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Archives of Orthopaedic and Trauma Surgery
Published in: Archives of Orthopaedic and Trauma Surgery 3/2019

01-03-2019 | Arthroscopy and Sports Medicine

Functional outcomes and repair integrity after arthroscopic repair of partial articular supraspinatus tendon avulsion

Authors: Roberto Castricini, Francesco La Camera, Marco De Gori, Nicola Orlando, Massimo De Benedetto, Olimpio Galasso, Giorgio Gasparini

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 3/2019

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Abstract

Introduction

Partial-thickness rotator cuff tears are a common cause of shoulder pain and disability. Arthroscopic repair is an effective treatment for partial articular supraspinatus tendon avulsion (PASTA) lesions, and transtendon repair and completion of the tear and repair are the surgical techniques commonly used to treat such lesions. Our aim was to retrospectively evaluate the minimum 24-month clinical and radiological results of PASTA.

Materials and methods

Patients suffering from PASTA lesion who underwent arthroscopic repair with a minimum 24-month follow-up were included in this study. The Constant and Murley score (CMS) was used to assess the patients’ functionality pre- and postoperatively. The postoperative patient assessment included the simple shoulder test (SST). Postoperative tendon integrity was evaluated by ultrasound examination.

Results

151 patients (153 shoulders) were retrospectively evaluated 73.9 (24–142) months after a completion–repair (94 cases) or transtendon repair (59 cases) of a PASTA lesion. The CMS significantly improved from 47.7 (22–63) preoperatively to 84.2 (62–100) postoperatively (p < 0.001). The mean postoperative SST score was 10.1 (5–12), and 95% of patients were satisfied with the surgery. No significant differences were noted between the two techniques in terms of postoperative CMS, SST score and satisfaction. Seventy-four and 43 cases treated with completion and repair and transtendon repair, respectively, performed ultrasound examination 66.1 (24–142) months after surgery. The overall retear rate was 13.7%, supraspinatus retears were observed in ten shoulder subjected to completion and repair (13.5%) and six shoulders subjected to transtendon repair (13.9%), and no significant differences were noted between the two techniques as for CMS (p = 0.896), SST (p = 0.973), satisfaction (p = 0.621) and retear (p = 0.999). Males and younger patients had a higher postoperative CMS (p values < 0.001), and SST score (p < 0.001 and p = 0.038, respectively).

