Skip to main content
Top
Published in: MUSCULOSKELETAL SURGERY 1/2013

01-06-2013 | Original Article

Functional repair in massive immobile rotator cuff tears leads to satisfactory quality of living: results at 3-year follow-up

Authors: P. Arrigoni, C. Fossati, L. Zottarelli, V. Ragone, P. Randelli

Published in: MUSCULOSKELETAL SURGERY | Special Issue 1/2013

Login to get access

Abstract

Purpose

The aim of this retrospective study was to report clinical results of a selective population undergone to arthroscopic functional repair of massive, contracted, immobile rotator cuff tears.

Methods

From 2005 to 2009, 311 patients with rotator cuff tears were treated at our institution. Of them, 26 shoulders in 25 patients with a mean age of 64 years that presented a massive, contracted immobile tear repaired using an interval slide technique, were included in this study.

Results

The mean postoperative follow-up period was 39 months (range 19–70 months). The mean postoperative disabilities of the arm, shoulder and hand (DASH) score and simple shoulder test (SST) score were, respectively, 20.91 and 8.8 (range DASH: 0.83–59.1; range SST: 2–12). Based on single assessment numeric evaluation score, the outcome of surgery was satisfactory with a mean of 76 % (range 0–100 %). The residual level of pain was low, as reported by a final mean visual analog scale score of 1.8 (range 0–8). The mean postoperative range of motion was 157.5° in forward elevation (range 90°–180°) and 55.3° in extra rotation (range 0°–90°). Eleven patients reached mid-back, in 7, the lower back and in 8 cases, upper back.

