Introduction The purpose of this study was to evaluate the early outcomes of thumb metacarpophalangeal (MCP) joint ulnar collateral ligament (UCL) repair using suture anchors with suture tape augmentation.
Materials and Methods Six patients underwent thumb UCL repair or reconstruction with suture tape augmentation and six patients underwent thumb UCL repair with intraosseous suture anchors between January 2013 and January 2018. The main outcome measures were range of motion, strength, Disabilities of the Arm, Shoulder, and Hand (DASH) score, and complications.
Results At final follow-up for patients who had suture tape augmentation, the average thumb MCP joint and interphalangeal (IP) joint flexion were 65 and 73 degrees, respectively. The average DASH score was 4.3. At final follow-up for patients who had intraosseous suture anchor repair, the average thumb MCP joint and IP joint flexion were 50 and 60 degrees, respectively. The average DASH score was 38. There were no complications or secondary procedures in either group.
Conclusion The use of suture anchor repair with suture tape augmentation for thumb UCL injuries is a treatment option that allows for early range of motion with satisfactory early outcomes that are comparable to intraosseous suture anchor repair.
Level of Evidence This is a level IV, case series article.
Background: Superior humeral migration has been established as a component of rotator cuff disease, as it disrupts normal glenohumeral kinematics. Decreased acromiohumeral interval (AHI) as measured on radiographs has been used to indicate rotator cuff tendinopathy. Currently, the data are mixed regarding the specific rotator cuff pathology that contributes the most to humeral head migration. Purpose: To determine the relationship between severity of rotator cuff tears (RCTs) and AHI via a large sample of magnetic resonance imaging (MRI) shoulder examinations. Study Design: Cohort study; Level of evidence, 3. Methods: A search was performed for 3-T shoulder MRI performed in adults for any indication between January 2010 and June 2019 at a single institution. Three orthopaedic surgeons and 1 musculoskeletal radiologist measured AHI on 2 separate occasions for patients who met the inclusion criteria. Rotator cuff pathologies were recorded from imaging reports made by fellowship-trained musculoskeletal radiologists. Results: A total of 257 patients (mean age, 52 years) met the inclusion criteria. Of these, 199 (77%) had at least 1 RCT, involving the supraspinatus in 174 (67.7%), infraspinatus in 119 (46.3%), subscapularis in 80 (31.1%), and teres minor in 3 (0.1%). Full-thickness tears of the supraspinatus, infraspinatus, or subscapularis tendon were associated with significantly decreased AHI (7.1, 5.3, and 6.8 mm, respectively) compared with other tear severities ( P < .001). Having a larger number of RCTs was also associated with decreased AHI (ρ = –0.157; P = .012). Isolated infraspinatus tears had the lowest AHI (7.7 mm), which was significantly lower than isolated supraspinatus tears (8.9 mm; P = .047). Conclusion: Although various types of RCTs have been associated with superior humeral head migration, this study demonstrated a significant correlation between a complete RCT and superior humeral migration. Tears of the infraspinatus tendon seemed to have the greatest effect on maintaining the native position of the humeral head. Further studies are needed to determine whether early repair of these tears can slow the progression of rotator cuff disease.
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