Medium-term follow-up of arthroscopic rotator cuff repair was evaluated in 48 consecutive arthroscopic repairs of medium to large rotator cuff tears. Mean rotator cuff tear size was 2.4 cm (range, 2-4 cm), mean age at surgery was 57.6 years (range, 38-80 years), and mean follow-up was 39 months (range, 24-66 months). Mean University of California at Los Angeles End-Result Scores were 17.2 preoperatively and 33.7 postoperatively (P <.001). American Shoulder and Elbow Surgeons mean scores were 42.2 and 94.9, respectively. There were no complications requiring reoperation. There were 35 excellent, 11 good, 2 fair, and no poor results; however, 1 patient had clinical evidence of a failed repair. Forty-four of 45 patients (47/48 repairs) were satisfied with their results.
"Une étude réalisée par Yamamoto et al.  a rapporté une incidence de 5,1 % pour les patients âgés entre 20 et 50 ans. De nombreux travaux ont rapporté des résultats satisfaisants chez les patients âgés, quelle que soit la technique utilisée : ciel ouvert, mini-open et arthroscopie     . En revanche, peu d'études ont évalué les résultats des réparations (sous-arthroscopie ou à ciel ouvert) des ruptures, partielles ou complètes, chez une population plus jeune          . "
[Show abstract][Hide abstract] ABSTRACT: Rotator cuff tears are classically considered to result from a degenerative process. Many studies have reported satisfactory outcome for surgical treatment in older patients. Information is scarce however on partial or total cuff repairs, using arthroscopic or open procedures, in younger populations. The purpose of this work was to analyze the literature on rotator cuff repair in patients aged less than 50 years.
Journal de Traumatologie du Sport 05/2015; 32(2). DOI:10.1016/j.jts.2015.04.001
"Arthroscopic rotator cuff repair is a currently popular treatment. While open repair has been a common surgical method for the treatment of rotator cuff tears, arthroscopic repair has recently been accepted widely, reporting equal or better results than the open repairs.1,2) Surgical rotator cuff repair is aimed at obtaining biological healing through the minimization of bone-tendon gap formation by high initial fixation strength and maintenance of mechanical stability against repetitive loads. "
[Show abstract][Hide abstract] ABSTRACT: We retrospectively assessed the clinical outcomes and investigated risk factors influencing retear after arthroscopic suture bridge repair technique for rotator cuff tear through clinical assessment and magnetic resonance arthrography (MRA).
Between January 2008 and April 2011, sixty-two cases of full-thickness rotator cuff tear were treated with arthroscopic suture bridge repair technique and follow-up MRA were performed. The mean age was 56.1 years, and mean follow-up period was 27.4 months. Clinical and functional outcomes were assessed using range of motion, Korean shoulder score, Constant score, and UCLA score. Radiological outcome was evaluated with preoperative and follow-up MRA. Potential predictive factors that influenced cuff retear, such as age, gender, geometric patterns of tear, size of cuff tear, acromioplasty, fatty degeneration, atrophy of cuff muscle, retraction of supraspinatus, involved muscles of cuff and osteolysis around the suture anchor were evaluated.
Thirty cases (48.4%) revealed retear on MRA. In univariable analysis, retear was significantly more frequent in over 60 years age group (62.5%) than under 60 years age group (39.5%; p = 0.043), and also in medium to large-sized tear than small-sized tear (p = 0.003). There was significant difference in geometric pattern of tear (p = 0.015). In multivariable analysis, only age (p = 0.036) and size of tear (p = 0.030) revealed a significant difference. The mean active range of motion for forward flexion, abduction, external rotation at the side and internal rotation at the side were significantly improved at follow-up (p < 0.05). The mean Korean shoulder score, Constant score, and UCLA score increased significantly at follow-up (p < 0.01). The range of motion, Korean shoulder score, Constant score, and UCLA score did not differ significantly between the groups with retear and intact repairs (p > 0.05). The locations of retear were insertion site in 10 cases (33.3%) and musculotendinous junction in 20 cases (66.7%; p = 0.006).
Suture bridge repair technique for rotator cuff tear showed improved clinical results. Cuff integrity after repair did not affect clinical results. Age of over 60 years and size of cuff tear larger than 1 cm were factors influencing rotator cuff retear after arthroscopic suture bridge repair technique.
Clinics in orthopedic surgery 12/2013; 5(4):306-13. DOI:10.4055/cios.2013.5.4.306
"Among factors that represent the interplay of sex/gender, "age" had an interesting relationship with disability. Patient's age has been reported to have a negative or insignificant impact on disability [18,20,21,69]. In contrast, some literature indicates a reversed relationship with reported disability or satisfaction following surgery with older patients reporting better function [70-73]. "
[Show abstract][Hide abstract] ABSTRACT: Rotator-cuff pathology is the most common cause of pain and disability in the shoulder. Examining the combined effect of biological and societal factors on disability would potentially identify existing differences between men and women with rotator cuff pathology which would help to provide suggestions for better models of care. Purpose of this study was to determine the overall differences in disability between men and women and to examine the relationship between factors that represent sex (biological factors) and gender (non-biological factors) with disability and satisfaction with surgical outcome 6 months after rotator cuff surgery.
Patients with impingement syndrome and/or rotator cuff tear who underwent rotator cuff surgery completed the Western Ontario Rotator Cuff (WORC) index, the American Shoulder & Elbow Surgeons (ASES) assessment form, and the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) outcome measures prior to surgery and 6 months post-operatively. They also rated their satisfaction with surgery at their follow-up appointment.
One hundred and seventy patients entered into the study (85 men and 85 women). One hundred and sixty patients (94%) completed the 6-month assessment. Women reported more disability both prior to and after surgery. Disability at 6 months was associated with pain-limited range of motion, participation limitation, age and strength. Satisfaction with surgery was associated with level of reported disability, expectations for improved pain, pain-limited range of motion and strength.
The results of this study indicate that women with rotator cuff pathology suffer from higher levels of pre- and post-operative disability and sex and gender qualities contribute to these differences. Gender-sensitive approach will help to identify existing differences between men and women which will help to promote more effective and tailored care by health professionals.
Johnathan F Williams, Shaan S Patel, Dustin K Baker, Joseph M Schwertz, Gerald McGwin, Brent A Ponce
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