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Published in: Journal of Orthopaedic Surgery and Research 1/2017

Open Access 01-12-2017 | Research article

High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear

Authors: Nuri Aydin, Bedri Karaismailoglu

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2017

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Abstract

Background

Partial-thickness rotator cuff tears (PTRCTs) are one of the leading causes of shoulder dysfunction. Successful results have been reported with different treatment techniques, but the long-term consequences of these procedures are not yet clearly known. The purposes of this study were to evaluate and compare the mid- and long-term clinical outcomes of arthroscopically repaired bursal-side PTRCTs after conversion to full-thickness tears and identify the possible effects of age, gender, and hand dominance on clinical outcomes.

Methods

Twenty-nine patients who had undergone arthroscopic repair of a significant bursal-side PTRCT were functionally evaluated. The repair was made after conversion to a full-thickness tear. The average patient age was 55.2 years (range 35–69 years, SD ±7.6 years). Clinical outcomes were evaluated at 2 and 5 years after surgery. Constant Shoulder Score (CSS) and Visual Analogue Scale for Pain (VAS pain) were used as outcome measures.

Results

The average CSS improved from 38.9 preoperatively to 89.2 and 87.8 at 2 and 5 years after surgery, respectively (p < 0.001). The average VAS pain score decreased from 7.90 preoperatively to 1.17 and 1.31 at 2 and 5 years after surgery, respectively (p < 0.001). A significant improvement was detected in patient functional outcomes and VAS pain scores at 2 and 5 years after surgery compared with the preoperative period. The patients who underwent surgery from their non-dominant extremity showed a significantly higher CSS increase relative to those who underwent surgery on the dominant extremity (p = 0.022).

