Clinico-radiological evaluation of retear rate in arthroscopic double row versus single row repair technique in full thickness rotator cuff tear

Wade, Roshan; Salgar, Sameer

doi:10.1016/j.jor.2017.01.001

Cited by 17 publications

(9 citation statements)

References 37 publications

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“…Many previous studies have shown that the double-row repair technique can achieve stronger fixation and a lower rotator cuff retear rate. 25,27,55 The results of this study suggest that the repair technique (single row or double row) is not a risk factor for rotator cuff retear after ARCR. Based on the results of this study and considering the clinical practicability and the economic ability of patients, a single-row suture technique with relatively low cost and technical difficulty can be selected.…”

Section: Intraoperative Factorsmentioning

confidence: 69%

Risk factors affecting rotator cuff retear after arthroscopic repair: a meta-analysis and systematic review

Zhao

Luo

Pan

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Retear after arthroscopic rotator cuff repair (ARCR) consistently challenges medical staff and patients, and the incidence of retear after surgery is 10%-94%. The purpose of this study was to identify the risk factors that cause retear after ARCR and provide theoretical guidance for clinical intervention to reduce the occurrence of postoperative rotator cuff retear. Methods: The protocol for this meta-analysis was registered with PROSPERO (CRD42021225088). PubMed, Web of Science, and Embase were searched for observational studies on risk factors for rotator cuff retear after arthroscopic repair. Meta-analytical methods were used to determine the odds ratio or weighted mean difference of potential risk factors related to postoperative rotator cuff retear. Stata 15.1 was used to quantitatively evaluate the publication bias of the statistical results. Results: Fourteen studies from 6 countries with a total of 5693 patients were included. The meta-analysis revealed that the risk factors for retear after rotator cuff repair were age, body mass index, diabetes, subscapularis and infraspinatus fatty infiltration, symptom duration, bone mineral density, tear length, tear width, tear size area, amount of retraction, critical shoulder angle, acromiohumeral interval, distance from the musculotendinous junction to the glenoid, operative duration, biceps procedure, and postoperative University of California Los Angeles shoulder score. Conclusion: These findings can help clinical medical staff identify patients who are prone to retear early after arthroscopic repair and develop targeted prevention and treatment strategies for modifiable risk factors, which are of great significance for reducing the occurrence of rotator cuff retear after ARCR.

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Section: Intraoperative Factorsmentioning

confidence: 69%

Risk factors affecting rotator cuff retear after arthroscopic repair: a meta-analysis and systematic review

Zhao

Luo

Pan

et al. 2021

Journal of Shoulder and Elbow Surgery

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“…The internal validity of the trial is further ensured by: minimising bias by use off an online computer-based randomising system, blinding of patients and outcome accessors, use of appropriate statistical testing, blinded data interpretation and an adequate sample size based on a power calculation. In addition to the patient-related factors, the repair technique of the tear can influence the final outcome and retear rates according to reports of patient series 62 63. However, the latest meta-analyses showed no sound evidence on the difference in clinical outcome or retear rates between single and double row repair in small to medium sized (<3 cm) tears 64–67.…”

Section: Discussionmentioning

confidence: 99%

Acute Cuff Tear Repair Trial (ACCURATE): protocol for a multicentre, randomised, placebo-controlled trial on the efficacy of arthroscopic rotator cuff repair

Ryösä¹,

Kukkonen

Hallgren

et al. 2019

BMJ Open

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IntroductionRotator cuff tear is a very common and disabling condition that can be related to acute trauma. Rotator cuff tear surgery is a well-established form of treatment in acute rotator cuff tears. Despite its widespread use and almost a gold standard position, the efficacy of an arthroscopic rotator cuff repair is still unknown. The objective of this trial is to investigate the difference in outcome between arthroscopic rotator cuff repair and inspection of the shoulder joint defined as placebo surgery in patients 45–70 years of age with an acute rotator tear related to trauma.Methods and analysisAcute Cuff Tear Repair Trial (ACCURATE) is a randomised, placebo-controlled, multicentre efficacy trial with sample size of 180 patients. Concealed allocation is done in 1:1 ratio. The randomisation is stratified according to participating hospital, gender and baseline Western Ontario Rotator Cuff Index (WORC). Both groups receive the same standardised postoperative treatment and physiotherapy. The primary outcome measure is the change in WORC score from baseline to 2-year follow-up. Secondary outcome measures include Constant-Murley Score, the Numerical Rating Scale for pain, subjective patient satisfaction and the health-related quality of life instrument 15 dimensions (15D). Patients and outcome assessors are blinded from the allocated intervention. The primary analysis of results will be conducted according to intention-to-treat analysis.Ethics and disseminationThe study protocol for this clinical trial has been approved by the Ethics Committee of the Hospital District of Southwest Finland and Regional Ethics Committee in Linköping Sweden and Regional Committees for Medical and Health Research Ethics South East in Norway. Every recruiting centre will apply local research approvals. The results of this study will be submitted for publication in peer-reviewed journals.Trial registration numberNCT02885714; Pre-results.

