Rotater cuff repair

PURPOSE: To evaluate the clinical results of an arthroscopy-assisted latissimus dorsi tendon transfer (aLD) for irreparable posterosuperior cuff tears as a primary surgery. The secondary aim of this study was to quantify the learning curve using the log-linear model. We hypothesized that aLD significantly improved shoulder function and that there was consistent reduction of the operative time in support of a learning-curve effect. METHODS: After the arthroscopic partial repair was completed, the latissimus dorsi tendon was harvested via axillary mini-open incision and fixed with a knotless anchor arthroscopically...

PURPOSE: To compare the outcomes of patients who undergo a long head of the biceps (LHB) procedure (tenotomy or tenodesis) concomitant with rotator cuff repair (RCR) to those of patients who undergo isolated RCR. METHODS: Prospectively collected data were retrospectively reviewed on 80 patients, >18 years old, who underwent repair of a full-thickness rotator cuff tear and with 1-year patient-reported outcome scores collected June 2012 to March 2015. The exclusion criteria were concomitant procedures other than LHB tenotomy, tenodesis, or subacromial decompression; prior shoulder surgery; or other shoulder pathology...

PURPOSE: To investigate the 2-year postoperative clinical and subjective outcomes after arthroscopic rotator cuff repair (ARCR) with xenologous porcine dermal patch augmentation compared with ARCR alone. METHODS: Patients aged 60 years or older with a complete supraspinatus (SSP) tendon tear underwent primary ARCR with a transosseous-equivalent technique. By use of a matched-pair comparative trial design, a consecutive series of 20 patients receiving additional xenologous porcine dermal patch augmentation (patch group) was matched by tear location with 20 patients who received ARCR only (control group)...

BACKGROUND: The repair of anterior L-shaped tears is usually difficult because of the lack of anterior rotator cuff tendon to cover the footprint. The biceps tendon is usually exposed from the retracted anterolateral corner of the torn tendon and can be easily used to augment rotator cuff repair. Hypothesis/Purpose: This study compared the clinical outcomes of the biceps augmentation technique with those of partial tendon repair for the arthroscopic treatment of large anterior L-shaped rotator cuff tears to evaluate the role of additional biceps augmentation in tendon healing...

INTRODUCTION: We report a case of a lost metal platelet from a radiofrequency ablation probe (VAPR VUE Radiofrequency System, Cool Pulse 90, DePuy, Synthes, Switzerland) in the shoulder joint during elective arthroscopic cuff repair. To the best of our knowledge, this kind of an incident during elective arthroscopy has not been described in the literature so far. In addition, we present an algorithm on how to deal with such an incident. CASE REPORT: A 69-year-old woman underwent an arthroscopic subacromial decompression and rotator cuff repair for a torn supraspinatus tendon...

INTRODUCTION: The spectrum of pathoanatomic lesions encountered in anterior shoulder dislocation is broad. There could be a presence of loose bodies, chondral and osteochondral, in the shoulder joint and also concomitant rotator cuff partial tears resulting from acute and chronic shoulder instability. CASE REPORT: We present one case report of a 46-year-old male Chinese with an uncommon case of Bankart lesion, with a full thickness chondral defect over the superior glenoid articular surface manifesting as a large intra-articular loose cartilaginous body...

BACKGROUND: Early repair of isolated supraspinatus tears could prevent further deterioration of the rotator cuff; however, there is no consensus on the management of such tears because of a lack of long-term outcome studies. The purposes of this study were to report the 10-year outcomes of isolated supraspinatus repairs and to investigate the factors that favor healing and recovery. METHODS: We retrieved the records of all 511 patients who, in 2003, underwent repair of full-thickness isolated supraspinatus tears, performed by 15 surgeons at 15 centers...

BACKGROUND: Platelet-rich plasma (PRP) has been applied as an adjunct to rotator cuff repair to improve tendon-bone healing and potentially reduce the incidence of subsequent tendon retears. PURPOSE: To investigate whether the midterm clinical and radiographic outcomes of arthroscopic supraspinatus repair are enhanced after repeated postoperative applications of PRP. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 60 patients (30 control; 30 PRP) were initially randomized to receive 2 ultrasound-guided injections of PRP to the tendon repair site at 7 and 14 days after double-row arthroscopic supraspinatus repair or not...

BACKGROUND: Recent studies have shown a correlation between scapular geometry and the development of atraumatic rotator cuff tears. However, a paucity of literature is available on the effects of critical shoulder angle (CSA) and acromial index (AI) on functional outcomes after arthroscopic rotator cuff repair. Hypothesis/Purpose: The purpose was to investigate the influence of CSA and AI on 24-month functional outcomes after arthroscopic rotator cuff repair. The hypothesis was that a larger CSA or AI would result in poorer postoperative outcomes...

BACKGROUND: The prevalence of rotator cuff repair continues to rise, with a noted transition from open to arthroscopic techniques in recent years. One reported advantage of arthroscopic repair is a lower infection rate. However, to date, the infection rates of these 2 techniques have not been directly compared with large samples at a single institution with fully integrated medical records. PURPOSE: To retrospectively compare postoperative infection rates between arthroscopic and open rotator cuff repair...

