Clinical and Magnetic Resonance Imaging Results of Arthroscopic Full-Layer Repair of Bursal-Side Partial-Thickness Rotator Cuff Tears

Koh, Kyoung Hwan; Shon, Min Soo; Lim, Tae Kang; Yoo, Jae Chul

doi:10.1177/0363546511412165

Cited by 39 publications

(24 citation statements)

References 49 publications

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“…Upon closer inspection of the studies involving bursal-side tears, a controversy remains regarding which surgical technique yields the best clinical outcome. Koh et al and Xiao and Cui achieved good clinical outcomes at 2-year follow-ups in their studies that included 38 and 48 patients, respectively, with high-grade bursal-side PTRCTs repaired arthroscopically by transtendon repair [11, 17]. Donohue et al reported similar good results with articular, intratendinous, and bursal high-grade partial tears repaired arthroscopically after conversion to full-thickness tears in a study including 20 patients in each group [18].…”

Section: Discussionmentioning

confidence: 99%

High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear

Aydın

Karaismailoğlu

2017

J Orthop Surg Res

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BackgroundPartial-thickness rotator cuff tears (PTRCTs) are one of the leading causes of shoulder dysfunction. Successful results have been reported with different treatment techniques, but the long-term consequences of these procedures are not yet clearly known. The purposes of this study were to evaluate and compare the mid- and long-term clinical outcomes of arthroscopically repaired bursal-side PTRCTs after conversion to full-thickness tears and identify the possible effects of age, gender, and hand dominance on clinical outcomes.MethodsTwenty-nine patients who had undergone arthroscopic repair of a significant bursal-side PTRCT were functionally evaluated. The repair was made after conversion to a full-thickness tear. The average patient age was 55.2 years (range 35–69 years, SD ±7.6 years). Clinical outcomes were evaluated at 2 and 5 years after surgery. Constant Shoulder Score (CSS) and Visual Analogue Scale for Pain (VAS pain) were used as outcome measures.ResultsThe average CSS improved from 38.9 preoperatively to 89.2 and 87.8 at 2 and 5 years after surgery, respectively (p < 0.001). The average VAS pain score decreased from 7.90 preoperatively to 1.17 and 1.31 at 2 and 5 years after surgery, respectively (p < 0.001). A significant improvement was detected in patient functional outcomes and VAS pain scores at 2 and 5 years after surgery compared with the preoperative period. The patients who underwent surgery from their non-dominant extremity showed a significantly higher CSS increase relative to those who underwent surgery on the dominant extremity (p = 0.022).ConclusionsArthroscopic repair of high-grade bursal-side PTRCTs after conversion to full-thickness tears is a reliable surgical technique with good functional outcomes and pain relief both at mid- and long-term follow-ups. Surgery on the non-dominant side may be related to better functional outcomes.

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Section: Discussionmentioning

confidence: 99%

High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear

Aydın

Karaismailoğlu

2017

J Orthop Surg Res

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“…Some authors[ 13 14 ] have proposed to complete a full thickness tear and repair it, whereas others[ 15 16 17 ] believe that the normal articular sided tissue should be reserved because it can protect the repaired bursal side tendon and offer a good opportunity for healing of the repaired tendon. In addition, with preservation of an intact articular side tendon, some authors[ 16 17 ] tend to perform a full-layer repair whereas others[ 15 18 ] prefer to repair the outer layer only. In the present study, we preserved the healthy articular side tendon as much as possible and repaired the bursal flap back to the bone.…”

Section: Discussionmentioning

confidence: 99%

“…Koh et al . [ 16 ] reported good structural integrity (88% healing rate) on MRI after arthroscopic full-layer repair. Kim et al .…”

Section: Discussionmentioning

confidence: 99%

Clinical and Magnetic Resonance Imaging Results of Arthroscopic Repair of Intratendinous Partial-thickness Rotator Cuff Tears

