Clinics in Shoulder and Elbow

Korean Shoulder and Elbow Society (대한견·주관절의학회)
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A Mid-Term Reults of Arthroscopic Versus Open Repair for Large and Massive Rotator Cuff Tears

회전근 개 대 파열 및 광범위 파열에 대한 관절경적 봉합술과 개방적 봉합술 간의 중기 결과

  • Wang, Seong-Il (Department of Orthopedic Surgery, Chonbuk National University Medical School) ;
  • Park, Jong-Hyuk (Department of Orthopedic Surgery, Chonbuk National University Medical School)
  • 왕성일 (전북대학교 의학전문대학원 정형외과학교실) ;
  • 박종혁 (전북대학교 의학전문대학원 정형외과학교실)
  • Received : 2011.10.31
  • Accepted : 2011.12.16
  • Published : 2011.12.31
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Abstract

Purpose: To compare the mid-term clinical results of arthroscopic and open repair for large to massive rotator cuff tear. Materials and Methods: We retrospectively reviewed 48 patients who underwent either arthroscopic or open repair for large to massive rotator cuff tear. 28 patients underwent arthroscopic repair and 20 patients had open repair. The clinical outcome for the 2 groups was evaluated using range of motion, Visual Analogue Scale (VAS) for pain and function, American Shoulder and Elbow Society (ASES) score and Korean Shoulder Scoring System (KSS) score. Results: The range of motion, VAS for pain and function and ASES score was improved significantly in both groups at the final follow-up visit compared with preoperative values. However, there were no significant differences between the two groups statistically (p>0.05). There were no significant differences between the two groups statistically at the final follow-up KSS score (p>0.05) either. Conclusion: We could obtain improved mid-term clinical outcomes in both arthroscopic repair and open repair without any statistically significant differences between the two groups.

서론: 회전근 개 대 파열 및 광범위 파열에 대한 관절경적 봉합술 군과 개방적 봉합술 군 간의 중기 임상적 결과를 비교 분석하였다. 대상 및 방법: 회전근 개 대 파열 및 광범위 파열에 대해 봉합술을 실시한 48예 를 후향적으로 분석하였다. 관절경적 봉합술을 시행한 군은 28예, 개방적 봉합술을 시행한 군은 20예 였다. 임상적 결과는 관절운동 범위, 통증과 기능에 대한 VAS, ASES 점수 및 KSS 점수를 평가하였다. 결과: 관절운동 범위, 통증에 대한 VAS 점수, 기능에 대한 VAS 점수 및ASES 점수는 두 군 모두 술 전에 비해 최종 추시상 의미있는 향상을 보였으나 최종 추시상 두 군간에 통계학적으로 유의한 차이는 없었다 (p>0.05). KSS 점수도 최종 추시상 두 군간에 통계학적으로 유의한 차이는 없었다 (p>0.05). 결론: 관절경적 봉합술과 개방적 봉합술 모두 향상된 중기 임상 결과를 얻을 수 있었으며 두 군간에 의미있는 차이는 없었다.