Conclusion

Arthroscopic functional repair could be considered an appropriate treatment option in case of massive, contracted and immobile cuff tears. This treatment can provide improvement in pain and function that positively affects patients’ quality of life without precluding other, more invasive, eventually consequent solutions.
Literature
1.
go back to reference Burkhart SS (1997) Partial repair of massive rotator cuff tears: the evolution of a concept. Orthop Clin North Am 28(1):125–132PubMedCrossRef Burkhart SS (1997) Partial repair of massive rotator cuff tears: the evolution of a concept. Orthop Clin North Am 28(1):125–132PubMedCrossRef
2.
go back to reference Patte D (1990) Classification of rotator cuff lesions. Clin Orthop Relat Res 254:81–86PubMed Patte D (1990) Classification of rotator cuff lesions. Clin Orthop Relat Res 254:81–86PubMed
3.
go back to reference Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 8:599–605PubMedCrossRef Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 8:599–605PubMedCrossRef
4.
go back to reference Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuffruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop 304:78–83PubMed Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuffruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop 304:78–83PubMed
5.
go back to reference Tauro JC (2004) Arthroscopic repair of large rotator cuff tears using the interval slide technique. Arthroscopy 20(1):13–21PubMedCrossRef Tauro JC (2004) Arthroscopic repair of large rotator cuff tears using the interval slide technique. Arthroscopy 20(1):13–21PubMedCrossRef
6.
go back to reference Carter CW, Levine WN, Kleweno CP, Bigliani LU, Ahmad CS (2008) Assessment of shoulder range of motion: introduction of a novel patient self-assessment tool. Arthroscopy 24(6):712–717 PubMedCrossRef Carter CW, Levine WN, Kleweno CP, Bigliani LU, Ahmad CS (2008) Assessment of shoulder range of motion: introduction of a novel patient self-assessment tool. Arthroscopy 24(6):712–717 PubMedCrossRef
7.
go back to reference Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The upper extremity collaborative group (UECG). Am J Ind Med 29(6):602–608PubMedCrossRef Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The upper extremity collaborative group (UECG). Am J Ind Med 29(6):602–608PubMedCrossRef
8.
go back to reference Lippit SB, Harryman DT, Matsen FA (1993) A practical tool for evaluating function: the simple shoulder test. In: Matsen FA, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. American Academy of Orthopaedic Surgeons, Rosemont, pp 501–518 Lippit SB, Harryman DT, Matsen FA (1993) A practical tool for evaluating function: the simple shoulder test. In: Matsen FA, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. American Academy of Orthopaedic Surgeons, Rosemont, pp 501–518
9.
go back to reference Langley GB, Sheppeard H (1985) The visual analogue scale: its use in pain measurement. Rheumatol Int 5(4):145–148PubMedCrossRef Langley GB, Sheppeard H (1985) The visual analogue scale: its use in pain measurement. Rheumatol Int 5(4):145–148PubMedCrossRef
10.
go back to reference Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC (1999) Comparison of the single assessment numeric evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 27(2):214–221PubMed Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC (1999) Comparison of the single assessment numeric evaluation method and two shoulder rating scales. Outcomes measures after shoulder surgery. Am J Sports Med 27(2):214–221PubMed
11.
go back to reference Deering SJ, Mair SD, Lattermann C (2012) Treatment options for chronic retracted degenerative rotator cuff tears. Med Sport Sci. 57:153–167PubMedCrossRef Deering SJ, Mair SD, Lattermann C (2012) Treatment options for chronic retracted degenerative rotator cuff tears. Med Sport Sci. 57:153–167PubMedCrossRef
12.
go back to reference Porcellini G, Castagna A, Cesari E, Merolla G, Pellegrini A, Paladini P (2011) Partial repair of irreparable supraspinatus tendon tears: clinical and radiographic evaluations at long-term follow-up. J Shoulder Elbow Surg 20(7):1170–1177PubMedCrossRef Porcellini G, Castagna A, Cesari E, Merolla G, Pellegrini A, Paladini P (2011) Partial repair of irreparable supraspinatus tendon tears: clinical and radiographic evaluations at long-term follow-up. J Shoulder Elbow Surg 20(7):1170–1177PubMedCrossRef
13.
go back to reference Burkhart SS, Nottage WM, Ogilvie-Harris DJ et al (1994) Partial repair of irreparable rotator cuff tears. Arthroscopy 10:363–370PubMedCrossRef Burkhart SS, Nottage WM, Ogilvie-Harris DJ et al (1994) Partial repair of irreparable rotator cuff tears. Arthroscopy 10:363–370PubMedCrossRef
14.
go back to reference Burkhart SS (2001) Arthroscopic treatment of massive rotator cuff tears. Clin Orthop Relat Res 390:107–118PubMedCrossRef Burkhart SS (2001) Arthroscopic treatment of massive rotator cuff tears. Clin Orthop Relat Res 390:107–118PubMedCrossRef
15.
go back to reference Berth A, Neumann W, Awiszus F, Pap G (2010) Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. J Orthop Traumatol 11(1):13–20PubMedCrossRef Berth A, Neumann W, Awiszus F, Pap G (2010) Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. J Orthop Traumatol 11(1):13–20PubMedCrossRef
16.
go back to reference Duralde XA, Bair B (2005) Massive rotator cuff tears: the result of partial rotator cuff repair. J Shoulder Elbow Surg 14(2):121–127PubMedCrossRef Duralde XA, Bair B (2005) Massive rotator cuff tears: the result of partial rotator cuff repair. J Shoulder Elbow Surg 14(2):121–127PubMedCrossRef
17.
go back to reference Lo IK, Burkhart SS (2004) Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: technique and preliminary results. Arthroscopy 20(1):22–33PubMedCrossRef Lo IK, Burkhart SS (2004) Arthroscopic repair of massive, contracted, immobile rotator cuff tears using single and double interval slides: technique and preliminary results. Arthroscopy 20(1):22–33PubMedCrossRef
18.
go back to reference Burkhart SS (1994) Reconciling the paradox of rotator cuff repair versus debridement: a unified biomechanical rationale for the treatment of rotator cuff tears. Arthroscopy 10:4–19PubMedCrossRef Burkhart SS (1994) Reconciling the paradox of rotator cuff repair versus debridement: a unified biomechanical rationale for the treatment of rotator cuff tears. Arthroscopy 10:4–19PubMedCrossRef
19.
go back to reference Ellman H, Kay SP, Wirth M (1993) Arthroscopic treatment of full thickness rotator cuff tears: 2- to 7-year follow-up study. Arthroscopy 9:195–200PubMedCrossRef Ellman H, Kay SP, Wirth M (1993) Arthroscopic treatment of full thickness rotator cuff tears: 2- to 7-year follow-up study. Arthroscopy 9:195–200PubMedCrossRef
Metadata
Title
Functional repair in massive immobile rotator cuff tears leads to satisfactory quality of living: results at 3-year follow-up
Authors
P. Arrigoni
C. Fossati
L. Zottarelli
V. Ragone
P. Randelli
Publication date
01-06-2013
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue Special Issue 1/2013
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-013-0252-5

Other articles of this Special Issue 1/2013

MUSCULOSKELETAL SURGERY 1/2013 Go to the issue