Long-Term Outcomes After In Situ Arthroscopic Repair of Partial Rotator Cuff Tears

Rossi, Luciano; Atala, Nicolas A.; Bertona, Agustín; Bongiovanni, Santiago; Tanoira, Ignacio; Maignon, Gastón; Ranalletta, Maximiliano

doi:10.1016/j.arthro.2018.09.026

Cited by 31 publications

(40 citation statements)

References 26 publications

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“…2 Repairs of rotator cuff tears show excellent outcomes, with statistically significant improvements in most patients. [3][4][5][6][7][8][9][10][11] However, from the patient's perspective, the prospect of undergoing a rotator cuff repair can be daunting, from understanding how best to prepare for surgery and undergoing anesthesia to optimal strategies for a successful recovery. To learn about their condition and prepare for surgery, many patients will turn to the Internet as a source of information.…”

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confidence: 99%

Online Resources for Rotator Cuff Repair: What are Patients Reading?

Goldenberg

Schairer

Dekker

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose: The purpose of this study was to use a novel scoring system to evaluate the content and grade the quality of websites that patients may use to learn about rotator cuff repair. Methods: Two search terms ("rotator cuff repair" and "rotator cuff surgery") were entered into 3 Internet search engines (Google, Yahoo, and Bing). We scored the quality of information using a novel scoring system. Website quality was further assessed by the Journal of the American Medical Association (JAMA) benchmark criteria and Health on the Net Foundation (HON) code certification. The readability of the websites was evaluated with the Flesch-Kincaid score. Results: We evaluated 47 websites. The average quality for all websites was 6.47 AE 5.21 (maximum 20 points). There was a large difference in scores between the top 5 websites and the remaining websites (16.30 vs 5.51, P < .001). There was no difference in scores when comparing the 3 different search engines (P ¼ .85). The mean reading level was 10.17 AE 2.24. Reading level was not significantly correlated with quality (r s ¼ 0.14, P ¼ .36). The average JAMA benchmark criteria score for all websites was 2.34 AE 1.11 (maximum 4 points). JAMA criteria score was not significantly correlated with quality (r s ¼ 0.02, P ¼ .91). Sites without HONcode certification had higher quality scores (8.33 AE 4.80) than sites with HONcode certification (6.18 AE 4.66), but this difference was not statistically significant (P ¼ .15). Conclusion: The quality of patient-level information on rotator cuff repair on the Internet is both incomplete and written at a reading level higher than current recommendations. Information quality is not significantly correlated with reading level or JAMA criteria, and does not depend on the search term used or HONcode certification. Clinical Relevance: Patients having rotator cuff repair may seek information on the Internet; the information may require surgeon clarification.

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confidence: 99%

Online Resources for Rotator Cuff Repair: What are Patients Reading?

Goldenberg

Schairer

Dekker

et al. 2019

Arthroscopy, Sports Medicine, and Rehabilitation

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“…This is because of concomitant disease of the LHB that is present at the time of the PT-RCT or acquired disease of the LHB that occurs after the PT-RCT repair owing to stenosis or entrapment of the LHB at the superior aspect of the bicipital groove. 12 Although Rossi et al 1 showed a final ASES score of 85, we have shown in a past study that PT-RCT in situ repair with treatment of the LHB tendon yielded better ASES scores, with a mean score of 97 at a mean follow-up of 6 years. 5 LHB pathology is often seen concomitantly with PT-RCT because they are adjacent to one another anatomically and because they have similar mechanisms of injury with repetitive overhead motion.…”

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confidence: 59%

“…The outcomes of 62 patients with a mean age of 52.4 years who had undergone isolated arthroscopic in situ repairs for PT-RCTs were reported. 1 The results were quite convincing after a mean follow-up period of 10.4 years (minimum, 8 years), showing significant improvements in the American Shoulder and Elbow Surgeons (ASES) score and the visual analog scale score for pain. Furthermore, of the 30 patients who participated in sports (21 recreational athletes and 9 competitive athletes), 26 (87%) were able to return to sports and 24 (80%) returned to the same level as before injury.…”

