Arthroscopic rotator cuff repair: Prospective functional outcome and repair integrity at minimum 2-year follow-up

Cole, Brian J.; McCarty, L. Pearce; Kang, Richard W.; Alford, Winslow; Lewis, Paul B.; Hayden, Jennifer

doi:10.1016/j.jse.2006.12.011

Cited by 281 publications

(198 citation statements)

References 25 publications

(37 reference statements)

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“…There have been numerous efforts to determine the prognostic factors affecting the outcome of rotator cuff repair, and many structural (tear size, muscle atrophy, fatty degeneration, etc) and clinical factors (age, patients' expectation, and surgeons' experience, etc) have been proposed [2,3,10,14,16,21,24]. Fatty degeneration (FD) of the rotator cuff muscle is one of the factors negatively influencing functional and anatomic outcomes [7,9,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles

Kim

Choi

et al. 2010

Clinical Orthopaedics &Amp; Related Research

158

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Fatty degeneration of the rotator cuff muscles is considered one of the most important factors for the outcomes of cuff repair. However, the reliability of the grading system is not well validated. Two specialists in musculoskeletal radiology and three shoulder fellowshiptrained orthopaedic surgeons reviewed the fatty degeneration grades of each cuff muscle of consecutive 75 fullthickness cuff tears. Fatty degeneration grades were assessed according to the systems of Goutallier et al. and Fuchs et al. using preoperative MR and postoperative CT arthrographies. The interclass correlation coefficient was analyzed to assess interobserver and intraobserver reliabilities. For interobserver reliability using the system of Goutallier et al. the interclass correlation coefficient was higher in MR arthrography (0.6-0.72) than in CT arthrography (0.43-0.6) and higher for radiologists (0.58-0.78) than for orthopaedic surgeons (0.32-0.68).

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Section: Introductionmentioning

confidence: 99%

Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles

Kim

Choi

et al. 2010

Clinical Orthopaedics &Amp; Related Research

158

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“…3 In the case that a smaller tear progresses to a large tear, surgical repair of a full rotator cuff tear remains one of the least successful orthopedic interventions, with tear recurrence in up to 94% of cases (as summarized by Ref. 4).…”

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confidence: 99%

Exogenous collagen cross‐linking recovers tendon functional integrity in an experimental model of partial tear

Fessel

Wernli

et al. 2011

Journal Orthopaedic Research

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We investigated the hypothesis that exogenous collagen cross-linking can augment intact regions of tendon to mitigate mechanical propagation of partial tears. We first screened the low toxicity collagen cross-linkers genipin, methylglyoxal and ultra-violet (UV) light for their ability to augment tendon stiffness and failure load in rat tail tendon fascicles (RTTF). We then investigated crosslinking effects in load bearing equine superficial digital flexor tendons (SDFT). Data indicated that all three cross-linking agents augmented RTTF mechanical properties but reduced native viscoelasticity. In contrast to effects observed in fascicles, methylglyoxal treatment of SDFT detrimentally affected tendon mechanical integrity, and in the case of UV did not alter tendon mechanics. As in the RTTF experiments, genipin cross-linking of SDFT resulted in increased stiffness, higher failure loads and reduced viscoelasticity. Based on this result we assessed the efficacy of genipin in arresting tendon tear propagation in cyclic loading to failure. Genipin cross-linking secondary to a mid-substance biopsy-punch significantly reduced tissue strains, increased elastic modulus and increased resistance to fatigue failure. We conclude that genipin cross-linking of injured tendons holds potential for arresting tendon tear progression, and that implications of the treatment on matrix remodeling in living tendons should now be investigated. ß

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“…6 Rotator cuff repairs should maximize the contact pressure across the footprint to optimize the environment for repair healing, as well as re-create anatomic stability to withstand the loading forces applied to the shoulder. In a biomechanical study assessing contact pressure, force, and area over time, a transosseous-equivalent repair (double-row suture bridge) was shown to have the highest contact pressure and force compared with other arthroscopic repairs.…”

Section: Discussionmentioning

confidence: 99%

Hybrid Repair of Large Crescent Rotator Cuff Tears Using a Modified SpeedBridge and Double-Pulley Technique

Chauhan

Regal

Frank

2014

Arthroscopy Techniques

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An ideal rotator cuff repair maximizes the tendon-bone interface and has adequate biomechanical strength that can withstand a high level of demand. Arthroscopic transosseous-equivalent rotator cuff repairs have become popular and have been shown to be superior to many other methods of fixation. We present an alternative method of repair for large crescent rotator cuff tears that combines 2 well-known methods of fixation: modified SpeedBridge (Arthrex, Naples, FL) and double-pulley techniques. These 2 repair constructs were combined to provide the greatest amount of compression across the footprint while also providing rigid fixation. Ultimately, this can provide an optimal environment for healing in otherwise significant injuries.

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Arthroscopic rotator cuff repair: Prospective functional outcome and repair integrity at minimum 2-year follow-up

Cited by 281 publications

References 25 publications

Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles

Reliability of the Grading System for Fatty Degeneration of Rotator Cuff Muscles

Exogenous collagen cross‐linking recovers tendon functional integrity in an experimental model of partial tear

Hybrid Repair of Large Crescent Rotator Cuff Tears Using a Modified SpeedBridge and Double-Pulley Technique

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