Duran TOPAK, Burak KUŞCU, Fatih DOĞAR, Bilal ÖKKEŞ, Ahmet TEMİZ, Fatih VATANSEVER

Clinical and functional results of patients after arthroscopic single row rotator cuff repair and arthroscopic acromioplasty

Aim: The present study aims to evaluate clinical and functional results of arthroscopic single row rotator cuff repair and acromioplasty in patients with Rotator cuff tears (RCT).Materials and Methods: Sixty one patients whom were applied arthroscopic single row rotator cuff repair and arthroscopic acromioplasty between 2016 and 2019 were included in the present study. Patients’ rotator cuff tears (Patte classification) and acromion were classified based on X-ray and Magnetic Resonance Imaging (MRI) results. In addition, patients’ Constant Murley Scores, Shoulder Range of Motion (ROM) and visual analogue scale (VAS) scores were also analyzed prior to and following the surgical operation.Results: Forty one (67.2%) out of 61 patients in the present study were applied surgery on the right shoulders, while 20 of them (32.8%) were applied surgery on the left shoulders. Twenty one (34.4%) of patients were male, while 40 (65.6%) of them were female. Patients were divided into three groups as type 1 (n=10), type 2 (n=41), type 3 (n=10) based on their acromion classification and three stages as stage 1 (n= 15), stage 2 (n=36), and stage 3 (n=10) based on their rotator cuff tears. In addition, while their mean preoperative Constant-Murley and VAS scores were 29.8±0.79 and 9.14±0.11, respectively, it increased to 81.1±1.07 and decreased to 2.06±1.07 in the postoperative period, respectively. Finally, while patients’ preoperative mean abduction ROM was 60.73°±1.31°, it increased to 126.22°±2.27° in the postoperative period.Conclusion: Arthroscopic single row rotator cuff repair and arthroscopic acromioplasty in patients suffering from RCT contributes to significant relief of pain and remarkable increase in shoulder abduction ROM, thus offering an effective and reliable surgical treatment which allows the active use of extremities.

