The nature and extent of the obstructing lesion and its potential for further treatment are the major determinants of post-nephrostomy survival. Every effort should therefore be made to identify the nature of the obstruction before deciding on PND.
This is the first study to provide evidence that atrophy of the supraspinatus muscle is reversible. Changes in the types of fibre are discussed. MRI assessment of muscle atrophy may not be fully representative of myofibre atrophy. Cite this article: Bone Joint J 2016;98-B:1389-94.
Background
Management of degenerate rotator cuff tears associated with subacromial impingement is debatable.
Methods
We performed a prospective, randomised controlled trial to assess the efficacy of arthroscopic subacromial decompression (ASD) with or without repair of the rotator cuff using a mini‐open technique.
Results
42 patients (29 males and 13 females) with a mean age of 64 years (range 54–77 years) were recruited. 25 patients underwent ASD and cuff repair using mini‐open technique whereas 17 patients had only ASD alone. All the patients were followed for a minimal of 1 year post‐operatively.
At final follow‐up the mean Constant scores and patient satisfaction scores were not different between the groups (p value 0.06 and 0.44 respectively). The mean DASH scores were marginally significant (p value 0.05) and mean ASES scores were significant (p value 0.03). A 38% cuff rerupture rate was noted in the cuff repair group.
Conclusions
Our study demonstrates that in short‐term the results of ASD with or without rotator cuff repair are not significantly different, however positive trends were noted in the cuff repair group. Although a significant rerupture rate was noted (38%) this had little effect on the outcome.
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