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Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 12/2018

04.05.2018 | Shoulder

Arthroscopic rotator cuff surgery following shoulder trauma improves outcome despite additional pathologies and slow recovery

verfasst von: Barak Haviv, Tal Frenkel Rutenberg, Shlomo Bronak, Mustafa Yassin

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 12/2018

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Abstract

Purpose

To compare the outcome, recovery and surgical findings after shoulder arthroscopy of clinically defined traumatic and non-traumatic rotator cuff pathology in middle-aged patients.

Methods

Of the patients who underwent rotator cuff surgery, 37 patients who reported a preceding shoulder injury related to their shoulder symptoms (traumatic group) were compared to a control group of 58 patients without a preceding injury (non-traumatic group), matched by age, body mass index and comorbidities. Data included demographic details, patient history, surgical findings, the Oxford Shoulder Score questionnaires and overall satisfaction from surgery.

Results

The mean follow-up time was 33.2 ± 14.4 months. More concomitant pathologies were found in the study group. The proportion of large and massive supraspinatus tears was double in the study group (43%) compared to the control group (22%). The Oxford Shoulder Score (OSS) improved significantly after surgery in both groups (p < 0.001) with no differences between groups in OSS and overall satisfaction from surgery. Patients in the study group felt recovered at an average time of 6.1 ± 4.6 months from surgery, while patients in the control group felt recovered at 4.2 ± 2.6 months (p = 0.02). Patients who were operated at the first 6 months after the injury had better improvement in OSS than patients who were operated later.

Conclusion

Surgical arthroscopy for rotator pathology of the shoulder in middle-aged patients improved pain and function regardless of a traumatic onset; however, earlier repair after trauma resulted in better outcome scores. Larger full-thickness tears and concomitant pathologies were more common after injury.

