation, 77% of patients were pain free, 80% were completely satisfied, and 100% would have the surgery again. Group 1 (small retraction) versus Group 2 (large retraction) showed that post-operative pain levels, satisfaction, range of motion, strength, subjective shoulder value (95.4% vs. 92.3%), Constant Score (80.8 vs. 78.1), and American Society of Shoulder and Elbow Surgeons (96.2 vs. 93.5) scores were not statistically different. Ultrasound showed a tendon repair integrity rate of 87%. 2 patients who did have a re-tear were in Group 2, yet had comparative outcomes. Conclusion: In acute rotator cuff tears, equal patient satisfaction, pain scores, range of motion, strength, and outcome measures should be expected with surgical repair despite the level of retraction. Level of Evidence : Therapeutic level IV






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1 Department of Orthopedics, Shoulder and Elbow Service, Ohio State University, Columbus, OH, USA
2 The Harvard Shoulder Service, Brigham and Women's Hospital, Boston, MA 02155, USA
3 Atlanta Sports Medicine and Orthopedic Center, Suite 500, Atlanta, GA, USA

Correspondence Address:
Laurence D Higgins
The Harvard Shoulder Service, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02155
USA
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-6042.118906

Get Permissions

Purpose : This study evaluated retraction in the setting of acute rotator cuff tears and determined its effects on patient outcomes and tendon repair integrity. Materials and Methods : A total of 22 patients had surgery within 6 weeks or less from the time of injury. Fifteen of these patients were prospectively followed at a minimum of 2 years; average 40.5 months (range 24-69). Pre-operative objective and subjective outcomes were compared. Tendon repair integrity was assessed with ultrasound at a minimum of 1 year from surgery. The population was stratified into Group 1 (8 patients) with minimal intra-operative medial tendon retraction to the mid-line level of the humeral head and Group 2 (7 patients) with a large medial tendon retraction to the glenohumeral joint or greater. Results : The average time to surgery from the onset of symptoms was 27 days (range, 6-42). Post-operative motion increased significantly for external rotation and forward elevation, 77% of patients were pain free, 80% were completely satisfied, and 100% would have the surgery again. Group 1 (small retraction) versus Group 2 (large retraction) showed that post-operative pain levels, satisfaction, range of motion, strength, subjective shoulder value (95.4% vs. 92.3%), Constant Score (80.8 vs. 78.1), and American Society of Shoulder and Elbow Surgeons (96.2 vs. 93.5) scores were not statistically different. Ultrasound showed a tendon repair integrity rate of 87%. 2 patients who did have a re-tear were in Group 2, yet had comparative outcomes. Conclusion: In acute rotator cuff tears, equal patient satisfaction, pain scores, range of motion, strength, and outcome measures should be expected with surgical repair despite the level of retraction. Level of Evidence : Therapeutic level IV






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