CLINICAL RESEARCH
A comparison of partial repair with arthroscopic margin convergence suture and open superior capsular reconstruction in patients with massive rotator cuff tear
1
Medical School of Alanya, Alaaddin Keykubat University, Antalya, Turkey
2
Department of Orthopaedics and Traumatology, Medical School of Suleyman Demirel University, Isparta, Turkey
Submission date: 2021-12-14
Final revision date: 2023-01-05
Acceptance date: 2023-01-05
Publication date: 2023-03-14
Arch Med Sci Civil Dis 2023;8(1):2-8
KEYWORDS
shoulder arthroscopyarthroscopic partial repairmassive rotator cuff tearsuperior capsular reconstruction
TOPICS
ABSTRACT
Introduction:
Massive rotator cuff tears (MRCTs) remain a controversial problem for clinicians. There are several recommendations in the literature, from various surgical techniques to the effectiveness of conservative treatment. In this study, we aimed to compare clinical outcomes and functional results of open superior capsular reconstruction for massive rotator cuff tear and arthroscopic partial rotator cuff repair with margin convergence.
Material and methods:
This study included 40 patients with massive rotator cuff tears that could not be treated with arthroscopic partial repair with margin convergence or open superior capsular reconstruction. The patients were divided into 2 groups according to the treatment method. Patient assignments for each group were not randomized. Group 1 consisted of 20 patients who underwent open superior capsular reconstruction, and Group 2 comprised 20 patients who underwent arthroscopic partial repair. UCLA (University of California Los Angeles), CS (Constant shoulder score) scores, and the visual analogue pain scale (VAS) were used to evaluate the clinical outcomes of the patients.
Results:
At the time of the latest follow-up evaluation, both groups showed significant improvements in clinical outcomes (p < 0.05). There were no significant differences in the clinical outcomes between groups. The preoperative tear size was statistically significantly higher in the superior capsular reconstruction group (p < 0.05).
Conclusions:
Our results supported the benefits of arthroscopic and open surgical technique with similar clinical results in the treatment of massive rotator cuff tear. We think that arthroscopic partial repair may be preferred by surgeons because it is minimally invasive compared to open superior capsular reconstruction.
Massive rotator cuff tears (MRCTs) remain a controversial problem for clinicians. There are several recommendations in the literature, from various surgical techniques to the effectiveness of conservative treatment. In this study, we aimed to compare clinical outcomes and functional results of open superior capsular reconstruction for massive rotator cuff tear and arthroscopic partial rotator cuff repair with margin convergence.
Material and methods:
This study included 40 patients with massive rotator cuff tears that could not be treated with arthroscopic partial repair with margin convergence or open superior capsular reconstruction. The patients were divided into 2 groups according to the treatment method. Patient assignments for each group were not randomized. Group 1 consisted of 20 patients who underwent open superior capsular reconstruction, and Group 2 comprised 20 patients who underwent arthroscopic partial repair. UCLA (University of California Los Angeles), CS (Constant shoulder score) scores, and the visual analogue pain scale (VAS) were used to evaluate the clinical outcomes of the patients.
Results:
At the time of the latest follow-up evaluation, both groups showed significant improvements in clinical outcomes (p < 0.05). There were no significant differences in the clinical outcomes between groups. The preoperative tear size was statistically significantly higher in the superior capsular reconstruction group (p < 0.05).
Conclusions:
Our results supported the benefits of arthroscopic and open surgical technique with similar clinical results in the treatment of massive rotator cuff tear. We think that arthroscopic partial repair may be preferred by surgeons because it is minimally invasive compared to open superior capsular reconstruction.
REFERENCES (16)
1.
Lo IK, Burkhart SS. Arthroscopic revision of failed rotator cuff repairs: technique and results. Arthroscopy 2004; 20: 250-67.
2.
Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Rel Res 1994; 304: 78-83.
3.
Cofield RH. Rotator cuff disease of the shoulder. J Bone Joint Surg 1985; 67: 974-9.
4.
Gerber C, Fuchs B, Hodler J. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am 2000; 82: 505-15.
5.
Burkhart SS, Esch JC, Jolson RS. The rotator crescent and rotator cable: an anatomic description of the shoulder’s “suspension bridge”. Arthroscopy 1993; 9: 611-6.
6.
Mihata T, McGarry MH, Pirolo JM, Kinoshita M, Lee TQ. Superior capsule reconstruction to restore superior stability in irreparable rotator cuff tears: a biomechanical cadaveric study. Am J Sports Med 2012; 40: 2248-55.
7.
Paribelli G, Boschi S, Randelli P, Compagnoni R, Leonardi F, Cassarino AM. Clinical outcome of latissimus dorsi tendon transfer and partial cuff repair in irreparable postero-superior rotator cuff tear. Musculoskelet Surg 2015; 99: 127-32.
8.
Porcellini G, Castagna A, Cesari E, Merolla G, Pellegrini A, Paladini P. Partial repair of irreparable supraspinatus tendon tears: clinical and radiographic evaluations at long-term follow-up. J Shoulder Elbow Surg 2011; 20: 1170-7.
9.
Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med 2007; 35: 719-28.
10.
Kim SJ, Lee IS, Kim SH, Lee WY, Chun YM. Arthroscopic partial repair of irreparable large to massive rotator cuff tears. Arthroscopy 2012; 28: 761-8.
11.
Galvin JW, Kenney R, Curry EJ, et al. Superior capsular reconstruction for massive rotator cuff tears: a critical analysis review. JBJS Rev 2019; 7: e1.
12.
Godenèche A, Freychet B, Lanzetti RM, Clechet J, Carrillon Y, Saffarini M. Should massive rotator cuff tears be reconstructed even when only partially repairable? Knee Surg Sports Traumatol Arthrosc 2017; 25: 2164-73.
13.
Ulstrup A, Reinhold M, Falster O. Superior capsular reconstruction: 2-year follow-up results. JSES Int 2020; 4: 893-9.
14.
de Campos Azevedo CI, Ângelo ACLPG, Vinga S. Arthroscopic superior capsular reconstruction with a minimally invasive harvested fascia lata autograft produces good clinical results. Orthop J Sports Med 2018; 6: 2325967118808242.
15.
Abd Elrahman AA, Sobhy MH, Abdelazim H, Omar Haroun HK. Superior capsular reconstruction: fascia lata versus acellular dermal allograft: a systematic review. Arthrosc Sports Med Rehabil 2020; 2: e389-97.
16.
Jeong JY, Kim SJ, Yoon TH, Eum KS, Chun YM. Arthroscopic repair of large and massive rotator cuff tears: complete repair with aggressive release compared with partial repair alone at a minimum follow-up of 5 years. J Bone Joint Surg Am 2020; 102: 1248-54.
| ISSN: | 2451-0637 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