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confidence: 88%

“…The present options include completion of the tear and repair in a traditional fashion 2,3 or in situ repair, 4,5 as was reported in this study. 1 Some surgeons are not advocating bio-augmentation for these types of tears. 6 As summarized in a recent systematic review by our group, both techniques provide effective improvement of functional outcomes and pain relief without significant differences in outcomes when compared directly.…”

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confidence: 99%

“…4,7,8 Controversy still exists because in situ repairs perform better biomechanically at time zero, are better at preserving the tendon length, and restore the native Vail, Colorado footprint more anatomically 7,[9][10][11] whereas completion with repair of the tear removes all diseased tissue, offers a lower morbidity rate and earlier recovery, and in many instances is technically less challenging. We applaud Rossi et al 1 for generating data over this long period and for sharing the excellent results of the in situ repair technique. One of the strengths of this study, besides presenting long-term outcome results, is that patients underwent no concomitant procedures; so, it can be assumed that the postoperative improvement in patient satisfaction and outcome scores was related only to the PT-RCT in situ repair itself.…”

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confidence: 99%

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Editorial Commentary: Is Arthroscopic In Situ Repair Effective for Long-Term Functional Recovery and Pain Relief in Symptomatic Partial Rotator Cuff Tears?

Lacheta¹,

Millett²

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Currently, although most evidence suggests that surgery is effective in treating symptomatic partialthickness rotator cuff tears in patients with failure of nonoperative management and with a tear of more than 50% of the tendon thickness, there is little consensus on the best method of repair. Some surgeons would advocate completing the tear and repairing it, whereas others would advocate performing in situ repair. In our opinion, it is important to also consider treating the long head of the biceps tendon, which is frequently a source of pain at the time of or after surgery.

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Arthroscopic management of isolated partial‐thickness rotator cuff tears

Longo,

Marino,

Lalli

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of the present study is to provide a comprehensive review on the surgical outcomes following arthroscopic treatments of partial‐thickness rotator cuff tears (PT‐RCTs) and to compare the postoperative American Shoulder and Elbow Surgeons (ASES) score following in situ transtendon repair and tear completion, followed by repair.MethodsMedline, EMBASE, Scopus, CINAHL and CENTRAL bibliographic databases were searched. Papers including patients with PT‐RCTs of any grade who underwent treatment using debridement, in situ transtendon repair, tear completion and repair or bioinductive collagen implants were reviewed. Primary PT‐RCTs were the sole indication for surgery. Primary postoperative outcomes assessed included the ASES score, the Absolute Constant–Murley score, the Simple Shoulder Test, the Visual Analogue Scale, the University of California‐Los Angeles Shoulder Scale, the Western Ontario Rotator Cuff Score, range of motion, complications and revisions. A meta‐analysis of comparative studies compared the postoperative ASES score between patients treated with in situ transtendon repair versus tear completion repair.ResultsTwenty‐eight studies were included. The ASES score was reported by four comparative studies with contrasting results. The heterogeneity was high (I2 = 86%), and effect sizes ranged from −0.49 in favour of the tear completion and repair technique to an effect size of +1.07 favouring in situ transtendon repair. The overall effect size of 0.02 suggests an equivalence between the two techniques in terms of the ASES score. Two studies with a total sample size of 111 patients reported on debridement, and four studies with a total sample size of 155 patients reported on bioinductive collagen implants.ConclusionDebridement alone is suitable for Ellman grades I‐II PT‐RCTs. In situ transtendon and tear completion repair techniques yield similar postoperative outcomes. Bioinductive collagen implants hold promise but lack long‐term efficacy data. High‐quality comparative studies are needed to determine the best treatment for PT‐RCTs.Level of EvidenceLevel IV.

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Long-Term Outcomes After In Situ Arthroscopic Repair of Partial Rotator Cuff Tears

Cited by 31 publications

References 26 publications

Online Resources for Rotator Cuff Repair: What are Patients Reading?

Online Resources for Rotator Cuff Repair: What are Patients Reading?

Editorial Commentary: Is Arthroscopic In Situ Repair Effective for Long-Term Functional Recovery and Pain Relief in Symptomatic Partial Rotator Cuff Tears?

Arthroscopic management of isolated partial‐thickness rotator cuff tears

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