Xiao

Cui

2015

Chinese Medical Journal

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Background:Partial-thickness rotator cuff tears (PTRCTs) are being diagnosed more often because of high-resolution magnetic resonance imaging (MRI). Compared with articular and bursal side tears, there have been few studies about evaluating the clinical and structural outcomes after intratendinous tear repair.Methods:From 2008 to 2012, 33 consecutive patients with intratendinous PTRCTs underwent arthroscopic repair. All of them were retrospectively evaluated. The University of California at Los Angeles (UCLA) and constant scores were evaluated before operation and at the final follow-up. Postoperative cuff integrity was determined using MRI according to Sugaya's classification.Results:At the 2-year follow-up, the average UCLA score increased from 16.7 ± 1.9 to 32.5 ± 3.5, and the constant score increased from 66.2 ± 10.5 to 92.4 ± 6.9 (P < 0.001). Twenty seven patients received follow-up MRI examinations at an average of 15.2 months after surgery. Of these 27 patients, 22 (81.5%) had a healed tendon, and five patients had partial tears. There was no association between functional and anatomic results.Conclusions:For intratendinous PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2-year after arthroscopic repair.

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“…Also for bursal-sided PRCTs, several different techniques of in-situ repair have been described [35][36][37] , with similar results. Tear conversions to full-thickness rotator cuff tears and repair can also be performed with one of the various techniques for rotator cuff repair.…”

Section: Bursal-sided Partial Thickness Rotator Cuff Tearsmentioning

confidence: 97%

Surgical Treatment Options for Partial Rotator Cuff Tears: A Review of the Literature

Borbas

Hoy

2019

International Journal of Orthopaedics

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Partial-thickness rotator cuff tears (PTRCT) can be articularsided, bursal-sided or intratendinous. New research suggests that a considerable proportion (up to 30%) of cuff thickness on the articular side is taken up histologically by the superior joint capsule conjoined to the rotator cuff tissue. This means that newer reviews of the surgical options may be required to complement the Ellman classification which grades lesions as grade 1 (less than 25% of tendon thickness involved), grade 2 (25-50%) or grade 3 (greater than 50% of tendon thickness). If primary non-operative treatment fails, many surgical options can be considered. The surgical technique chosen has been based on depth of the tear and the tear location. Surgical treatment can be distinguished between debridement and repair of PTRCT's, as well as biologically active experimental techniques showing some promise. Debridement can be successfully performed for bursal-sided Ellman grade 1 tears and articular-sided grade 1 and 2 tears. All other techniques show better results with a repair technique, which can be either performed with an in-situ or trans-cuff repair technique (leaving the intact rotator cuff portion intact) or with tear conversion to a full-thickness cuff tear and subsequent repair. Successful functional and structural outcome after repair of Ellman grade 3 tears can be shown with both repair techniques. The current literature also suggests evidence for inferior outcomes and higher failure rates after arthroscopic debridement of bursal-sided partial-thickness rotator cuff tears compared to articularsided lesions, which may reflect the contribution of capsule to the tear. Articular-sided partial cuff tears are frequently seen in overhead athletes and should be treated non-operatively whenever possible. If conservative treatment fails, debridement seems to be a better surgical choice in most cases, as only a half of professional athletes return to the same level of play after repair of partial-thickness rotator cuff tears.

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Clinical and Magnetic Resonance Imaging Results of Arthroscopic Full-Layer Repair of Bursal-Side Partial-Thickness Rotator Cuff Tears

Abstract: For bursal-side PTRCT, clinical outcomes and tendon healing showed good results at a minimum 2 years after surgery, with minimal damage to intact articular tendon fibers on postoperative MRIs.

Cited by 39 publications

References 49 publications

High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear

High-grade bursal-side partial rotator cuff tears: comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear

Clinical and Magnetic Resonance Imaging Results of Arthroscopic Repair of Intratendinous Partial-thickness Rotator Cuff Tears

Surgical Treatment Options for Partial Rotator Cuff Tears: A Review of the Literature

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