ShoulderArthroscopic repair of large rotator cuff tears using the double-row technique: an analysis of surgeon experience on efficiency and outcomes
Section snippets
Methods
We performed a retrospective review of the rotator cuff repairs performed by a single shoulder and elbow fellowship–trained surgeon, starting with his first repair. These data spanned 30 months, from November 1, 2005 to May 1, 2008.
Inclusion criteria included (1) age of 18 years or older; (2) full-thickness, large tears (3-5 cm)4; and (3) complete medical record including preoperative and postoperative data. Exclusion criteria included patients with (1) less than 6 months’ follow-up, (2)
Results
This study included 69 patients, 35 in the early group and 34 in the late group. The mean ages of patients were similar between the groups: 63 years and 65 years in groups 1 and 2, respectively. Patients in groups 1 and 2 were followed up for a mean of 12.9 months (range, 6-34 months; SD, 8.5 months) and 13.6 months (range, 6-28 months; SD, 5.5 months), respectively. Both groups were noted to be similar in terms of demographics (Table I).
Discussion
Rotator cuff repair has become one of the most commonly performed orthopaedic surgical procedures with relatively consistent good clinical results reported.18, 21, 22 The techniques used to approach rotator cuff surgery have evolved over the years from open to arthroscopic. Correspondingly, recent reports have failed to show significant advantages of the open and mini-open approaches compared with the arthroscopic approach in terms of clinical and functional outcomes.12, 20, 24, 25
Despite
Conclusion
This study provides insight as to the effects of surgical experience on outcomes. In 2 patient cohorts, we noted that satisfactory results after rotator cuff repair are attainable early in one's practice albeit with possibly longer operative times. Further research is required to better elucidate training-specific factors that better prepare surgeons entering practice.
Disclaimer
The authors, their immediate families, and any research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
References (28)
- et al.
Results of endoscopic carpal tunnel release relative to surgeon experience with the Agee technique
J Hand Surg Am
(2011) - et al.
Learning curve analysis of mitral valve repair using telemanipulative technology
J Thorac Cardiovasc Surg
(2011) - et al.
Long-term functional and structural outcome in patients with intact repairs 1 year after open transosseous rotator cuff repair
J Shoulder Elbow Surg
(2009) - et al.
Arthroscopic rotator cuff repair: the learning curve
Arthroscopy
(2005) - et al.
Clinical outcome and tendon integrity of arthroscopic versus mini-open supraspinatus tendon repair: a magnetic resonance imaging-controlled matched-pair analysis
Arthroscopy
(2007) - et al.
Prospective analysis of arthroscopic rotator cuff repair: subgroup analysis
J Shoulder Elbow Surg
(2009) - et al.
The acromion: morphologic condition and age-related changes. A study of 420 scapulas
J Shoulder Elbow Surg
(1996) - et al.
Outcomes of arthroscopic rotator cuff repair in patients aged 70 years or older
Arthroscopy
(2010) - et al.
An evaluation of the learning curve for a complex surgical technique: the full endoscopic interlaminar approach for lumbar disc herniations
Spine J
(2011) - et al.
Outcomes of arthroscopic rotator cuff repairs in obese patients
J Shoulder Elbow Surg
(2011)
Learning curve of computer-assisted navigation system in spine surgery
Chin Med J (Engl)
Results of a second attempt at surgical repair of a failed initial rotator-cuff repair
J Bone Joint Surg Am
Single-row versus double-row rotator cuff repair: techniques and outcomes
J Am Acad Orthop Surg
The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears
J Bone Joint Surg Am
Cited by (0)
Study approved by the University of Pennsylvania Institutional Board Review (No. 811418).