Dataset Information

Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

ABSTRACT:

Background

Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors-including age, sex, and tear severity-have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial.

Purpose

To investigate the influence of tear etiology (degenerative vs traumatic) on functional and structural outcomes in patients with supraspinatus tendon tears.

Study design

Cohort study; Level of evidence, 2.

Methods

Patients undergoing ARCR from 19 centers were prospectively enrolled between June 2020 and November 2021. Full-thickness, nonmassive tears involving the supraspinatus tendon were included. Tears were classified as degenerative (chronic shoulder pain, no history of trauma) or traumatic (acute, traumatic onset, no previous shoulder pain). Range of motion, strength, the Subjective Shoulder Value, the Oxford Shoulder Score (OSS), and the Constant-Murley Score (CMS) were assessed before (baseline) and 6 and 12 months after ARCR. The Subjective Shoulder Value and the OSS were also determined at the 24-month follow-up. Repair integrity after 12 months was documented, as well as additional surgeries up to the 24-month follow-up. Tear groups were compared using mixed models adjusted for potential confounding effects.

Results

From a cohort of 973 consecutive patients, 421 patients (degenerative tear, n = 230; traumatic tear, n = 191) met the inclusion criteria. The traumatic tear group had lower mean baseline OSS and CMS scores but significantly greater score changes 12 months after ARCR (OSS, 18 [SD, 8]; CMS, 34 [SD,18] vs degenerative: OSS, 15 [SD, 8]; CMS, 22 [SD, 15]) (P < .001) and significantly higher 12-month overall scores (OSS, 44 [SD, 5]; CMS, 79 [SD, 9] vs degenerative: OSS, 42 [SD, 7]; CMS, 76 [SD, 12]) (P≤ .006). At the 24-month follow-up, neither the OSS (degenerative, 44 [SD, 6]; traumatic, 45 [SD, 6]; P = .346) nor the rates of repair failure (degenerative, 14 [6.1%]; traumatic 12 [6.3%]; P = .934) and additional surgeries (7 [3%]; 7 [3.7%]; P = .723) differed between groups.

Conclusion

Patients with degenerative and traumatic full-thickness supraspinatus tendon tears who had ARCR show satisfactory short-term functional results. Although patients with traumatic tears have lower baseline functional scores, they rehabilitate over time and show comparable clinical results 1 year after ARCR. Similarly, degenerative and traumatic rotator cuff tears show comparable structural outcomes, which suggests that degenerated tendons retain healing potential.

SUBMITTER: Baum C

PROVIDER: S-EPMC10838469 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

Baum Cornelia C Audigé Laurent L Stojanov Thomas T Müller Sebastian A SA Candrian Christian C Müller Andreas M AM Rosso Claudio C Fankhauser Lena L Willscheid Gernot G Moroder Philipp P Akgün Doruk D Danzinger Victor V Gebauer Henry H Imiolczyk Jan-Philipp JP Karpinski Katrin K Lacheta Lucca L Minkus Marvin M Paksoy Alp A Samaniego Eduardo E Thiele Kathi K Weiss Isabella I Suter Thomas T Müller-Lebschi Julia J Mueller Sebastian S Saner Markus M Haag-Schumacher Claudia C Tamborrini-Schütz Giorgio G Trong Mai Lan Dao MLD Buitrago-Tellez Carlos C Hasler Julian J Riede Ulf U Weber Sandra S Moor Beat B Biner Matthias M Fournier Sarah S Gallusser Nicolas N Marietan Deborah D Pawlak Sebastien S Spormann Christoph C Hansen Britta B Mamisch Nadja N Durchholz Holger H Bräm Jakob J Cunningham Gregory G Kourhani Abed A Ossipow Sarah S Simao Patricia P Lädermann Alexandre A Egli Rainer R Erdbrink Stephanie S Flückiger Remy R Lombardo Paolo P Pinworasarn Tawan T Scacchi Philipp P Weihs Johannes J Zumstein Matthias M Flury Matthias M Berther Ralph R Ehrmann Christine C Hübscher Larissa L Schwappach David D Eid Karim K Bensler Susanne S Fritz Yannick Y Grünberger Nisha N Kriechling Philipp P Langthaler Daniel D Niehaus Richard R Nobs Raffaela R Benninger Emanuel E de Groot Quintin Q Doert Aleksis A Ebert Sebastian S Grimm Philemon P Mottier Fabian F Pisan Markus M Schätz Jan J Schwank Ariane A Wiedenbach Julian J Scheibel Markus M Audigé Laurent L Bellmann Frederik F Brune Daniela D de Jong Marije M Diermayr Stefan S Endell David D Etter Marco M Freislederer Florian F Gkikopoulos Nikitas N Glanzmann Michael M Grobet Cécile C Jung Christian C Moro Fabrizio F Moroder Philipp P Ringer Ralph R Schätz Jan J Schwyzer Hans-Kaspar HK Weber Béatrice B Wehrli Martina M Wirth Barbara B Nötzli Manuela M Franz Anne A Oswald Jörg J Steiger Birgit B Ameziane Yacine Y Child Christopher C Spagna Giovanni G Candrian Christian C Del Grande Filippo F Feltri Pietro P Filardo Giuseppe G Marbach Francesco F Schönweger Florian F Jost Bernhard B Badulescu Michael M Lüscher Stephanie S Napieralski Fabian F Öhrström Lena L Olach Martin M Rechsteiner Jan J Scheler Jörg J Spross Christian C Zdravkovic Vilijam V Zumstein Matthias A MA Chlasta Adrian A Gerber Kate K Hayoz Annabel A Müller-Lebschi Julia J Schuster Frederick F Wieser Karl K Borbas Paul P Bouaicha Samy S Camenzind Roland R Catanzaro Sabrina S Gerber Christian C Grubhofer Florian F Hasler Anita A Hochreiter Bettina B Marcus Roy R Selman Farah F Sutter Reto R Wyss Sabine S Appenzeller-Herzog Christian C Aghlmandi Soheila S Ahlborn Ilona I Baum Cornelia C Eckers Franziska F Grezda Kushtrim K Hatz Simone S Hunziker Sabina S Stojanov Thomas T Taha Mohy M Tamborrini-Schütz Giorgio G Mueller Andreas Marc AM

