Shoulder evaluation with isokinetic strength testing after arthroscopic rotator cuff repairs

Bigoni, Marco; Gorla, Massimo; Guerrasio, S; Brignoli, A; Cossio, Andrea; Grillo, Paolo; Marinoni, E. C.

doi:10.1016/j.jse.2008.09.002

Cited by 38 publications

(25 citation statements)

References 23 publications

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“…For example, Cools and colleagues 14 reported that patient-reported outcomes improved from presurgery to 18 months after surgery as indicated by a 68% increase in the Constant-Murley score. Similarly, Bigoni et al 11 demonstrated a 43% to 93% increase (depending on repair technique) in the Constant score from presurgery to 12 months after rotator cuff repair. Similar improvements in subjective assessment after rotator cuff repair have been reported by Klintberg and colleagues.…”

Section: Discussionmentioning

confidence: 82%

In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

et al. 2011

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Background Surgical repair of a torn rotator cuff is based on the belief that repairing the tear is necessary to restore normal glenohumeral joint (GHJ) mechanics and achieve a satisfactory clinical outcome. Hypothesis Dynamic joint function is not completely restored by rotator cuff repair, thus compromising shoulder function and potentially leading to long-term disability. Study Design Controlled laboratory study and Case series; Level of evidence, 4. Methods Twenty-one rotator cuff patients and 35 control participants enrolled in the study. Biplane radiographic images were acquired bilaterally from each patient during coronal-plane abduction. Rotator cuff patients were tested at 3, 12, and 24 months after repair of a supraspinatus tendon tear. Control participants were tested once. Glenohumeral joint kinematics and joint contact patterns were accurately determined from the biplane radiographic images. Isometric shoulder strength and patient-reported outcomes were measured at each time point. Ultrasound imaging assessed rotator cuff integrity at 24 months after surgery. Results Twenty of 21 rotator cuff repairs appeared intact at 24 months after surgery. The humerus of the patients’ repaired shoulder was positioned more superiorly on the glenoid than both the patients’ contralateral shoulder and the dominant shoulder of control participants. Patient-reported outcomes improved significantly over time. Shoulder strength also increased over time, although strength deficits persisted at 24 months for most patients. Changes over time in GHJ mechanics were not detected for either the rotator cuff patients’ repaired or contralateral shoulders. Clinical outcome was associated with shoulder strength but not GHJ mechanics. Conclusion Surgical repair of an isolated supraspinatus tear may be sufficient to keep the torn rotator cuff intact and achieve satisfactory patient-reported outcomes, but GHJ mechanics and shoulder strength are not fully restored with current repair techniques. Clinical Relevance The study suggests that current surgical repair techniques may be effective for reducing pain but have not yet been optimized for restoring long-term shoulder function.

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Section: Discussionmentioning

confidence: 82%

In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

et al. 2011

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“…After discarding duplicate abstracts, there were a total of ten studies with a level of evidence of III or better that compared different arthroscopic techniques 1,[15][16][17][24][25][26][27][28][29] , and six of these studies compared single-row and double-row techniques 1,[15][16][17]24,25 . A review of the references for these ten manuscripts did not reveal any other clinical studies with a level of evidence of III or better that compared arthroscopic repair techniques.…”

Section: Literature Searchmentioning

confidence: 99%

“…The six studies that were included in the analysis are listed in Table I. The other four studies with a level of evidence of III or better were excluded because they compared a single-row simple-stitch repair with a mattress-lockingstitch repair (two studies 26,27 ), compared side-to-side repair with tendon-to-bone fixation with anchors (one study 29 ), or compared ''knotted'' and ''knotless'' anchor repair techniques (one study 28 ).…”

Section: Literature Searchmentioning

confidence: 99%

Outcomes of Single-Row and Double-Row Arthroscopic Rotator Cuff Repair: A Systematic Review

Saridakis

Jones

2010

The Journal of Bone and Joint Surgery-American Volume

149

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There appears to be a benefit of structural healing when an arthroscopic rotator cuff repair is performed with double-row fixation as opposed to single-row fixation. However, there is little evidence to support any functional differences between the two techniques, except, possibly, for patients with large or massive rotator cuff tears (> or = 3 cm). A risk-reward analysis of a patient's age, functional demands, and other quality-of-life issues should be considered before deciding which surgical method to employ. Double-row fixation may result in improved structural healing at the site of rotator cuff repair in some patients, depending on the size of the tear.

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“…Because most functional activities are dynamic, evaluating isokinetic shoulder strength may be more appropriate when relating strength to functional performance and clinical outcome. However, data for isokinetic strength measurements around the shoulder are available only for normal healthy subjects [7], patients after open fixation of glenoid rim fractures [33], open [1, 10] and arthroscopic anterior stabilization [15, 21], rotator cuff surgery [4, 11, 14, 34, 43], with adhesive capsulitis [26, 27, 41], subacromial impingement [16, 24, 30], and pectoralis major muscle rupture [17], but not for patients with a reverse shoulder prosthesis.…”

Section: Introductionmentioning

confidence: 99%

Are Shoulders with A Reverse Shoulder Prosthesis Strong Enough? A Pilot Study

Alta

Veeger

Janssen

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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BackgroundIt has been suggested that limited active ROM of reverse shoulder prostheses relates to lack of strength. However, the postoperative strength has not been quantified.Questions/purposesWe therefore measured joint torques in patients with reverse shoulder prostheses and correlated torques with functional scores.MethodsWe recruited 33 patients (age, 72 ± 8 years) with a reverse prosthesis (37 shoulders, 21 primary and 16 revisions). We obtained Constant-Murley, DASH, and Simple Shoulder Test ([D]SST) scores, and performed two isokinetic protocols (abduction/adduction and external/internal rotation) at 60° per second. Minimum followup was 4 months (average, 23 months; range, 4–63 months).ResultsTwenty-three patients (24 shoulders; 13 primaries, 11 revisions) were able to perform at least one of the defined tasks. Mean abduction and adduction torques were 15 Nm ± 7 Nm and 16 Nm ± 10 Nm (19%–78% of normal shoulders). External and internal rotation tasks could be performed by only 13 patients (14 shoulders; nine primary, five revisions) generating 9 Nm ± 4 Nm and 8 Nm ± 3 Nm, respectively (13%–71% of normal shoulders). We found moderate correlations between Constant-Murley, DASH and (D)SST (D = Dutch translation) scores and abduction and external rotation.ConclusionsPatients with a reverse prosthesis had reduced strength when compared with normal values reported in the literature (only 65% of patients could perform the protocol). This effect was greatest for external rotation and might explain clinical outcomes with which a moderately strong relationship was observed. Our observations suggest limited strength is a major factor in reduced ROM.

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Shoulder evaluation with isokinetic strength testing after arthroscopic rotator cuff repairs

Cited by 38 publications

References 23 publications

In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

Outcomes of Single-Row and Double-Row Arthroscopic Rotator Cuff Repair: A Systematic Review

Are Shoulders with A Reverse Shoulder Prosthesis Strong Enough? A Pilot Study

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