Conclusions

Arthroscopic repair of high-grade bursal-side PTRCTs after conversion to full-thickness tears is a reliable surgical technique with good functional outcomes and pain relief both at mid- and long-term follow-ups. Surgery on the non-dominant side may be related to better functional outcomes.
Literature
1.
go back to reference Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87:1229–40.PubMed Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87:1229–40.PubMed
2.
go back to reference Lafosse L, Brozska R, Toussaint B, Gobezie R. The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg Am. 2007;89:1533–41.PubMed Lafosse L, Brozska R, Toussaint B, Gobezie R. The outcome and structural integrity of arthroscopic rotator cuff repair with use of the double-row suture anchor technique. J Bone Joint Surg Am. 2007;89:1533–41.PubMed
3.
go back to reference Park JY, Siti HT, Keum JS, Moon SG, Oh KS. Does an arthroscopic suture bridge technique maintain repair integrity?: a serial evaluation by ultrasonography. Clin Orthop Relat Res. 2010;468:1578–87.CrossRefPubMed Park JY, Siti HT, Keum JS, Moon SG, Oh KS. Does an arthroscopic suture bridge technique maintain repair integrity?: a serial evaluation by ultrasonography. Clin Orthop Relat Res. 2010;468:1578–87.CrossRefPubMed
4.
go back to reference Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;254:64–74. Ellman H. Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res. 1990;254:64–74.
5.
go back to reference Neer CS. Impingement lesions. Clin Orthop Relat Res. 1983;173:70–7. Neer CS. Impingement lesions. Clin Orthop Relat Res. 1983;173:70–7.
6.
go back to reference Fukuda H, Mikasa M, Yamanaka K. Incomplete thickness rotator cuff tears diagnosed by subacromial bursography. Clin Orthop Relat Res. 1987;223:51–8. Fukuda H, Mikasa M, Yamanaka K. Incomplete thickness rotator cuff tears diagnosed by subacromial bursography. Clin Orthop Relat Res. 1987;223:51–8.
7.
go back to reference Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy. 1999;15:126–31.CrossRefPubMed Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy. 1999;15:126–31.CrossRefPubMed
8.
go back to reference Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthrosc - J Arthrosc Relat Surg. 2012;28:25–33.CrossRef Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthrosc - J Arthrosc Relat Surg. 2012;28:25–33.CrossRef
9.
go back to reference Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–4. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160–4.
10.
go back to reference Spencer EE Jr, Dunn WR, Wright RW, Wolf BR, Spindler KP, McCarty E, et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sport Med. 2008;36:99–103.CrossRef Spencer EE Jr, Dunn WR, Wright RW, Wolf BR, Spindler KP, McCarty E, et al. Interobserver agreement in the classification of rotator cuff tears using magnetic resonance imaging. Am J Sport Med. 2008;36:99–103.CrossRef
11.
go back to reference Xiao J, Cui G. Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears. J Shoulder Elb Surg. 2015;24:e41–6.CrossRef Xiao J, Cui G. Clinical and structural results of arthroscopic repair of bursal-side partial-thickness rotator cuff tears. J Shoulder Elb Surg. 2015;24:e41–6.CrossRef
12.
go back to reference Deutsch A. Arthroscopic repair of partial-thickness tears of the rotator cuff. J Shoulder Elb Surg. 2007;16:193–201.CrossRef Deutsch A. Arthroscopic repair of partial-thickness tears of the rotator cuff. J Shoulder Elb Surg. 2007;16:193–201.CrossRef
13.
go back to reference Brockmeier SF, Dodson CC, Gamradt SC, Coleman SH, Altchek DW. Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes. Arthrosc - J Arthrosc Relat Surg. 2008;24:961–5.CrossRef Brockmeier SF, Dodson CC, Gamradt SC, Coleman SH, Altchek DW. Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes. Arthrosc - J Arthrosc Relat Surg. 2008;24:961–5.CrossRef
14.
go back to reference Franceschi F, Papalia R, Del Buono A, Vasta S, Costa V, Maffulli N, et al. Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomized controlled trial. Int Orthop. 2013;37:1487–93.CrossRefPubMedPubMedCentral Franceschi F, Papalia R, Del Buono A, Vasta S, Costa V, Maffulli N, et al. Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomized controlled trial. Int Orthop. 2013;37:1487–93.CrossRefPubMedPubMedCentral
15.
16.
go back to reference Nakajima T, Rokuuma N, Hamada K, Tomatsu T, Fukuda H. Histologic and biomechanical characteristics of the supraspinatus tendon: reference to rotator cuff tearing. J Shoulder Elb Surg. 1994;3:79–87.CrossRef Nakajima T, Rokuuma N, Hamada K, Tomatsu T, Fukuda H. Histologic and biomechanical characteristics of the supraspinatus tendon: reference to rotator cuff tearing. J Shoulder Elb Surg. 1994;3:79–87.CrossRef
17.
go back to reference Koh KH, Shon MS, Lim TK, Yoo JC. Clinical and magnetic resonance imaging results of arthroscopic full-layer repair of bursal-side partial-thickness rotator cuff tears. Am J Sports Med. 2011;39:1660–7.CrossRefPubMed Koh KH, Shon MS, Lim TK, Yoo JC. Clinical and magnetic resonance imaging results of arthroscopic full-layer repair of bursal-side partial-thickness rotator cuff tears. Am J Sports Med. 2011;39:1660–7.CrossRefPubMed
18.
go back to reference Donohue NK, Nickel BT, Grindel SI. High-grade articular, bursal, and intratendinous partial-thickness rotator cuff tears: a retrospective study comparing functional outcomes after completion and repair. Am J Orthop. 2016;45:e254–60.PubMed Donohue NK, Nickel BT, Grindel SI. High-grade articular, bursal, and intratendinous partial-thickness rotator cuff tears: a retrospective study comparing functional outcomes after completion and repair. Am J Orthop. 2016;45:e254–60.PubMed
19.
go back to reference Kim KC, Shin HD, Cha SM, Park JY. Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear: articular- versus bursal-side partial tears. Am J Sports Med. 2014;42:451–6.CrossRefPubMed Kim KC, Shin HD, Cha SM, Park JY. Repair integrity and functional outcome after arthroscopic conversion to a full-thickness rotator cuff tear: articular- versus bursal-side partial tears. Am J Sports Med. 2014;42:451–6.CrossRefPubMed
20.
go back to reference Aleem AW, Syed UAM, Wascher J, Zoga AC, Close K, Abboud JA, et al. Functional outcomes after bilateral arthroscopic rotator cuff repair. J Shoulder Elb Surg. 2016;25:1668–73.CrossRef Aleem AW, Syed UAM, Wascher J, Zoga AC, Close K, Abboud JA, et al. Functional outcomes after bilateral arthroscopic rotator cuff repair. J Shoulder Elb Surg. 2016;25:1668–73.CrossRef
21.
go back to reference Grasso A, Milano G, Salvatore M, Falcone G, Deriu L, Fabbriciani C. Single-row versus double-row arthroscopic rotator cuff repair: a prospective randomized clinical study. Arthrosc J Arthrosc Relat Surg. 2009;25:4–12.CrossRef Grasso A, Milano G, Salvatore M, Falcone G, Deriu L, Fabbriciani C. Single-row versus double-row arthroscopic rotator cuff repair: a prospective randomized clinical study. Arthrosc J Arthrosc Relat Surg. 2009;25:4–12.CrossRef
22.
go back to reference Kamath G, Galatz LM, Keener JD, Teefey S, Middleton W, Yamaguchi K. Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears. J Bone Joint Surg Am. 2009;91:1055–62.CrossRefPubMed Kamath G, Galatz LM, Keener JD, Teefey S, Middleton W, Yamaguchi K. Tendon integrity and functional outcome after arthroscopic repair of high-grade partial-thickness supraspinatus tears. J Bone Joint Surg Am. 2009;91:1055–62.CrossRefPubMed
Metadata
Title
High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear
Authors
Nuri Aydin
Bedri Karaismailoglu
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2017
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-017-0619-7

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