The American journal of sports medicine 20240123 2

<h4>Background</h4>Arthroscopic rotator cuff repair (ARCR) is among the most commonly performed orthopaedic procedures. Several factors-including age, sex, and tear severity-have been identified as predictors for outcome after repair. The influence of the tear etiology on functional and structural outcome remains controversial.<h4>Purpose</h4>To investigate the influence of tear etiology (degenerative vs traumatic) on functional and structural outcomes in patients with supraspinatus tendon tears ...[more]

PMID: 38259113

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Project description:PurposeTo determine the likelihood of and risk factors for tear progression among patients with a symptomatic partial or full-thickness rotator cuff tears (RCTs) who return with continued shoulder pain and obtain subsequent magnetic resonance imaging (MRI) and to identify various patient factors and MRI findings associated with rotator cuff tear progression.MethodsWe performed a retrospective review of MRI studies from Veteran's Affair patients with conservatively treated partial- or full-thickness rotator cuff tears. Patient characteristics and demographics were obtained via chart review. Tear characteristics were measured on MRI obtained a minimum of 1 year apart. We defined progression as either (1) an increase from a partial to a full-thickness tear or (2) an increase in tear width or retraction of at least 5 mm. Statistical analysis using χ2, Fisher exact, Student t, and Mann-Whitney U test was then performed as appropriate, looking for factors involved in RCT progression.ResultsWe evaluated 412 MRI studies from 206 Veteran's Affair patients with conservatively treated partial- or full-thickness rotator cuff tears from October 1999 to March 2020. Overall, 61% of RCTs had progressed at a mean of 3.2 ± 2.3 years follow-up. Among all patients, 74% of full-thickness tears progressed in size, 42% of partial-thickness tears progressed in size, and 29% of partial-thickness tears progressed to full-thickness tears. On univariate analysis, full-thickness tears (P < .001), disruption of the anterior rotator cuff cable (P = .001), subscapularis involvement (P = .004), tear retraction (P < .001), and tear width (P < .001) all increased the likelihood of progression. On multivariate analysis, full-thickness tears (P < .001) and subscapularis involvement (P = .045) were correlated with progression.ConclusionsRCTs progress over time in terms of size of tear and from partial- to full-thickness tears. There is an increased risk of tear progression in patients with full-thickness tears when compared with partial-thickness tears along with subscapularis tear involvement. Rates of progression are larger than previously reported rates for both partial- and full-thickness tears, noting that our study population were those patients who continued to be symptomatic from their tears.Level of evidenceLevel IV, prognostic case series.

Project description:BACKGROUND: The single-row and double-row fixation techniques have been widely used for rotator cuff tears. However, whether the double-row technique produces superior clinical or anatomic outcomes is still considered controversial. This study aims to use meta-analysis to compare the clinical and anatomical outcomes between the two techniques. METHODS: The Pubmed, Embase, and Cochrane library databases were searched for relevant studies published before November 1, 2012. Studies clearly reporting a comparison of the single-row and double-row techniques were selected. The Constant, ASES, and UCLA scale systems and the rotator cuff integrity rate were evaluated. The weighted mean differences and relative risks were calculated using a fixed-effects or random-effects model. RESULTS: Eight studies were included in this meta-analysis. The weighted mean differences of the ASES (-0.84; P?=?0.04; I(2)?=?0%) and UCLA (-0.75; P?=?0.007; I(2)?=?0%) scales were significantly low in the single-row group for full-thickness rotator cuff tears. For tear sizes smaller than 3 cm, no significant difference was found between the groups no matter in Constant (P?=?0.95; I(2)?=?0%), ASES (P?=?0.77; I(2)?=?0%), or UCLA (P?=?0.24; I(2)?=?13%) scales. For tear sizes larger than 3 cm, the ASES (-1.95; P?=?0.001; I(2)?=?49%) and UCLA (-1.17; P?=?0.006; I(2)?=?0%) scales were markedly lower in the single-row group. The integrity of the rotator cuff (0.81; P?=?0.0004; I(2)?=?10%) was greater and the partial thickness retear rate (1.93; P?=?0.007; I(2)?=?10%) was less in the double-row group. Full-thickness retears showed no difference between the groups (P?=?0.15; I(2)?=?0%). CONCLUSION: The meta-analysis suggests that the double-row fixation technique increases post-operative rotator cuff integrity and improves the clinical outcomes, especially for full-thickness rotator cuff tears larger than 3 cm. For tear sizes smaller than 3 cm, there was no difference in the clinical outcomes between the two techniques. LEVEL OF EVIDENCE: Level I.

Dataset Information

Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

Background

Purpose

Study design

Methods

Results

Conclusion

Publications

Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the Supraspinatus Tendon.

Similar Datasets

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