Repair Tension During Arthroscopic Rotator Cuff Repair is Correlated With Preoperative Tendon Retraction and Postoperative Rotator Cuff Integrity

Takeda, Yoshitsugu; Fujii, Koji; Suzue, Naoto; Miyatake, Katsutoshi; Kawasaki, Yoshiaki; Yokoyama, Kenji

doi:10.1016/j.arthro.2021.03.069

Cited by 20 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They concluded that repair tension is significantly associated with failure of healing of rotator cuff repairs. 22 Park et al 31 used a tensionmeter to measure repair tension during arthroscopic procedures and found that the cutoff value of tension for retear was 35 N. Takeda et al 37 also used a tensiometer to measure repair tension during arthroscopic procedures and found that the cutoff value of repair tension for retear of large to massive tears was 35.6 N. Yokoya et al 41 reported that achieving a tension of <30 N significantly reduced the incidence of failure after rotator cuff repair. Uno et al 39 used a tensiometer to measure repair tension during arthroscopic procedures and found that a rotator repair tension of ≥10 N was a risk factor for poor cuff integrity.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Excessively High Repair Tension Decreases Microvascular Blood Flow Within the Rotator Cuff

et al. 2022

View full text Add to dashboard Cite

Background: Repair tension and microvascular blood flow within the rotator cuff has a critical impact on tendon healing after rotator cuff repair. However, the relationship between repair tension and microvascular blood flow within the rotator cuff remains unclear. Purpose/Hypothesis: The purpose of this study was to determine how much tension adversely affects microvascular blood flow within the rotator cuff. The hypothesis was that as the repair tension increases, the microvascular blood flow within the rotator cuff decreases. Study Design: Controlled laboratory study. Methods: Repair tension and microvascular blood flow within the rotator cuff of 30 patients with full-thickness rotator cuff tears were simultaneously measured using a digital tension meter and a contact-type laser Doppler flowmeter, respectively. Microvascular blood flow was measured under 4 levels of tension (0, 10, 20, and 30 N) at 5 points on the rotator cuff. The obtained values were statistically analyzed by a linear mixed-effects model to clarify the effect of tension on microvascular blood flow within the rotator cuff. Results: There was no statistically significant difference in microvascular blood flow (mL/min/100 g) within the rotator cuff between 0 N (mean, 3.51; 95% CI, 3.0-4.0) and 10 N (mean, 3.74; 95% CI, 3.2-4.3) of tension ( P = .716). However, there were statistically significant differences in microvascular blood flow within the rotator cuff between 0 and 20 N of tension (mean, 2.84; 95% CI, 2.3-3.4) ( P = .002) and between 0 and 30 N of tension (mean, 2.45; 95% CI, 1.9-3.0) ( P < .001). Conclusion/Clinical Relevance: Our findings indicate that tension of ≥10 N during rotator cuff repair significantly decreases the microvascular blood flow within the rotator cuff. These data will contribute to determining the optimal repair tension during rotator cuff repair.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Previous studies have clarified that excessively high tension during rotator cuff repair leads to poor postoperative clinical outcomes and greater postoperative pain. 7,22,31,37,39,41 However, the amount of repair tension that is optimal for rotator cuff healing remains unclear.…”

mentioning

confidence: 99%

Excessively High Repair Tension Decreases Microvascular Blood Flow Within the Rotator Cuff

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The goal of rotator cuff repair is to restore the normal anatomy and balance the force couple by reinserting the torn tendon to the original footprint. In some long‐standing, severe RCT cases, this goal is unachievable due to distinct tendon retraction and diminished cuff flexibility [30]. Such cases are defined as irreparable MRCT.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound shear wave elastography-derived tissue stiffness is positively correlated with rotator cuff tear size and muscular degeneration

Huang

Jiang

Wang

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

PurposeThe purpose of this study is to describe rotator cuff muscle stiffness in patients with different degrees of rotator cuff tear (RCT) severity and to assess its predictive ability for RCT reparability. MethodsOne hundred and thirty‐three consecutive patients who were scheduled to undergo arthroscopic shoulder surgery were prospectively enrolled. Tendon retraction, fatty infiltration, and muscle atrophy were evaluated using magnetic resonance imaging. Shear modulus of supraspinatus (SSP) and infraspinatus (ISP) muscles were measured by ultrasound shear wave elastography (SWE). The tear size and reparability were determined intraoperatively. ResultsThere were 97 patients in RCT group and 36 patients in control group. Bilateral shear modulus discrepancy (Δshear modulus) was used to represent rotator cuff stiffness. Severely fatty‐infiltrated rotator cuff muscles possessed a significantly higher stiffness compared with their counterparts (SSP: CI 27.8–31.8 vs. 13.5–15.6 kPa, ISP: CI 33.2–38.1 vs. 8.8–11.2 kPa, p < 0.001). The same trend applied to muscles with distinct tendon retraction (SSP: CI 27.7–32.3 vs. 10.9–14.9 kPa, ISP: CI 33.2–38.6 vs. 6.5–11.0 kPa, p < 0.001) and obvious muscle atrophy (SSP: CI 27.9–32.1 vs. 13.6–15.8 kPa, ISP: CI 32.9–38.2 vs. 9.0–11.7 kPa, p < 0.001). Irreparable massive RCT (MRCT) patients had significantly stiffer SSP (CI 27.7–31.9 vs. 13.5–16.5 kPa, p < 0.001) and ISP (CI 33.5–37.8 vs. 10.3–14.8 kPa, p < 0.001) than reparable MRCT. The Δshear modulus of the ISP was a highly accurate predictor of RCT reparability. A cutoff value of 18.0 kPa had a sensitivity of 100% and specificity of 98.8% for irreparable MRCT. ConclusionUltrasound SWE‐derived rotator cuff muscle stiffness is closely correlated with RCT size and severity. Level of evidenceI.

show abstract

“…The chronic medial retraction of the rotator cuff could cause fixation failure due to high tension after fixation. 17 …”

Section: Discussionmentioning

confidence: 99%

A Mid-Scapular Portal for Arthroscopic-Assisted Fixation of Severe Retraction Greater Tuberosity Avulsion Fracture

Jaruwanneechai

Boonrod

2022

Arthroscopy Techniques

View full text Add to dashboard Cite

Repair Tension During Arthroscopic Rotator Cuff Repair is Correlated With Preoperative Tendon Retraction and Postoperative Rotator Cuff Integrity

Cited by 20 publications

References 28 publications

Excessively High Repair Tension Decreases Microvascular Blood Flow Within the Rotator Cuff

Excessively High Repair Tension Decreases Microvascular Blood Flow Within the Rotator Cuff

Ultrasound shear wave elastography-derived tissue stiffness is positively correlated with rotator cuff tear size and muscular degeneration

A Mid-Scapular Portal for Arthroscopic-Assisted Fixation of Severe Retraction Greater Tuberosity Avulsion Fracture

Contact Info

Product

Resources

About