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Knee Surgery, Sports Traumatology, Arthroscopy

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01-10-2011 | Shoulder

A comparison of early versus delayed repair of traumatic rotator cuff tears

Authors: Michael E. Hantes, Georgios K. Karidakis, Mariana Vlychou, Sokratis Varitimidis, Zoe Dailiana, Konstantinos N. Malizos

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 10/2011

Abstract

Purpose

The purpose of this study was to compare the clinical and magnetic resonance imaging (MRI) results between early and delayed operative treatment in patients with traumatic rotator cuff tears (RCT).

Methods

Thirty-five patients with a traumatic RCT who have been treated surgically during a 4-year period were included in the study. The results of early versus delayed repair of traumatic rotator RCT were assessed using the Constant and UCLA scores. In addition, all patients underwent a postoperative MRI to evaluate repair integrity. Early repair (within 3 weeks) was performed in 15 patients (group I) and delayed repair (after 3 weeks) in the rest 20 patients (group II). The time interval between injury and operation was 12 and 131 days on average for group I and II, respectively.

Results

Follow-up time was 34 and 38 months for group I and II, respectively. Postoperatively, the UCLA score was 31 and 26 (P < 0.05) for group I and II, respectively. The Constant score was 82 and 70 (P < 0.05) for group I and II, respectively. Range of motion was significantly better in group I. According to MRI, 5 patients (33%) in the group I and 7 patients (35%) in the group II had a retear.

Conclusions

Early repair of a traumatic RCT provides better results in terms of shoulder function in comparison with a delayed repair. A delayed diagnosis of a traumatic RCT leads to difficulties in surgery and less good results.

Level of evidence

Level III, therapeutic, retrospective, comparative study.

Amstutz HC, Sew Hoy AL, Clarke IC (1981) UCLA anatomic total shoulder arthroplasty. Clin Orthop Rel Res 155:7–20

Basset RW, Cofield RH (1983) Acute tears of the rotator cuff. The timing of surgical repair. Clin Orthop Rel Res 175:18–24

Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am 87:1229–1240PubMedCrossRef

Braune C, von Eisenhart-Rothe R, Welsch F, Teufel M, Jaeger A (2003) Mid-term results and quantitative comparison of postoperative shoulder function in traumatic and non-traumatic rotator cuff tears. Arch Orthop Trauma Surg 123:419–424PubMedCrossRef

Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Rel Res 214:160–164

Galatz LM, Rothermich SY, Zaeqel M, Silva MJ, Havlioglu N, Thomopoulos S (2005) Delayed repair of tendon to bone injuries leads to decreased biomechanical properties and bone loss. J Orthop Res 23:1441–1447PubMed

Gerber C, Hersche O, Farron A (1996) Isolated rupture of the subscapularis tendon. J Bone Joint Surg Am 78:1015–1023PubMed

Gimbel JA, Van Kleunen JP, Lake SP, Williams GR, Soslowsky LJ (2007) The role of repair tension on tendon to bone healing in an animal model of chronic rotator cuff tears. J Biomech 40:561–568PubMedCrossRef

Green A (2003) Chronic massive rotator cuff tears: evaluation and management. JAAOS 11:321–331

10.

Ide J, Tokiyoshi A, Hirose J, Mizuta H (2007) Arthroscopic repair of traumatic combined rotator cuff tears involving the subscapularis tendon. J Bone Joint Surg Am 89:2378–2388PubMedCrossRef

11.

Klepps S, Bishop J, Lin J (2004) Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med 32:1716–1722PubMedCrossRef

12.

Lafosse L, Brozska R, Toussaint B, Gobezie R (2007) The outcome ans structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg Am 89:1533–1541PubMedCrossRef

13.

Lähteenmäki HE, Virolainen P, Hiltunen A, Heikkilä J, Nelimarkka OI (2006) Results of early operative treatment of rotator cuff tears with acute symptoms. J Should Elb Surg 15:148–153CrossRef

14.

Lichtenberg S, Liem D, Magosch P, Habermeyer P (2006) Influence of tendon healing after arthroscopic rotator cuff repair on clinical outcome using single-row Mason-Allen suture technique: a prospective, MRI controlled study. Knee Surg Sports Traumatol Arthrosc 14:1200–1206PubMedCrossRef

15.

Liem D, Bartl C, Lichtenberg S, Magosch P, Habermeyer P (2007) Clinical outcome and tendon integrity of arthroscopic versus mini-open supraspinatus tenson repair: a magnetic resonance imaging controlled matched-pair analysis. Arthroscopy 23:514–521PubMedCrossRef

16.

Loew M, Habermeyer P, Wiedmann E, Rickert M, Gohlke F (2000) Recommendations for diagnosis and legal assessment of traumatic rotator cuff tears. Unfallchirurgv 103:417–426CrossRef

17.

Namdari S, Frank Henn R III, Green A (2008) Traumatic anterosuperior rotator cuff tears: the outcome of open surgical repair. J Bone Joint Surg Am 90:1906–1913PubMedCrossRef

18.

Nich C, Muetschler C, Vandenbussche E, Augereau B (2009) Long-term clinical and MRI results of open repair of the supraspinatus tendon. Clin Orthop 467:2613–2622PubMedCrossRef

19.

Owen RS, Iannoti JP, Kneeland JB, Dalinka MK, Deren JA, Oleaga L (1993) Shoulder after surgery: MR imaging with surgical validation. Radiology 186:443–447PubMed

20.

Post M, Silver R, Singh M (1983) Rotator cuff tear. Diagnosis and treatment. Clin Orthop Relat Res 173:78–91PubMed

21.

Sørensen AK, Bak K, Krarup AL, Thune CH, Nygaard M, Jørgensen U, Sloth C, Torp-Pedersen S (2007) Acute rotator cuff tear: do we miss the early diagnosis? A prospective study showing a high incidence of rotator cuff tears after shoulder trauma. J Should Elbow Surg 16:174–180CrossRef

22.

Warner JJ, Higgins L, Parsons IM 4th, Dowdy P (2001) Diagnosis and treatment of anterosuperior cuff tears. J Should Elbow Surg 10:37–46CrossRef

23.

Woertlet K (2007) Mutlimodality imaging of the postoperative shoulder. Eur Radiol 17:3038–3055CrossRef

24.

Yoo CJ, Ahn JH, Koh KH, Lim KS (2009) Rotator cuff integrity after arthroscopic repair for large tears with less than optimal footprint coverage. Arthroscopy 25:1093–1100PubMedCrossRef

25.

Zanetti M, Hodler J (2006) MR imaging of the shoulder after surgery. Radiol Clin N Am 44:537–551PubMedCrossRef

Title: A comparison of early versus delayed repair of traumatic rotator cuff tears
Authors: Michael E. Hantes
Georgios K. Karidakis
Mariana Vlychou
Sokratis Varitimidis
Zoe Dailiana
Konstantinos N. Malizos
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Knee Surgery, Sports Traumatology, Arthroscopy / Issue 10/2011
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI: https://doi.org/10.1007/s00167-011-1396-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A comparison of early versus delayed repair of traumatic rotator cuff tears

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Level of evidence

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