Arthroscopic treatments for partial articular surface tendon avulsions and clinical outcomes analysis

Abstract

Objective To study and analyze the efficacy of arthroscopic treatments of Ellman grade three partial articular surface tendon avulsions(PASTA), including the transtendon technique and completing technique. Methods The retrospective study collected 42 cases who had PASTA from March 2015 to June 2017 in orthopedics department of the First Affiliated Hospital of Nanjing Medical University. The choice of surgical techniques was done according to the integrity, texture and tension of the bursal-side residual rotator cuff tissue during the surgery. Twenty cases received transtendon repair (group A), 22 cases received completing repair (group B). The residual rotator cuff on the bursal side was preserved in group A while the rotator cuff intact was removed during operation in group B, then a standard single row reparing of full-thickness rotator cuff tear was done. To assess the extent of pain, the visual analogue scale (VAS) was evaluated preoperatively, in 24 h after the surgery and at the last follow-up. All the patients were evaluated by the Constant-Murley shoulder’s scalpel score (CSS) and the University of California Los Angeles score (UCLA) for shoulder function before the surgery and at the final follow-up. The postoperative complications were also compared in the two groups during the follow-up. Measurement data were analyzed using χ2-test for parametric variables. Functional scores between the groups were analyzed using Students t-test for parametric variables. Differences between preoperative and postoperative outcomes were analyzed using the paired t-test for parametric variables. Results Forty-two cases were all followed up for six to 30 months, an average of (16±7)months. The VAS scores in both groups in 24h after surgery and at the last follow-up were significantly lower than those before operation (P 0.05). No serious complication happened in all the patients during the follow-up. Conclusions For PASTA of Ellman grade three, both of the arthroscopic transtendon repair technique and the completing reparing technique could achieve satisfactory clinical results. The transtendon technique can rebuild the footprint anatomically and restore the integrity of the rotator cuff, which could be a more ideal surgical technique. Key words: Arthroscopy; Rotator cuff; Lacerations; Suture techniques