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European Journal of Orthopaedic Surgery & Traumatology

Erschienen in:

03.04.2021 | Original Article

Early versus delayed repair of traumatic rotator cuff tears. Does timing matter on outcomes?

verfasst von: Vishal Patel, Christopher Thomas, Helen Fort, Richard Wood, Amit Modi, Radhakant Pandey, Harvinder Singh, Alison Armstrong

Erschienen in: European Journal of Orthopaedic Surgery & Traumatology | Ausgabe 2/2022

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Abstract

Introduction

The purpose of this study was to determine if delay (before or after 4 months) in repairing a symptomatic traumatic rotator cuff tear affected clinical outcome, re-rupture rates and use of interpositional dermal grafts.

Methods

This was a case matched (age + tear size) series of patients who underwent an early (≤ 4 months) or delayed (> 4 months) rotator cuff repair following a traumatic tear. If a direct repair could not be achieved a dermal interposition graft was used. Outcomes were collected at a median time of 30 months post-operatively using the Oxford, Constant and EQ5D scores.

Results

Twenty patients underwent rotator cuff repair within 4 months (1–4) of injury. Twenty age and cuff tear size—matched patients were identified who had undergone a delayed repair (4.1–24 months) after injury. We found no significant difference (p > 0.05) in patient reported outcomes scores between the early and delayed repair. [Oxford scores; Early 43(13–48), Delayed 45 (31–48); Constant scores; Early 73 (21–94), Delayed 73.5 (44–87); EQ5D; Early 0.75 (0.25–1), Delayed 0.77 (0.4–1)]. Time to full recovery was significantly longer (14 vs 33.8 months) for the delayed repair group (P > 0.05).

When cuff tears were subdivided into < 3 cm tears or ≥ 3 cm tears, no significant difference outcome scores were founds. However, use of dermal interposition graft was 44% in delayed group for tears ≥ 3 cm. No grafts were used in early repair group. There was one symptomatic re-tear in our series which was in the early repair group.

Conclusion

When compared to the delayed repair group, patients that underwent early repair of traumatic rotator cuff tears had shorter time of recovery, and less need for allograft augmentation for tears 3 cm or greater. However, at mid-term follow-up, this study found no difference in patient reported outcomes following early versus delayed repair of traumatic rotator cuff tears.

Level of evidence: 3

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Titel: Early versus delayed repair of traumatic rotator cuff tears. Does timing matter on outcomes?
verfasst von: Vishal Patel
Christopher Thomas
Helen Fort
Richard Wood
Amit Modi
Radhakant Pandey
Harvinder Singh
Alison Armstrong
Publikationsdatum: 03.04.2021
Verlag: Springer Paris
Erschienen in: European Journal of Orthopaedic Surgery & Traumatology / Ausgabe 2/2022
Print ISSN: 1633-8065
Elektronische ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-021-02962-w

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Early versus delayed repair of traumatic rotator cuff tears. Does timing matter on outcomes?