Keywords

References

  1. McKee MD, Yoo DJ. The effect of surgery for rotator cuff disease on general health status. Results of a prospective trial. J Bone Joint Surg Am. 2000;82:970-9. https://doi.org/10.2106/00004623-200007000-00009
  2. Zumstein MA, Jost B, Hempel J, Hodler J, Gerber C. The clinical and structural long-term results of open repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2008;90:2423-31. https://doi.org/10.2106/JBJS.G.00677
  3. Klepps S, Bishop J, Lin J, et al. Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med. 2004; 32:1716-22. https://doi.org/10.1177/0363546504265262
  4. Paulos LE, Kody MH. Arthroscopically Enhanced "Miniapproach"to Ro"tator Cuff Repair. Am J Sports Med. 1994;22:19-25. https://doi.org/10.1177/036354659402200104
  5. Murray TF Jr, Lajtai G, Mileski RM, Snyder SJ. Arthroscopic repair of medium to large full-thickness rotator cuff tears: outcome at 2- to 6-year follow-up. J Shoulder Elbow Surg. 2002;11:19-24. https://doi.org/10.1067/mse.2002.120142
  6. Severud EL, Ruotolo C, Abbott DD, Nottage WM. All-arthroscopic versus mini-open rotator cuff repair: A long-term retrospective outcome comparison. Arthroscopy. 2003;19:234-8. https://doi.org/10.1053/jars.2003.50036
  7. Wilson F, Hinov V, Adams G. Arthroscopic repair of full-thickness tears of the rotator cuff: 2- to 14-year follow-up. Arthroscopy. 2002;18:136-44. https://doi.org/10.1053/jars.2002.30443
  8. Burkhart SS, Danaceau SM, Pearce CE. Arthroscopic rotator cuff repair: analysis of results by tear size and by repair technique: Margin convergence versus direct tendon-to-bone. Arthroscopy. 2001;17:905-12. https://doi.org/10.1053/jars.2001.26821
  9. Jones CK, Savoie FH. Arthroscopic repair of large and massive rotator cuff tears. Arthroscopy. 2003;19: 564-71. https://doi.org/10.1016/S0749-8063(03)00169-5
  10. Cofield RH. Current concept review. Rotator cuff disease of the shoulder. J Bone Joint Surg Am. 1985;67: 974-9. https://doi.org/10.2106/00004623-198567060-00024
  11. Cerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000;82:505-15.
  12. Wierks C, Skolasky RL, Ji JH, McFarland EG. Reverse total shoulder replacement: intraoperative and early postoperative complications. Clin Orthop Relat Res. 2009;467:225-34. https://doi.org/10.1007/s11999-008-0406-1
  13. Yoo JC, Kim JH, Lee YS, Park JH, Kang HJ. Arthroscopic double mattress repair in incomplete subscapularis tears. Orthopedics. 2008;31:851-4. https://doi.org/10.3928/01477447-20080901-39
  14. Richards RR, An KN, Blgliani LU, et al. A standardized method for the assessment of shoulder function. J shoulder Elbow Surg. 1994;3:347-52. https://doi.org/10.1016/S1058-2746(09)80019-0
  15. Tae SK, Rhee YG, Park TS, et al. The development and validation of an appraisal method for rotator cuff disorders. The Korean Shoulder Scoring System. J Shoulder Elbow Surg. 2009;18:689-96. https://doi.org/10.1016/j.jse.2008.11.019
  16. Bigliani LU, Cordasco FA, McIlveen SJ, Musso ES. Operative repair of massive rotator cuff tears. Longterm results. J Shoulder Elbow Surg. 1992;1:120-30. https://doi.org/10.1016/1058-2746(92)90089-L
  17. Nobuhara K, Hata Y, Komai M. Surgical procedures and results of repair of massive tears of the rotator cuff. Clin Orthop Relat Res. 1994;304:54-9.
  18. Levy HJ, Uribe JW, Kelaney LG. Arthroscopic assisted rotator cuff repair: preliminary results. Arthroscopy. 1990;6:55-60. https://doi.org/10.1016/0749-8063(90)90099-Y
  19. Karas EH, Iannotti JP. Failed repair of the rotator cuff: evaluation and treatment of complication. Instr Course Lect. 1998;47:87-95.
  20. Seo JB, Bahng SC. Early complications after repair of massive rotator cuff tear. J Korean Shoulder Elbow Soc. 2006;9:27-33. https://doi.org/10.5397/CiSE.2006.9.1.027
  21. Romeo AA, Hang DW, Bach BR, Shott S. Repair of full thickness rotator cuff tears. Clin Orthop Relat Res. 1999;367:243-55.
  22. Kim SH, Ha KI, Park JH, Kang JS, Oh SK, Oh IV. Arthroscopic versus mini-open salvage repair of the rotator cuff tear: Outcome analysis at 2 to 6 years' follow-up. Arthroscopy. 2003;19:746-54. https://doi.org/10.1016/S0749-8063(03)00395-5
  23. Sugaya H, Maeda K, Matsuki K, Moriishi J. Functional and structural outcome after arthroscopic full thickness rotator cuff repair: single-row versus dualrow fixation. Arthroscopy. 2005;21:1307-16. https://doi.org/10.1016/j.arthro.2005.08.011
  24. Yoo JC, Ahn JH, Yang JH, Koh KH, Choi SH, Yoon YC. Correlation of arthroscopic repairability of large to massive rotator cuff tears with preoperative magnetic resonance imaging scans. Arthroscopy. 2009;25:573-82. https://doi.org/10.1016/j.arthro.2008.12.015
  25. Rockwood CA, Williams GR, Burkhead WZ. Debridement of degenerative, irreparable lesions of the rotator cuff. J Bone Joint Surg Am. 1995;77:857-66. https://doi.org/10.2106/00004623-199506000-00006
  26. Elhassan B, Ozbaydar M, Massimini D, Diller D, Higgins L, Warner JJ. Transfer of pectoralis major for the treatment of irreparable tears of subscapularis:does it work? J Bone Joint Surg Br. 2008;90:1059-65. https://doi.org/10.1302/0301-620X.90B8.20659
  27. Moser M, Jablonski MV, Horodyski M, Wright TW. Functional outcome of surgically treated massive rotator cuff tears: a comparison of complete repair, partial repair, and debridement. Orthopedics. 2007;30:479-82.
  28. Gerber C, Pennington SD, Nyffeler RW. Reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2009;17:284-95.
  29. Duralde XA, Bair B. Massive rotator cuff tears: the result of partial rotator cuff repair. J Shoulder Elbow Surg. 2005;14:121-7. https://doi.org/10.1016/j.jse.2004.06.015
  30. Yoo JC, Ko KH, Woo KJ. Clinical result of arthroscopic partial repairs in massive rotator cuff tears. J Korean Shoulder Elbow Soc. 2009;12:150-8. https://doi.org/10.5397/CiSE.2009.12.2.150
  31. Park JY, Lhee SH, Choi JH, Park HK, Yu JW, Seo JB. Comparison of the clinical outcomes of single with double row repair in rotator cuff tears. Am J Sports Med. 2008;36:1310-6. https://doi.org/10.1177/0363546508315039
  32. Calvert PT, Packer NP, Stoker DJ, Bayley JI, Kessel L. Arthrography of the shoulder after operative repair of the torn rotator cuff. J Bone Joint Surg Br. 1986;68: 147-50.
  33. Hanusch BC, Goodchild L, Finn P, Rangan A. Large and massive tears of the rotator cuff: functional outcome and integrity of the repair after a mini-open procedure. J Bone Joint Surg Br. 2009;91:201-5. https://doi.org/10.1302/0301-620X.91B2.21286
  34. Liu SH, Baker CL. Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994;10:54-60. https://doi.org/10.1016/S0749-8063(05)80293-2