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“…We investigated the following 11 variables that have been previously reported: age 8,21 ; AP tear width and mediolateral tear length 2,8,14,16,18,20,21 ; fatty infiltration of the rotator cuff muscles (ie, supraspinatus, infraspinatus, and subscapularis) and global fatty degeneration index 2,8,17,21 ; CSA 12,22 ; hyperlipidemia, 13 cholesterol level, diabetes mellitus, 8 and smoking 26 ; and surgical technique (ie, single-row, double-row, and suture bridging). 4,6,15,27,30 Hyperlipidemia and diabetes mellitus were defined by the primary care physician who treated the patient at the time of evaluation. The cholesterol and glycated hemoglobin (HbA1c) levels were based on preoperative blood test data.…”

Section: Outcome Measuresmentioning

confidence: 99%

Combination of risk factors affecting retear after arthroscopic rotator cuff repair: a decision tree analysis

Harada

Gotoh

Ishitani

et al. 2021

Journal of Shoulder and Elbow Surgery

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Background: Several risk factors for postoperative retear after arthroscopic rotator cuff repair (ARCR) have been cited in a large number of reports; various combinations of these seem to be present in the clinical setting. Purpose: Using a combination model for decision tree analysis, we aimed to investigate the combination of risk factors that affect postoperative retear the most. Methods: A total of 286 patients who underwent magnetic resonance (MR) imaging at 6 months after surgery were included in this study. Based on the structural integrity of the MR images taken 6 months after surgery, the patients were divided into a healed group (intact tendon, 254 patients) and a retear group (ruptured tendon, 32 patients). Using univariate and decision tree analyses, we selected a combination of 11 risk factors that drastically affected postoperative retear. Results: The mean age was 64.9 AE 7.1 years, and the mean symptom duration was 9.7 AE 11.6 months. The tear was small/medium in 177 patients and large/massive in 109 patients. The technique for surgical repair was single row in 42 patients, double row in 60 patients, and suture bridging in 216 patients. On univariate analysis, both groups had significant differences in the anteroposterior (AP) tear size (P < .0001), mediolateral tear size (P < .0001), hyperlipidemia (P ¼ .0178), global fatty degeneration index (P < .0001), supraspinatus fatty degeneration stage (P < .0001), and critical shoulder angle (CSA) (P ¼ .0015). All of these 5 risk factors, except for mediolateral tear size, were selected as candidates for the decision tree analysis. Eight combination patterns were determined to have prediction probabilities that ranged from 4.3% to 86.1%. In particular, the combination of an AP tear size of !40 mm, hyperlipidemia, and a CSA of !37 affected retear after ARCR the most.The study was approved by the Health Sciences Institutional Review Board of Fukuoka Shion Hospital (approval no. 7).

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Clinico-radiological evaluation of retear rate in arthroscopic double row versus single row repair technique in full thickness rotator cuff tear

Abstract: Retear rate is low in double row repair technique.

Cited by 17 publications

References 37 publications

Risk factors affecting rotator cuff retear after arthroscopic repair: a meta-analysis and systematic review

Risk factors affecting rotator cuff retear after arthroscopic repair: a meta-analysis and systematic review

Acute Cuff Tear Repair Trial (ACCURATE): protocol for a multicentre, randomised, placebo-controlled trial on the efficacy of arthroscopic rotator cuff repair

Combination of risk factors affecting retear after arthroscopic rotator cuff repair: a decision tree analysis

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