Clinics in Shoulder and Elbow

대한견·주관절의학회 (Korean Shoulder and Elbow Society)
권호 표지
DOI QR코드

DOI QR Code

Treatment of Large and Massive Rotator Cuff Tears: Does Infraspinatus Muscle Tear Affect Repair Integrity?

  • Choi, Sungwook (Department of Orthopedic Surgery, Jeju National University School of Medicine) ;
  • Yang, Hyunchul (Department of Orthopedic Surgery, Jeju National University School of Medicine) ;
  • Kang, Hyunseong (Department of Orthopedic Surgery, Jeju National University School of Medicine) ;
  • Kim, Gyeong Min (Department of Orthopedic Surgery, Jeju National University School of Medicine)
  • 투고 : 2019.09.06
  • 심사 : 2019.11.03
  • 발행 : 2019.12.01
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Background: Clinical outcomes and prognosis of large and massive rotator cuff tears are known to be unpredictable not only in degeneration of the rotator cuff, but also due to a high rate of retear. Methods: Totally, 81 patients who had undergone arthroscopic rotator cuff repair from May 2008 to February 2016 were evaluated in our study. Clinical and functional evaluations were performed with the Constant score and the University of California, Los Angeles (UCLA) score, as well as full physical examination of the shoulder. All patients were confirmed to have magnetic resonance imaging (MRI) of tendon healing at least 1 year postoperatively. Results: The average age at the time of surgery was 65 years (range, 47-78 years). The average duration of postoperative time in which a follow-up MRI was performed was 36.1 months (range, 12-110 months). Large tears were present in 48 cases (59.3%) and massive tears in 33 cases (40.7%). Overall, there were 33 retear cases (40.7%). All the average clinical outcome scores were significantly improved at the last follow-up (p<0.001), although repair integrity was not maintained. Compared to type A, types C, and D of the Collin's classification showed significantly higher retear rates (p=0.036). Conclusions: Arthroscopic rotator cuff repair yields improved clinical outcomes and a relatively high degree of patient satisfaction, despite the repair integrity not being maintained. Involvement of the subscapularis muscle or infraspinatus muscle had no effect on the retear rate.

키워드

참고문헌

  1. Goutallier D, Postel JM, Gleyze P, Leguilloux P, Van Driessche S. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg. 2003;12(6):550-4. doi: 10.1016/s1058-2746(03)00211-8.
  2. Burkhart SS, Barth JR, Richards DP, Zlatkin MB, Larsen M. Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthroscopy. 2007;23(4):347-54. doi:10.1016/j.arthro.2006.12.012.
  3. Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Joint Surg Am. 2005;87(6):1229-40. doi: 10.2106/JBJS.D.02035.
  4. Choi S, Kim MK, Kim GM, Roh YH, Hwang IK, Kang H. Factors associated with clinical and structural outcomes after arthroscopic rotator cuff repair with a suture bridge technique in medium, large, and massive tears. J Shoulder Elbow Surg. 2014;23(11):1675-81. doi: 10.1016/j.jse.2014.02.021.
  5. Anley CM, Chan SK, Snow M. Arthroscopic treatment options for irreparable rotator cuff tears of the shoulder. World J Orthop. 2014;5(5):557-65. doi: 10.5312/wjo.v5.i5.557.
  6. Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM. Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am. 2001;83(1):71-7. doi: 10.2106/00004623-200101000-00010.
  7. Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000;82(4):505-15. doi: 10.2106/00004623-200004000-00006.
  8. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;(214):160-4.
  9. Duquin TR, Buyea C, Bisson LJ. Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review. Am J Sports Med. 2010;38(4):835-41. doi:10.1177/0363546509359679.
  10. Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007;89(5):953-60. doi: 10.2106/JBJS.F.00512.
  11. Collin P, Matsumura N, Ladermann A, Denard PJ, Walch G. Relationship between massive chronic rotator cuff tear pattern and loss of active shoulder range of motion. J Shoulder Elbow Surg. 2014;23(8):1195-202. doi: 10.1016/j.jse.2013.11.019.
  12. Park JY, Lhee SH, Choi JH, Park HK, Yu JW, Seo JB. Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears. Am J Sports Med. 2008;36(7):1310-6. doi: 10.1177/0363546508315039.
  13. Neri BR, Chan KW, Kwon YW. Management of massive and irreparable rotator cuff tears. J Shoulder Elbow Surg. 2009;18(5):808-18. doi: 10.1016/j.jse.2009.03.013.
  14. 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(6):573-82. doi: 10.1016/j.arthro.2008.12.015.
  15. Bedi A, Dines J, Warren RF, Dines DM. Massive tears of the rotator cuff. J Bone Joint Surg Am. 2010;92(9):1894-908. doi:10.2106/JBJS.I.01531.
  16. Berhouet J, Collin P, Benkalfate T, et al.; Societe d'Orthopedie de l'Ouest. Massive rotator cuff tears in patients younger than 65 years. Epidemiology and characteristics. Orthop Traumatol Surg Res. 2009;95(4 Suppl 1):S13-8. doi: 10.1016/j.otsr.2009.03.006.
  17. Carbonel I, Martinez AA, Aldea E, Ripalda J, Herrera A. Outcome and structural integrity of rotator cuff after arthroscopic treatment of large and massive tears with double row technique: a 2-year followup. Adv Orthop. 2013;2013:914148. doi: 10.1155/2013/914148.
  18. Favard L, Berhouet J, Colmar M, et al.; Societe d'orthopedie de l'Ouest. Massive rotator cuff tears in patients younger than 65 years. What treatment options are available? Orthop Traumatol Surg Res. 2009;95(4 Suppl 1):S19-26. doi: 10.1016/j.otsr.2009.03.005.
  19. Paxton ES, Teefey SA, Dahiya N, Keener JD, Yamaguchi K, Galatz LM. Clinical and radiographic outcomes of failed repairs of large or massive rotator cuff tears: minimum ten-year follow-up. J Bone Joint Surg Am. 2013;95(7):627-32. doi:10.2106/JBJS.L.00255.
  20. Cho NS, Lee BG, Rhee YG. Arthroscopic rotator cuff repair using a suture bridge technique: is the repair integrity actually maintained? Am J Sports Med. 2011;39(10):2108-16. doi:10.1177/0363546510397171.
  21. Cho NS, Yi JW, Lee BG, Rhee YG. Retear patterns after arthroscopic rotator cuff repair: single-row versus suture bridge technique. Am J Sports Med. 2010;38(4):664-71. doi:10.1177/0363546509350081.
  22. Miller BS, Downie BK, Kohen RB, et al. When do rotator cuff repairs fail? Serial ultrasound examination after arthroscopic repair of large and massive rotator cuff tears. Am J Sports Med. 2011;39(10):2064-70. doi: 10.1177/0363546511413372.
  23. Park JS, Park HJ, Kim SH, Oh JH. Prognostic factors affecting rotator cuff healing after arthroscopic repair in small to medium-sized tears. Am J Sports Med. 2015;43(10):2386-92. doi:10.1177/0363546515594449.

피인용 문헌

  1. Suture Slippage After Arthroscopic Cuff Repair: Medial Displacement of Suture Knots on Follow-up Ultrasonography vol.9, pp.8, 2019, https://doi.org/10.1177/23259671211021820