Background The main objective of this study was to evaluate the association between the acromial index (AI) and the incidence of recurrent tears of the rotator cuff (RC) in a cohort of patients with full thickness tears who underwent arthroscopic primary repair. Methods A prognostic study of a prospective case series of 103 patients with full thickness RC tears was undertaken. The average age was 59.5 years (39-74) and follow-up was 30.81-months (12-72). True anterior-posterior X-rays were obtained during the pre-operative evaluation. Pre and post-operative magnetic resonance imaging (MRI) were recorded. Results Eighteen cases with recurrent tears (17.4 %) were seen on post-operative MRI. The average AI for patients with recurrent tears was 0.711±0.065 and for patients without recurrent tears 0.710±0.064 (p<0.05). A positive association between age and recurrent tears of the RC was noted (average ages: recurrent tears group 63±5.9 years; group without recurrent tears 58.8±7.5 years) (r=−0.216; p=0.029). We did not find an association between size of the primary tear and recurrent tears (r=−0.075; p<0.05) or between degrees of retraction of the primary and recurrent tears of the cuff (r=−0.073; p<0.05). We observed that 38.9 % of the recurrent tears cases presented with more than one tendon affected before the arthroscopy. At follow-up, none of these recurrent tears showed more than one tendon affected on MRI evaluation.
ConclusionIn this study, we found that the AI radiological measurement is not a predictor for recurrent tears of the RC after primary arthroscopic repair.
Objective:The aim of this study was to evaluate the contribution to hyaline cartilage regeneration of the microfracture (MFx) technique plus intraarticular betamethasone (BMS) or platelet-rich plasma (PRP).Design:Full-thickness chondral defects of 3 × 6 mm2 were surgically performed in both femoral condyles of each knee in 13 New Zealand rabbits and then treated with MFx associated with intraarticular BMS or PRP. At 12 weeks postimplantation, the animals were killed and the condyles were characterized macroscopically, molecularly according to collagen type II and I gene expression (quantitative reverse transcriptase–polymerase chain reaction), and histologically (hematoxylin–eosin staining). For the latter, samples were scored using the International Cartilage Repair Society visual histological scale. Data of MFx/BMS-treated and MFx/PRP-treated condyles were compared against untreated, MFx-treated, or normal condyles without lesions.Results:Our macroscopic findings showed that in MFx/BMS-treated and MFx/PRP-treated groups, the defects were filled with an irregular, partially rough tissue similar to the MFx-treated group. No differences in the ratio between collagen type II versus collagen type I expression were observed among groups. Histological changes were observed between MFx/BMS-treated and MFx/PRP-treated groups versus untreated defects mainly in surface regularity and cell distribution. However, International Cartilage Repair Society score analysis did not support statistical differences between MFx/BMS-treated and MFx/PRP-treated groups versus MFx-treated group.Conclusions:These results provide evidence that the use of intraarticular BMS or PRP as coadjuvants to the microfracture technique in the treatment of acute chondral lesions is not associated with a significant improvement of hyaline cartilage regeneration.
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