ARTIGO DO MÊS - (19/2009)

Prospective analysis of arthroscopic rotator cuff repair: Subgroup analysis

Nho, S. J.; Shindle, M. K.; Adler, R. S.; Warren, R. F.; Altchek, D. W.; Macgillivray, J. D.
J Shoulder Elbow Surg. 2009 Mar 6. [Epub ahead of print]

http://www.ncbi.nlm.nih.gov/pubmed/19269861?dopt=Citation

ABSTRACT

Background: The rotator cuff registry was established to prospectively evaluate the effectiveness of arthroscopic rotator cuff repair. The purpose of the present study is to report the preliminary data at the one-year and two-year time point, and perform subgroup analysis to identify factors that may affect outcome.

Methods: A total of one hundred ninety-three patients underwent all-arthroscopic repair of a rotator cuff tear and met the inclusion criteria, and 127 (65.8%) completed two-year follow-up. The outcome measurements included physical examination, manual muscle testing, the American Shoulder and Elbow Surgeons (ASES) score and ultrasonography.

Results: The pre-operative ASES score was 52.37 and improved to 83.88 at one year and 92.65 at two years. The percent healing for all patientswas 64.10% at 3 months and 64.34% at 1 year. At two years, there was a significant increase in the percentage of healed tendon at 75.42%compared to the three-month and the one-year timepoints.

Patients with intact tendons had an ASES score of 93.9 compared to tendon defects with a score of 88.0. Gender, tear size, and acromioclavicular joint involvement have a significant effect on ASES score.

Conclusion: Rotator cuff characteristics such as tear size, biceps pathology, acromioclavicular joint pathology, and tissue quality have a significant effect on post-operative tendon integrity. Arthroscopic rotator cuff repair demonstrates significant improvement in clinical outcomes and good rate of healing by post-operative ultrasound. Longer term studies are necessary to determine the efficacy over time.

Keywords: Arthroscopic rotator cuff repair; healing; ultrasound

Level of evidence: 3; Retrospective cohort study.
2009 Journal of Shoulder and Elbow Surgery Board of Trustees.


(...) The degree of rotator cuff size and associated pathology appear to have a dramatic affect on postoperative tendon integrity as well as age, to a lesser extent (...)