Prognostic factors for clinical outcomes after rotator cuff repair

Pécora, José Otávio Reggi; Malavolta, Eduardo Angeli; Assunção, Jorge Henrique; Gracitelli, Mauro Emílio Conforto; Martins, João Paulo Sobreiro; Neto, Arnaldo Amado Ferreira

doi:10.1590/1413-78522015230300992

Cited by 11 publications

(18 citation statements)

References 29 publications

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“…Our study included clinical, radiographic and MRI parameters to analyze the correlation with reparability of large-sized and massive rotator cuff tears. The rotator cuff tear is a degenerative disease as Pecora et al demonstrated that age is associated with clinical outcomes after rotator cuff repair [33]. From our study, age is one of the factors that correlates with rotator cuff reparability.…”

Section: Discussionsupporting

confidence: 59%

Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears

Kuptniratsaikul

Laohathaimongkol

Umprai

et al. 2019

BMC Musculoskelet Disord

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BackgroundThe purpose of this study is to determine the pre-operative factors that are associated with reparability of the large-sized and massive rotator cuff tears.MethodsSixty-six patients were included in this prognostic study. Demographic data, radiographic and MRI parameters were collected. Arthroscopic rotator cuff repair was performed for all included patient. Complete rotator cuff repair was achieved when the tendon covered up at least 50% of the anatomical footprint. The receiver operating characteristic (ROC) curve was analysed to define the cut-off level of each significant factor.ResultsEleven large-sized rotator cuff tears and fifty-five massive rotator cuff tears were defined from MRI. Fifty-four patients were in the complete repair group, and twelve patients were in the partial repair group. The mean duration between MRI and surgery of 5.5 weeks. Reparability was correlated with age, mediolateral (ML) and anteroposterior (AP) tear size, rotator cuff arthropathy, superior migration of humeral head, fatty infiltration and atrophy of the supraspinatus muscle, and fatty infiltration of infraspinatus muscle (p < 0.05). The ROC curve defined a cut-off level of each predicting factor which included age of ≥65 years, mediolateral tear size of ≥36 mm, anteroposterior tear size of ≥22 mm, Hamada’s rotator cuff arthropathy of ≥class2, acromiohumeral interval of ≥6 mm, ≥stage3 supraspinatus fatty infiltration, the presence of supraspinatus muscle atrophy, and ≥ stage1 infraspinatus fatty infiltration. In multivariated regression analysis, age, acromiohumeral interval, and anteroposterior tear size were statistically associated with the reparability. The intra- and inter-observer reliabilities were moderate to excellent.ConclusionAge, ML tear size, AP tear size, rotator cuff arthropathy, superior migration of humeral head, fatty infiltration of supraspinatus and infraspinatus muscles and supraspinatus muscle atrophy all correlate with reparability of large to massive rotator cuff tear.

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Section: Discussionsupporting

confidence: 59%

Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears

Kuptniratsaikul

Laohathaimongkol

Umprai

et al. 2019

BMC Musculoskelet Disord

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“…In the period evaluated, 712 original articles were published in the Brazilian Journal of Orthopedics and 588 in Acta Ortopédica Brasileira, or 1300 publications. Among these, 84 (6.7% of the total) were clinical articles on shoulder diseases; 25 publications (1.9% of the total) 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 evaluated the clinical results of treatment of rotator cuff tears ( Table 1 ); twenty studies (80%) were case series (level of evidence IV), one (4%) case–control study (level of evidence III) and four (16%) cohorts (level of evidence II). No randomized study was published in the period.…”

Section: Resultsmentioning

confidence: 99%

Outcome assessment in the treatment of rotator cuff tear: what is utilized in Brazil?

Assunção

Malavolta

Domingues

et al. 2017

Revista Brasileira de Ortopedia (English Edition)

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This review evaluated the outcomes used in clinical studies involving rotator cuff tear published in the last decade in the two leading Brazilian orthopedic journals. A literature review was performed using the journals Revista Brasileira de Ortopedia and Acta Ortopédica Brasileira. It included all original clinical articles describing at least one outcome measured before or after any clinical or surgical intervention related to rotator cuff tear, published between 2006 and 2015. The authors evaluated range of motion, muscle strength, patient satisfaction, and tendon integrity and functional outcomes scores. There were 25 clinical studies published about rotator cuff in the two principal Brazilian orthopedic journals in the last decade, 20 case series (80%), one case–control (4%), and four cohorts (16%). Objective measures such as muscle strength, patient satisfaction, and evaluation of tendon integrity were little used. Range of motion measurements were performed in 52% of the articles. Evaluations of muscle strength and patient satisfaction were reported by 28% and 16% of the studies, respectively. Only 28% of the articles evaluated tendon integrity after surgery. Of these, 16% did so by magnetic resonance imaging and 12% by ultrasonography. The most used scale was the UCLA, present in 92% of the articles, while the Constant–Murley appeared in 20%. Scales deemed reliable, with high internal consistency and good responsiveness, were rarely used.

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“…28 Those with a high BMI and increasing age are more likely to be allocated 13 to non-surgical management with age linked to a risk of re-tear and poorer functional outcomes. [28][29][30] Optimal time to surgery…”

Section: Non-surgical Management Of Rotator Cuff Tearsmentioning

confidence: 99%

Rotator cuff tears: is non-surgical management effective?

Sealey

Lewis

2016

Physical Therapy Reviews

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Background: Rotator cuff related shoulder pain is a common musculoskeletal complaint with an increasing number of people with shoulder pain undergoing surgical repair each year. The relationship between rotator cuff tendon tears and shoulder pain remains equivocal due to the high prevalence of tears in people without symptoms, which suggests that a proportion of people will undergo surgery on tissues not related to their symptoms. As a result there have been suggestions to initially manage atraumatic tears non-surgically. Objectives: The objective of this narrative review was to present current evidence regarding the assessment and management of full-thickness rotator cuff tears. Major Findings: To date three randomised controlled trials have compared surgical with non-surgical management of rotator cuff tears. Outcomes show a small but non-significant effect in favour of surgery. Only one study has looked at long term outcomes of greater than one year. Overall 129 subjects have completed a course of non-surgical management and therefore low participant numbers may not be sufficient to draw firm conclusions. Conclusions: Current evidence currently supports the consideration of a non-surgical approach in the management of people with shoulder symptoms and identified rotator cuff tears, for a 2 period of time.

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Prognostic factors for clinical outcomes after rotator cuff repair

Cited by 11 publications

References 29 publications

Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears

Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears

Outcome assessment in the treatment of rotator cuff tear: what is utilized in Brazil?

Rotator cuff tears: is non-surgical management effective?

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