BACKGROUND: The purpose of this study was to investigate the prevalence, epidemiology, and outcomes of anterosuperior (A group) rotator cuff tears (RCTs) and posterosuperior (P group) RCTs treated by arthroscopic rotator cuff repair (ARCR). METHODS: A total of 67 A group patients and 14 P group patients were included in the study. RESULTS: The prevalence of the A group (82.3%) was significantly higher than that of the P group (17.7%). CONCLUSION: The outcomes in both groups were good, even though the A group had a higher rate of injury to the LHB than the P group...

This Level II study assessed clinically relevant outcomes for repair of large, retracted infraspinatus tendons (ISTs) using a demineralized bone matrix (DBM) sponge (FlexiGraft) hydrated in platelet-rich plasma (PRP) versus direct repair in a validated canine model. Adult research dogs (n = 10) were used. The IST was transected in each shoulder (n = 20) and randomized to direct repair or repair with DBM-PRP interposition at 4 weeks posttransection. At 12 weeks postrepair, dogs were sacrificed, and the repair evaluated by magnetic resonance imaging (MRI), histology, and biomechanical testing...

BACKGROUND: Current evaluation of muscle fatty infiltration has been limited by subjective classifications. Quantitative fat evaluation through magnetic resonance imaging (MRI) may allow for an improved longitudinal evaluation of the effect of surgical repair on the progression of fatty infiltration. HYPOTHESES: We hypothesized that (1) patients with isolated full-thickness supraspinatus tendon tears would have less progression in fatty infiltration compared with patients with full-thickness tears of multiple tendons and (2) patients with eventual failed repair would have higher baseline levels of fatty infiltration...

PURPOSE: Various researchers have observed small areas of osteolysis after using bioabsorbable anchors in shoulder surgeries. The purpose of this study is to determine whether radiographic perianchor radiolucent rings after rotator cuff repair are associated with the failure of repair and also assess their clinical implications. Further, the most frequent location of the radiolucent rings in the double-row suture bridge configuration was also assessed. METHODS: One hundred and twenty-nine consecutive patients who underwent arthroscopic rotator cuff repair by suture bridge technique were retrospectively evaluated radiographically and clinically...

Tendon-to-bone healing in rotator cuff repair is affected by the method of footprint preparation. Bone drilling and preserving the native fibrocartilage at the tendon attachment site improved tissue quality and mechanical strength of bone-tendon interface in an animal model.

Surgical repair is a common treatment for rotator cuff tear; however, the retear rate is high. A high degree of suture repair strength is important to ensure rotator cuff integrity for healing. The purpose of this study was to compare the mechanical performance of rotator cuffs repaired with a mesh suture vs traditional polydioxanone suture II and FiberWire sutures in a canine in vitro model. Seventy-two canine shoulders were harvested. An infraspinatus tendon tear was created in each shoulder. Two suture techniques-simple interrupted sutures and 2-row suture bridge-were used to reconnect the infraspinatus tendon to the greater tuberosity, using 3 different suture types: mesh suture, polydioxanone suture II, or FiberWire...

BACKGROUND: Arthroscopic subscapularis (SSC) repair is a technically demanding procedure with a long learning curve. As effective completion of resident's practical experience remains controversial, a prospective clinical study was performed to assess the functional and anatomical outcomes of subscapularis (SSC) arthroscopic repair by orthopedic residents. The pathological anatomy of the tears, the surgical approach and the difficulties encountered at the beginning of the learning curve were reported...

PURPOSE: To evaluate the outcomes of two commonly used transosseous-equivalent (TOE) arthroscopic rotator cuff repair (RCR) techniques for full-thickness supraspinatus tendon tears (FTST) using a robust multi-predictor model. METHODS: 155 shoulders in 151 patients (109 men, 42 women; mean age 59 ± 10 years) who underwent arthroscopic RCR of FTST, using either a knotted suture bridging (KSB) or a knotless tape bridging (KTB) TOE technique were included. ASES and SF-12 PCS scores assessed at a minimum of 2 years postoperatively were modeled using propensity score weighting in a multiple linear regression model...

Healing of rotator cuff (RC) injuries with current suture or augmented scaffold techniques fails to regenerate the enthesis and instead forms a weaker fibrovascular scar that is prone to subsequent failure. Regeneration of the enthesis is the key to improving clinical outcomes for RC injuries. We hypothesized that the utilization of our tissue-engineered tendon to repair either an acute or a chronic full-thickness supraspinatus tear would regenerate a functional enthesis and return the biomechanics of the tendon back to that found in native tissue...

BACKGROUND: Arthroscopic rotator cuff repair (ARCR) can be associated with significant postoperative pain. Concern for opioid abuse has led surgeons to identify alternative, efficacious methods of postoperative analgesia. To determine whether transcutaneous electrical nerve stimulation (TENS) can have a similarly beneficial effect after shoulder procedures, we conducted a prospective double-blinded randomized trial in patients undergoing outpatient ARCR. METHODS: All patients undergoing ARCR of a full-thickness rotator cuff tear by the senior authors were identified...