PDF

___

1. Getz CL, Buzzell JE, Krishnan SG. Shoulder Instability and Rotator Cuff Tears. In: Flynn JM, eds. Orthopaedic Knowledge Update 10. Tenth edition. Rosemont: American Academy of Orthopaedic Surgeons 2011;299-315.
2. Bunker T. Rotator Cuff Disease. Current Orthopaedics 2002;16:223-33.
3. Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg 1999;8:296-9.
4. Yamaguchi K, Ditsios K, Middleton WD, et al. The demographic and morphological features of rotator cuff disease. A comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg Am 2006;88:1699-704.
5. Romeo AA, Hang DW, Bach BR Jr, et al. Repair of full thick¬ness rotator cuff tears. Gender, age, and other factors affect¬ing outcome. Clin Orthop 1999; 367:243-55.
6. Baysal D, Balyk R, Otto D. Functional outcome and health-related quality of life after surgical repairof full-thickness rotator cuff tear using a mini-open technique. Am J Sports Med 2005;13:46-55.
7. Neer CS, Marberry TA. On the disadvantages of radical ac¬romionectomy. J Bone Joint Surg 1981;63:41-69.
8. Gartsman GM, Khan M, Hammerman SM. Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am 1998;80:832-40.
9. Haneveld H, Hug K, Diederichs G, et al. Arthroscopic double-row repair of the rotator cuff: a comparison of bio obsorbable and non-resorbable anchors regarding os¬seous reaction. Knee Surg Sports Traumatol Arthrosc 2013;7:1647-54.
10. Kijima H, Minagawa H, Nishi T, et al. Long-term followup of cases of rotator cuff tear treated conservatively. J Shoulder Elbow Surg 2012;21:491-4.
11. Maman E, Harris C, White L, et al. Outcome of nonoperative treatment of symptomatic rotator cuff tears monitored by magnetic resonance imaging. J Bone Joint Surg Am 2009;91:1898-906.
12. Van der Zwaal P, Thomassen BJ, Nieuwenhuijse MJ, et al. Clinical outcome in all-arthroscopic versus miniopen rota¬tor cuff repair in small to medium-sized tears: A random¬ized controlled trial in 100 patients with 1-year follow-up. Arthroscopy 2013;29:266-73.
13. Burkhart SS, Lo IK. Arthroscopic rotator cuff repair. J Am Acad Orthop Surg 2006;14:333-46. 14. Sevimli R, Aslanturk O, Ergen E, et al. Mid-Term Outcomes of Arthroscopic Treatment in Patients with a Stiff Elbow. Cureus 2018;10:2630-37
15. Nutton RW, McBirnie JM, Phillips C. Treatment of chronic rotatorcuff impingement by arthroscopic subacromial decompression. J Bone Joint Surg 1997;79:73-6.
16. McLaughlin HL. Rupture of the rotator cuff. J Bone Joint Surg Am 1962;44:979-83.
17. Galatz LM, Ball CM, Teefey SA, Met al. The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears. J Bone Joint Surg Am 2004;86:219-24.
18. Chen M, Xu W, Dong Q, et al. Outcomes of single-row versus double-row arthroscopic rotator cuff repair: A systematic review and meta-analysis of current evidence. Arthroscopy 2013;29:1437-49.
19. Millett PJ, Warth RJ, Dornan GJ, et al. Clinical and struc¬tural outcomes after arthroscopic single-row versus double-row rotator cuff repair: A systematic review and meta-anal¬ysis of level I randomized clinical trials. J Shoulder Elbow Surg 2014;23:586-97.
20. Kim DH, Elattrache NS, Tibone JE, et al. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med 2006;34:407-14.
21. Park JY, Lhee SH, Choi JH, et al. Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears. Am J Sports Med 2008;36:1310-6.
22. Sheibani-Rad S, Giveans MR, Arnoczky SP, et al. Ar¬throscopic single-row versus double-row rotator cuff re¬pair: a meta-analysis of the randomized clinical trials. Ar¬throscopy 2013;29:343-8.
23. Li X, Yu B. Arthroscopic double-row rotator cuff repair: is it the same as single-row repair regarding clinical outcomes? Arthroscopy 2013;29:1464-5.
24. Gerhardt C1, Hug K, Pauly S, et al. Arthroscopic singlerow modified mason-allen repair versus doublerow suture bridge reconstruction for supraspinatus tendon tears: a matched-pair analysis. Am J Sports Med 2012;12:2777-85.
25. Adamson GJ, Tibone JE. Ten year assessment of primary rotator cuff repairs. J Shoulder Elbow Surg 1993;2:57-65.
26. Bigliani LU, Cordasco F, Mcllveen SJ, et al. Operative repair of massive rotator cuff tears: long term results. J Shoulder Elbow Surg 1992;1:120-30.
27. Knudsen HB, Gelineck J, Sojbjerg JO, et al. Functional and magnetic resonance imaging evaluation after single tendon rotator cuff reconstruction. J Shoulder Elbow Surg 1999;8:242-6.
28. Bigliani LU, Morrison D, April EW. The morphology of the acromion and relationship to the rotator cuff tears. Orthop Trans 1986;10:228.
29. Barber FA, Hrnack SA, Snyder SJ, Hapa O. Rotator cuff repair healing influenced by platelet-rich plasma construct augmentation. Arthroscopy 2011;27:1029- 35.
30. Jo CH, Shin JS, Lee YG, et al. Platelet-Rich Plasma for Arthroscopic Repair of Large to Massive Rotator Cuff Tears: A Randomized, Single-Blind, Parallel-Group Trial. Am J Sports Med 2013,41:2240-8
31. George MS, Khazzam M. Current concepts review: revision rotator cuff repair. J Schoulder Elbow Surg 2012;21:431-40.