Clinical outcome and repair integrity after arthroscopic rotator cuff repair significantly improved during the surgeon’s learning curve

Lim, Tae Kang; Bae, Kyu Hwan; Choi, Yun Sun; Kim, Jong Ho; Yoo, Jae Chul

doi:10.1016/j.jse.2020.10.031

Cited by 4 publications

(2 citation statements)

References 24 publications

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“… 42 Recent studies assessing learning curves regarding surgery have been using this method which could indicate that it is becoming the new standard methodology to determine learning curves. 30 , 32 …”

Section: Discussionmentioning

confidence: 99%

Surgical learning curve in reverse shoulder arthroplasty for proximal humerus fractures

Blaas¹,

Yuan²,

Lameijer³

et al. 2021

JSES International

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Background Fracture reverse shoulder arthroplasty (fRSA) in geriatric, complex dislocated proximal humerus fractures is becoming the standard treatment next to conservative treatment. fRSA is a multifaceted, reasonably challenging procedure of which functional outcomes and complication rates are likely to depend on the experience of the surgeon. The goal of this study was to determine whether there is a learning curve for fRSA. Methods All patients with a dislocated multipart proximal humerus fracture that were treated with an fRSA between 2013 and 2019 in a specialized institution were included. The functional outcomes (Constant Shoulder Score, Oxford Shoulder Score, and range of motion), complications, and operation time of fRSA were assessed with linear regression plots and cumulative summation analysis to establish whether a learning curve was present. Results In this cohort study, 50 patients were included. They had a mean age of 77.1 years and were treated with an fRSA by one trauma surgeon. Learning curves were distinguished for functional outcomes, complications, and operation time based on learning targets for daily activity and the mean complications and operation time. Results indicated that an optimal treatment is achieved after performing 20 fRSAs. Conclusion The results show that functional outcomes of PHFs treated with an fRSA improve with surgical experience. Also, outcomes are getting less variable after about 20 procedures. Surgeons starting this procedure should be aware of the learning curve and, therefore, should consider guidance from an experienced surgeon to swiftly optimize functional outcomes and prevent unnecessary complications.

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Section: Discussionmentioning

confidence: 99%

Surgical learning curve in reverse shoulder arthroplasty for proximal humerus fractures

Blaas¹,

Yuan²,

Lameijer³

et al. 2021

JSES International

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“… 13 14 Even though the surgeon's skill continues to improve, successful repair of large-to-massive tears especially with retraction and immobility is still challenging, and retear could continue to occur. Recently, Lim et al 15 in their learning curve analysis demonstrated that as a surgeon's experience of rotator cuff repair accumulated, retear rate successfully decreased in small to medium-sized tears, but not in large-to-massive tears. This may reflect the fact that successful healing of large or massive rotator cuff tears might be associated with many factors including biologic aspects of tendon-bone healing, other than only surgical skill-dependent factors such as release, mobilization, and strong fixation.…”

Section: Introductionmentioning

confidence: 99%

Nanofiber Scaffolds by Electrospinning for Rotator Cuff Tissue Engineering

et al. 2021

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Rotator cuff tears continue to be at risk of retear or failure to heal after surgical repair, despite the use of various surgical techniques, which stimulate development of novel scaffolding strategies. They should be able to address the known causes of failure after the conventional rotator cuff repair: (1) failure to reproduce the normal tendon healing process, (2) resultant failure to reproduce four zones of the enthesis, and (3) failure to attain sufficient mechanical strength after repair. Nanofiber scaffolds are suited for this application because they can be engineered to mimic the ultrastructure and properties of the native rotator cuff tendon. Among various methods for tissue-engineered nanofibers, electrospinning has recently been highlighted in the rotator cuff field. Electrospinning can create fibrous and porous structures that resemble natural tendon's extracellular matrix. Other advantages include the ability to create relatively large surface-to-volume ratios, the ability to control fiber size from the micro to the nano scale, and the flexibility of material choices. In this review, we will discuss the anatomical and mechanical features of the rotator cuff tendon, their potential impacts on improper healing after repair, and the current knowledge of the use of electrospinning for rotator cuff tissue engineering.

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Impact of Surgeon Volume, Experience, and Training on Outcomes After Arthroscopic Rotator Cuff Repair: A Nationwide Analysis of 1,489 surgeons

Sadjadi,

Nosrat,

et al. 2024

JSES International

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Clinical outcome and repair integrity after arthroscopic rotator cuff repair significantly improved during the surgeon’s learning curve

Cited by 4 publications

References 24 publications

Surgical learning curve in reverse shoulder arthroplasty for proximal humerus fractures

Surgical learning curve in reverse shoulder arthroplasty for proximal humerus fractures

Nanofiber Scaffolds by Electrospinning for Rotator Cuff Tissue Engineering

Impact of Surgeon Volume, Experience, and Training on Outcomes After Arthroscopic Rotator Cuff Repair: A Nationwide Analysis of 1,489 surgeons

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