When Do Rotator Cuff Repairs Fail? Serial Ultrasound Examination After Arthroscopic Repair of Large and Massive Rotator Cuff Tears

Miller, Bruce S.; Downie, Brian; Kohen, Robert B.; Kijek, Theresa Guckian; Lesniak, Bryson P.; Jacobson, Jon A.; Hughes, R.; Carpenter, James E.

doi:10.1177/0363546511413372

Cited by 278 publications

(206 citation statements)

References 37 publications

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“…It has been stated that intrinsic factors such as age of the patients, size of the tear, fatty degeneration and retraction of the affected tendons may play a role as predictors for recurrent tears after successful surgery [1][2][3][4][5][6][7]. Regardless, at this point, the only clear predictor that positively correlates with a higher recurrent tear rate seems to be the age of the patient at the moment of surgical intervention [2,5,7,8].…”

Section: Introductionmentioning

confidence: 99%

The acromial index is not predictive for failed rotator cuff repair

Meleán

Lichtenberg²,

Montoya

et al. 2013

International Orthopaedics (SICOT)

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Background The main objective of this study was to evaluate the association between the acromial index (AI) and the incidence of recurrent tears of the rotator cuff (RC) in a cohort of patients with full thickness tears who underwent arthroscopic primary repair. Methods A prognostic study of a prospective case series of 103 patients with full thickness RC tears was undertaken. The average age was 59.5 years (39-74) and follow-up was 30.81-months (12-72). True anterior-posterior X-rays were obtained during the pre-operative evaluation. Pre and post-operative magnetic resonance imaging (MRI) were recorded. Results Eighteen cases with recurrent tears (17.4 %) were seen on post-operative MRI. The average AI for patients with recurrent tears was 0.711±0.065 and for patients without recurrent tears 0.710±0.064 (p<0.05). A positive association between age and recurrent tears of the RC was noted (average ages: recurrent tears group 63±5.9 years; group without recurrent tears 58.8±7.5 years) (r=−0.216; p=0.029). We did not find an association between size of the primary tear and recurrent tears (r=−0.075; p<0.05) or between degrees of retraction of the primary and recurrent tears of the cuff (r=−0.073; p<0.05). We observed that 38.9 % of the recurrent tears cases presented with more than one tendon affected before the arthroscopy. At follow-up, none of these recurrent tears showed more than one tendon affected on MRI evaluation. ConclusionIn this study, we found that the AI radiological measurement is not a predictor for recurrent tears of the RC after primary arthroscopic repair.

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Section: Introductionmentioning

confidence: 99%

The acromial index is not predictive for failed rotator cuff repair

Meleán

Lichtenberg²,

Montoya

et al. 2013

International Orthopaedics (SICOT)

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“…Jo et al 9 report their results at 1 year postoperatively, which they acknowledge is too soon to demonstrate meaningful clinical outcomes, but should be sufficient to detect most failures to heal. 12,18 In fact, in this group of patients with tears measuring at least 30 mm anteroposterior in size, they observed a significantly lower failure rate in the PRP-treated group (20%) compared with the conventional group (56%).…”

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confidence: 79%

Άπόπτωσις

Reider¹

2013

Am J Sports Med

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“…Regarding the existence of a new rupture, it was observed that most occur early in the postoperative period and that the initial rupture size and the age of the patient influence their incidence [35,41]. Jost et al [2] also found a relationship between the extent of fat infiltration of the infra-and supraspinatus muscles and the occurrence of new rupture [2].…”

Section: Complete Repairmentioning

confidence: 99%

Rotary Hood Massive Break Solutions? Massive Rotator Cuff Tear Solutions?

Panzina¹,

Gutierres²

2017

MOJOR

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Aim: review the current literature on options of treatment for massive rotator cuff tear Sources of data:The information was researched on the Pubmed using the following keywords: "massive", "rotator", "cuff ", "tear", "treatment". The survey was restricted to articles in english or portuguese, with less than 5 years. After selection 55 articles were used. Summary of data:Massive Rotator Cuff Tear is an orthopaedic challenge with a technically hard repair and a recurrence rate distinctively higher than the smaller tears rate. Its treatment has a high failure rate, which is influenced by factors such as patient's age, fatty degeneration and muscular retraction. The treatment choice should be based on patient's age, functional demands and symptoms. Conclusion:There are several options for the treatment of rotator cuff tears. Conservative treatment achieved good results in many patients, leaving many of them assymptomatic and with satisfactory function. The arthroscopic débridement, subacromial decompression and bicips tenotomy have as main objective the symptomatic relief and may be indicated in elderly patients with low functional demands, whose major complaint is pain. Repair should be tried specially in young symptomatic high-demand patients. Both hemiarthroplasty as reverse arthroplasty may be indicated in massive rupture and cuff arthropathy, being reverse arthroplasty the most effective treatment, although the not negligible mid-term complication rate.

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When Do Rotator Cuff Repairs Fail? Serial Ultrasound Examination After Arthroscopic Repair of Large and Massive Rotator Cuff Tears

Abstract: Recurrent rotator cuff tears are not uncommon after arthroscopic repair of large and massive tears. These recurrent tears appear to occur more frequently in the early postoperative period (within the first 3 months) and are associated with inferior clinical outcomes.

Cited by 278 publications

References 37 publications

The acromial index is not predictive for failed rotator cuff repair

The acromial index is not predictive for failed rotator cuff repair

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Rotary Hood Massive Break Solutions? Massive Rotator Cuff Tear Solutions?

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