Factors Predictive of Healing in Large Rotator Cuff Tears: Is It Possible to Predict Retear Preoperatively?

Jeong, Ho Yeon; Kim, Kang‐Il; Jeon, Young-Chan; Rhee, Yong Girl

doi:10.1177/0363546518762386

Cited by 95 publications

(115 citation statements)

References 54 publications

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“…In this prospective study, CEUS‐based preoperative SSP muscle perfusion revealed a correlation with postoperative tendon integrity and functional outcome and enabled the identification of patient subgroups with exceptionally high, respectively, low risk for tendon retear in our study cohort. The predictive value of SSP perfusion (PE rel ) for tendon healing was superior to MRI‐based fatty infiltration, tendon retraction, and tear size—both within our study cohort and compared with previous studies assessing MRI‐based predictors …”

Section: Discussionmentioning

confidence: 49%

Contrast‐Enhanced Ultrasound (CEUS) as Predictor for Early Retear and Functional Outcome After Supraspinatus Tendon Repair

Kamtchouing

Mick

Groß

et al. 2019

Journal Orthopaedic Research

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Supraspinatus (SSP) tendon tears represent a common indication for shoulder surgery. Yet, prediction of postoperative function and tendon retear remains challenging and primarily relies on morphologic magnetic resonance imaging (MRI)-based parameters, supported by patients' demographic data like age, gender, and comorbidities. Considering continuously high retear rates, especially in patients with larger tears and negative prognostic factors, improved outcome prediction could be of high clinical value. Contrastenhanced ultrasound (CEUS) enables an assessment of dynamic perfusion of the SSP muscle. As a potential surrogate for muscle vitality, CEUS might reflect functional properties of the SSP and support improved outcome prediction after tendon repair. Fifty patients with isolated SSP tendon tears were prospectively enrolled. Preoperatively, SSP muscle perfusion was quantified by CEUS and conventional morphologic parameters like tear size, fatty infiltration, and tendon retraction were assessed by MRI. At six months follow-up, shoulder function, tendon integrity, and muscle perfusion were reassessed. The predictive value of preoperative CEUS for postoperative shoulder function and tendon integrity was evaluated. 35 patients entered the statistical analysis. Preoperative CEUS-based assessment of SSP perfusion significantly correlated with early postoperative shoulder function (Constant, r = 0.48, p < 0.018) and tendon retear (r = 0.67, p < 0.001). CEUS-based subgroup analysis identified patients with exceptionally high, respectively low risk for tendon retear. CEUSbased assessment of the SSP seemed to predict early shoulder function and tendon retear after SSP repair and allowed to identify patient subgroups with exceptionally high or low risk for tendon retear.

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Section: Discussionmentioning

confidence: 49%

Contrast‐Enhanced Ultrasound (CEUS) as Predictor for Early Retear and Functional Outcome After Supraspinatus Tendon Repair

Kamtchouing

Mick

Groß

et al. 2019

Journal Orthopaedic Research

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show abstract

“…5 Tear size, fatty infiltration, age, and chronicity have all been reported as independent risk factors for retear following rotator cuff repair. [6][7][8][9][10] The rate of rotator cuff retears is considered to be lower in younger patients, younger than 50 years of age. 10 This inherently makes sense as the tissue quality of the tendon is expected to be better in the younger patient.…”

Section: See Related Article On Page 2971mentioning

confidence: 99%

Editorial Commentary: “Rotator-Metrics”: Understanding Risk Factors for Rotator Cuff Repair Failure May Lead to Better Outcomes

Athiviraham

Landy

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Retear following rotator cuff repair is a significant risk and is associated with worse patient-reported outcomes. Tear size, fatty infiltration, age, and chronicity have all been reported as independent risk factors. Understanding risk factors for rotator cuff repair failure may allow surgeons to optimize outcomes by addressing certain tears, such as tears involving the anterior rotator cuff cable and subscapularis, more acutely and incorporating patch augmentation in tears that are at high risk for failure.

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“…The ideal rotator cuff repair will make the repaired tendon intact and ensure high initial xation strength and mechanical stability [4]. According to literature, many factors affect the integrity of the repaired rotator cuff tendon, including the size of the initial rotator cuff tear, location, steatosis, tendon tension and tissue quality, patient age, and surgical technique [5,6].…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Evaluation of Tendon Integrity Initially After Arthroscopic Rotator Cuff Repair: Single Row Versus Suture Bridge Technique

Dai¹,

Li²,

Chen³

2020

Preprint

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Background: Previous studies have shown re-tear signs of rotator cuff tendon tearing after single row or suture bridge repair during follow-up. Few studies have investigated tendon integrity initially after successful rotator cuff repair. The purpose of this study was to assess and compare the magnetic resonance imaging (MRI) appearance of the completely repaired rotator cuff initially after surgery between single row and suture bridge techniques.Methods: Fifty patients with full-thickness rotator cuff tears were included in this study. Twenty-five patients underwent arthroscopic rotator cuff repair with single row technique (SR group) or and the other 25 patients underwent double row suture bridge technique (SB group). MRI examinations were performed at the second day after arthroscopic rotator cuff repair. Postoperative rotator cuff integrity was classified into 5 categories according to Sugaya method.Results: Postoperative MRI revealed 3 type I, 9 type II, 8 type III, 5 type IV, and 0 type V in single-row group (SR group), and 1 type I, 11 type II, 10 type III, 3 type IV, and no type V in suture bridge group (SB group). The postoperative re-tear rate was 20% in SR group and 12% in SB group, while no significant difference of re-tear rate was detected between groups (p = 0.70). In the 3 type IV cases of SB group, 1 case was found to have configuration deformity, and the other 2 cases revealed poor tissue quality of rotator cuff under arthroscopy. In the 5 type IV cases of SR group, 3 cases were found to have configuration deformity, and the other 2 cases revealed poor tissue quality of rotator cuff under arthroscopy.Conclusion: No difference of tendon integrity was detected between single row and suture bridge techniques initially after surgery. The re-tear sign of successfully repaired rotator cuff tendon was related with poor tendon tissue quality and also with configuration deformity after surgery.

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Factors Predictive of Healing in Large Rotator Cuff Tears: Is It Possible to Predict Retear Preoperatively?

Cited by 95 publications

References 54 publications

Contrast‐Enhanced Ultrasound (CEUS) as Predictor for Early Retear and Functional Outcome After Supraspinatus Tendon Repair

Contrast‐Enhanced Ultrasound (CEUS) as Predictor for Early Retear and Functional Outcome After Supraspinatus Tendon Repair

Editorial Commentary: “Rotator-Metrics”: Understanding Risk Factors for Rotator Cuff Repair Failure May Lead to Better Outcomes

Magnetic Resonance Imaging Evaluation of Tendon Integrity Initially After Arthroscopic Rotator Cuff Repair: Single Row Versus Suture Bridge Technique

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