Conclusions

Arthroscopic repair of PASTA lesion achieves high rates of repair integrity regardless of repair type and high levels of functional recovery and patient satisfaction 6 years after surgery.
Literature
1.
Codman E (1934) The shoulder: rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. RE Kreiger, Malabar
2.
Ellman H (1990) Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res 254:64–74
3.
Matava MJ, Purcell DB, Rudzki JR (2005) Partial-thickness rotator cuff tears. Am J Sports Med 33(9):1405–1417CrossRefPubMed
4.
Snyder SJ, Pachelli AF, Del Pizzo W, Friedman MJ, Ferkel RD, Pattee G (1991) Partial thickness rotator cuff tears: results of arthroscopic treatment. Arthroscopy 7:1CrossRefPubMed
5.
Finnan RP, Crosby LA (2010) Partial-thickness rotator cuff tears. J Shoulder Elbow Surg 19(4):609–616CrossRefPubMed
6.
Keener JD, Galatz LM, Teefey SA et al (2015) A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears. J Bone Jt Surg Am 97(2):89–98CrossRef
7.
Kartus J, Kartus C, Rostgård-Christensen L, Sernert N, Read J, Perko M (2006) Long-term clinical and ultrasound evaluation after arthroscopic acromioplasty in patients with partial rotator cuff tears. Arthroscopy 22(1):44–49CrossRefPubMed
8.
Ranalletta M, Rossi LA, Bertona AB et al (2016) Arthroscopic transtendon repair of partial-thickness articular-side rotator cuff tears. Arthroscopy 32(8):1523–1528CrossRefPubMed
9.
Deutsch A (2007) Arthroscopic repair of partial-thickness tears of the rotator cuff. J Shoulder Elbow Surg 16(2):193–201CrossRefPubMed
10.
11.
Stuart KD, Karzel RP, Ganjianpour M, Snyder SJ (2013) Long-term outcome for arthroscopic repair of partial articular-sided supraspinatus tendon avulsion. Arthroscopy 29(5):818–823CrossRefPubMed
12.
Vap AR, Mannava S, Katthagen JC et al (2018) Five-year outcomes after arthroscopic repair of partial-thickness supraspinatus tears. Arthroscopy 34(1):75–81CrossRefPubMed
13.
Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164
14.
Gallelli L, Galasso O, Urzino A et al (2012) Characteristics and clinical implications of the pharmacokinetic profile of ibuprofen in patients with knee osteoarthritis. Clin Drug Investig 32(12):827–833CrossRefPubMed
15.
Marchese C, Cristalli G, Pichi B et al (2012) Italian cross-cultural adaptation and validation of three different scales for the evaluation of shoulder pain and dysfunction after neck dissection: University of California, Los Angeles (UCLA) Shoulder Scale, Shoulder Pain and Disability Index (SPADI) and Simple Shoulder Test (SST). Acta Otorhinolaryngol Ital 32(1):12–17PubMedPubMedCentral
16.
Gasparini G, De Benedetto M, Cundari A et al (2016) Predictors of functional outcomes and recurrent shoulder instability after arthroscopic anterior stabilization. Knee Surg Sports Traumatol Arthrosc 24(2):406–413CrossRefPubMed
17.
Kamath G, Galatz LM, Keener JD, Teefey S, Middleton W, Yamaguchi K (2009) Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears. J Bone Jt Surg Am 91(5):1055–1062CrossRef
18.
Kukkonen J, Kauko T, Vahlberg T, Joukainen A, Aärimaa V (2013) Investigating minimal clinically important difference for constant score in patients undergoing rotator cuff surgery. J Shoulder Elbow Surg 22(12):1650–1655CrossRefPubMed
19.
Castagna A, Delle Rose G, Conti M et al (2009) Predictive factors of subtle residual shoulder symptoms after transtendinous arthroscopic cuff repair: a clinical study. Am J Sports Med 37:103–108CrossRefPubMed
20.
Castricini R, Panfoli N, Nittoli R, Spurio S, Pirani O (2009) Transtendon arthroscopic repair of partial-thickness, articular surface tears of the supraspinatus: results at 2 years. Chir Organi Mov 93(Suppl 1):S49–S54PubMed
21.
Desportes E, Lefere M, Flurin PH, Abadie P, Pesquer L, Dallaudiere B (2015) Is systematic long-term sonographic follow-up after arthroscopic rotator cuff repair useful in asymptomatic patients? Acta Orthop Belg 81(3):478–484PubMed
22.
Prickett WD, Teefey SA, Galatz LM, Calfee RP, Middleton WD, Yamaguchi K (2003) Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively. J Bone Jt Surg Am 85:1084–1089CrossRef
23.
Franceschi F, Papalia R, Del Buono A et al (2013) Articular sided rotator cuff tears: which is the best repair? A three year prospective randomised controlled trial. Int Orthop 37(8):1487–1493CrossRefPubMedPubMedCentral
24.
Kim KC, Shin HD, Cha SM, Park JY (2013) Clinical outcomes after arthroscopic trans-tendon suture-bridge technique in partial-thickness articular-side rotator cuff tear. Knee Surg Sports Traumatol Arthrosc 21(5):1183–1188CrossRefPubMed
25.
Shin SJ (2012) A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy 28(1):25–33CrossRefPubMed
26.
27.
Chung SW, Kim JY, Yoon JP, Lyu SH, Rhee SM, Oh S (2015) Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med 43(3):588–596CrossRefPubMed
28.
Gonzalez-Lomas G, Kippe MA, Brown GD et al (2008) In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg 17(5):722–728CrossRefPubMed
29.
Huberty DP, Schoolfield JD, Brady PC, Vadala AP, Arrigoni P, Burkhart SS (2009) Incidence and treatment of postoperative stiffness following arthroscopic rotator cuff repair. Arthroscopy 25(8):880–890CrossRefPubMed
30.
Vinanti GB, Rossato A, Scrimieri D, Petrera M (2017) Arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion. Knee Surg Sports Traumatol Arthrosc 25(7):2151–2156CrossRefPubMed
31.
Castagna A, Borroni M, Garofalo R et al (2015) Deep partial rotator cuff tear: transtendon repair or tear completion and repair? A randomized clinical trial. Knee Surg Sports Traumatol Arthrosc 23(2):460–463CrossRefPubMed
32.
Sun L, Zhang Q, Ge H, Sun Y, Cheng B (2015) Which is the best repair of articular-sided rotator cuff tears: a meta-analysis. J Orthop Surg Res 28 10:84CrossRefPubMedPubMedCentral
33.
Lam F, Mok D (2004) Open repair of massive rotator cuff tears in patients aged sixty-five years or over: is it worthwhile? J Shoulder Elbow Surg 13(5):517–521CrossRefPubMed
34.
Robinson PM, Wilson J, Dalal S, Parker RA, Norburn P, Roy BR (2013) Rotator cuff repair in patients over 70 years of age: early outcomes and risk factors associated with re-tear. Bone Jt J 95-B(2):199–205CrossRef
35.
Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL (2009) Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain 10(5):447–485CrossRefPubMedPubMedCentral
36.
Mariconda M, Galasso O, Secondulfo V, Cozzolino A, Milano C (2008) The functional relevance of neurological recovery after lumbar discectomy: a follow-up of more than 20 years. J Bone Jt Surg Br 90(5):622–628CrossRef
37.
Millett PJ, Espinoza C, Horan MP et al (2017) Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years. Arch Orthop Trauma Surg 137(10):1399–1408CrossRefPubMed
38.
Brockmeyer M, Schmitt C, Haupert A, Kohn D, Lorbach O (2017) Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff. Arch Orthop Trauma Surg 137(12):1719–1724CrossRefPubMed
39.
Bayle X, Pham TT, Faruch M, Gobet A, Mansat P, Bonnevialle N (2017) No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial. Arch Orthop Trauma Surg 137(12):1707–1712CrossRefPubMed
40.
Codsi MJ, Rodeo SA, Scalise JJ, Moorehead TM, Ma CB (2014) Assessment of rotator cuff repair integrity using ultrasound and magnetic resonance imaging in a multicenter study. J Shoulder Elbow Surg 23(10):1468–1472CrossRefPubMed
Metadata
Title
Functional outcomes and repair integrity after arthroscopic repair of partial articular supraspinatus tendon avulsion
Authors
Roberto Castricini
Francesco La Camera
Marco De Gori
Nicola Orlando
Massimo De Benedetto
Olimpio Galasso
Giorgio Gasparini
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
Archives of Orthopaedic and Trauma Surgery / Issue 3/2019
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-018-3044-4

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