Study design

Level III.
Literatur
1.
Zurück zum Zitat Bassett RW, Cofield RH (1983) Acute tears of the rotator cuff: the timing of surgical repair. Clin Orthop Relat Res 175:18–24 Bassett RW, Cofield RH (1983) Acute tears of the rotator cuff: the timing of surgical repair. Clin Orthop Relat Res 175:18–24
2.
Zurück zum Zitat Bjornsson HC, Norlin R, Johansson K, Adolfsson LE (2011) The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders. Acta Orthop 82:187–192CrossRef Bjornsson HC, Norlin R, Johansson K, Adolfsson LE (2011) The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders. Acta Orthop 82:187–192CrossRef
3.
Zurück zum Zitat Braune C, von Eisenhart-Rothe R, Welsch F, Teufel M, Jaeger A (2003) Midterm results and quantitative comparison of postoperative shoulder function in traumatic and non-traumatic rotator cuff tears. Arch Orthop Trauma Surg 123:419–424CrossRef Braune C, von Eisenhart-Rothe R, Welsch F, Teufel M, Jaeger A (2003) Midterm results and quantitative comparison of postoperative shoulder function in traumatic and non-traumatic rotator cuff tears. Arch Orthop Trauma Surg 123:419–424CrossRef
4.
Zurück zum Zitat Butler BR, Byrne AN, Higgins LD, Shah A, Fowler RL (2013) Results of the repair of acute rotator cuff tears is not influenced by tear retraction. Int J Shoulder Surg 7:91–109CrossRef Butler BR, Byrne AN, Higgins LD, Shah A, Fowler RL (2013) Results of the repair of acute rotator cuff tears is not influenced by tear retraction. Int J Shoulder Surg 7:91–109CrossRef
5.
Zurück zum Zitat Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL (2012) National trends in rotator cuff repair. J Bone Jt Surg Am 94:227–233CrossRef Colvin AC, Egorova N, Harrison AK, Moskowitz A, Flatow EL (2012) National trends in rotator cuff repair. J Bone Jt Surg Am 94:227–233CrossRef
6.
Zurück zum Zitat Dawson J, Harris KK, Doll H, Fitzpatrick R, Carr A (2016) A comparison of the Oxford shoulder score and shoulder pain and disability index: factor structure in the context of a large randomized controlled trial. Patient Relat Outcome Meas 7:195–203CrossRef Dawson J, Harris KK, Doll H, Fitzpatrick R, Carr A (2016) A comparison of the Oxford shoulder score and shoulder pain and disability index: factor structure in the context of a large randomized controlled trial. Patient Relat Outcome Meas 7:195–203CrossRef
7.
Zurück zum Zitat Duncan NS, Booker SJ, Gooding BW, Geoghegan J, Wallace WA, Manning PA (2015) Surgery within 6 months of an acute rotator cuff tear significantly improves outcome. J Shoulder Elbow Surg 24:1876–1880CrossRef Duncan NS, Booker SJ, Gooding BW, Geoghegan J, Wallace WA, Manning PA (2015) Surgery within 6 months of an acute rotator cuff tear significantly improves outcome. J Shoulder Elbow Surg 24:1876–1880CrossRef
8.
Zurück zum Zitat Gerber C, Hersche O, Farron A (1996) Isolated rupture of the subscapularis tendon. J Bone Jt Surg Am 78:1015–1023CrossRef Gerber C, Hersche O, Farron A (1996) Isolated rupture of the subscapularis tendon. J Bone Jt Surg Am 78:1015–1023CrossRef
9.
Zurück zum Zitat Gerber C, Meyer DC, Schneeberger AG, Hoppeler H, von Rechenberg B (2004) Effect of tendon release and delayed repair on the structure of the muscles of the rotator cuff: an experimental study in sheep. J Bone Jt Surg Am 86:1973–1982CrossRef Gerber C, Meyer DC, Schneeberger AG, Hoppeler H, von Rechenberg B (2004) Effect of tendon release and delayed repair on the structure of the muscles of the rotator cuff: an experimental study in sheep. J Bone Jt Surg Am 86:1973–1982CrossRef
10.
Zurück zum Zitat Hantes ME, Karidakis GK, Vlychou M, Varitimidis S, Dailiana Z, Malizos KN (2011) A comparison of early versus delayed repair of traumatic rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 19:1766–1770CrossRef Hantes ME, Karidakis GK, Vlychou M, Varitimidis S, Dailiana Z, Malizos KN (2011) A comparison of early versus delayed repair of traumatic rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 19:1766–1770CrossRef
11.
Zurück zum Zitat Ide J, Tokiyoshi A, Hirose J, Mizuta H (2007) Arthroscopic repair of traumatic combined rotator cuff tears involving the subscapularis tendon. J Bone Jt Surg Am 89:2378–2388 Ide J, Tokiyoshi A, Hirose J, Mizuta H (2007) Arthroscopic repair of traumatic combined rotator cuff tears involving the subscapularis tendon. J Bone Jt Surg Am 89:2378–2388
12.
Zurück zum Zitat Jeong JY, Song SY, Yoo JC, Park KM, Lee SM (2017) Comparison of outcomes with arthroscopic repair of acute-on-chronic within 6 months and chronic rotator cuff tears. J Shoulder Elbow Surg 26:648–655CrossRef Jeong JY, Song SY, Yoo JC, Park KM, Lee SM (2017) Comparison of outcomes with arthroscopic repair of acute-on-chronic within 6 months and chronic rotator cuff tears. J Shoulder Elbow Surg 26:648–655CrossRef
13.
Zurück zum Zitat Lahteenmaki HE, Virolainen P, Hiltunen A, Heikkila J, Nelimarkka OI (2006) Results of early operative treatment of rotator cuff tears with acute symptoms. J Shoulder Elbow Surg 15:148–153CrossRef Lahteenmaki HE, Virolainen P, Hiltunen A, Heikkila J, Nelimarkka OI (2006) Results of early operative treatment of rotator cuff tears with acute symptoms. J Shoulder Elbow Surg 15:148–153CrossRef
14.
Zurück zum Zitat Mall NA, Lee AS, Chahal J, Sherman SL, Romeo AA, Verma NN, Cole BJ (2013) An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy 29(2):366–376CrossRef Mall NA, Lee AS, Chahal J, Sherman SL, Romeo AA, Verma NN, Cole BJ (2013) An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy 29(2):366–376CrossRef
15.
Zurück zum Zitat Mukovozov I, Byun S, Farrokhyar F, Wong I (2013) Time to surgery in acute rotator cuff tear: a systematic review. Bone Jt Res 2:122–128CrossRef Mukovozov I, Byun S, Farrokhyar F, Wong I (2013) Time to surgery in acute rotator cuff tear: a systematic review. Bone Jt Res 2:122–128CrossRef
16.
Zurück zum Zitat Namdari S, Henn RF III, Green A (2008) Traumatic anterosuperior rotator cuff tears: the outcome of open surgical repair. J Bone Jt Surg Am 90:1906–1913CrossRef Namdari S, Henn RF III, Green A (2008) Traumatic anterosuperior rotator cuff tears: the outcome of open surgical repair. J Bone Jt Surg Am 90:1906–1913CrossRef
17.
Zurück zum Zitat Petersen SA, Murphy TP (2011) The timing of rotator cuff repair for the restoration of function. J Shoulder Elbow Surg 20:62–68CrossRef Petersen SA, Murphy TP (2011) The timing of rotator cuff repair for the restoration of function. J Shoulder Elbow Surg 20:62–68CrossRef
18.
Zurück zum Zitat Post M, Silver R, Singh M (1983) Rotator cuff tear. Diagnosis and treatment. Clin Orthop Relat Res 173:78–91 Post M, Silver R, Singh M (1983) Rotator cuff tear. Diagnosis and treatment. Clin Orthop Relat Res 173:78–91
19.
Zurück zum Zitat Tan M, Lam PH, Le BT, Murrell GA (2016) Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 25(1):12–21CrossRef Tan M, Lam PH, Le BT, Murrell GA (2016) Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 25(1):12–21CrossRef
20.
Zurück zum Zitat Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA (2006) The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Jt Surg Am 88:1699–1704CrossRef Yamaguchi K, Ditsios K, Middleton WD, Hildebolt CF, Galatz LM, Teefey SA (2006) The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Jt Surg Am 88:1699–1704CrossRef
21.
Zurück zum Zitat Yamamoto A, Takagishi K, Osawa T et al (2010) Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 19:116–120CrossRef Yamamoto A, Takagishi K, Osawa T et al (2010) Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 19:116–120CrossRef
Metadaten
Titel
Arthroscopic rotator cuff surgery following shoulder trauma improves outcome despite additional pathologies and slow recovery
verfasst von
Barak Haviv
Tal Frenkel Rutenberg
Shlomo Bronak
Mustafa Yassin
Publikationsdatum
04.05.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 12/2018
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-018-4969-4

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