Abstract
Purpose. The purpose of this study was to evaluate the functional outcome and the tendon healing after arthroscopic double row rotator cuff repair of large and massive rotator cuff tears. Methods. 82 patients with a full-thickness large and massive rotator cuff tear underwent arthroscopic repair with double row technique. Results were evaluated by use of the UCLA, ASES, and Constant questionnaires, the Shoulder Strength Index (SSI), and range of motion. Follow-up time was 2 years. Magnetic resonance imaging (MRI) studies were performed on each shoulder preoperatively and 2 years after repair. Results. 100% of the patients were followed up. UCLA, ASES, and Constant questionnaires showed significant improvement compared with preoperatively (P < 0.001). Range of motion and SSI in flexion, abduction, and internal and external rotation also showed significant improvement (P < 0.001). MRI studies showed 24 cases of tear after repair (29%). Only 8 cases were a full-thickness tear. Conclusions. At two years of followup, in large and massive rotator cuff tears, an arthroscopic double row rotator cuff repair technique produces an excellent functional outcome and structural integrity.
Highlights
Maximizing tendon healing is the primary goal of rotator cuff repair surgery
Whereas small and medium sized rotator cuff tears are successfully managed with any surgical repair in the vast majority of cases, the optimal management of big and massive rotator cuff tears has been controversial and continues to evolve
The mean number of anchors used in double row repair technique was 3.28 ± 0.6 (Table 1)
Summary
Maximizing tendon healing is the primary goal of rotator cuff repair surgery. Tendon healing has been shown to improve active motion, strength, and patient self-assessed function after rotator cuff repair [1, 2].Whereas small and medium sized rotator cuff tears are successfully managed with any surgical repair in the vast majority of cases, the optimal management of big and massive rotator cuff tears has been controversial and continues to evolve. Maximizing tendon healing is the primary goal of rotator cuff repair surgery. Tendon healing has been shown to improve active motion, strength, and patient self-assessed function after rotator cuff repair [1, 2]. Adhesions, and poor tissue quality common in these tears make repair one of the most technically complex procedures in the shoulder. Arthroscopic techniques and instrumentations are improving rapidly, and arthroscopic rotator cuff repair has gained popularity. Double row of anchors technique is reported to reestablish the normal rotator cuff footprint and increase the contact area for healing [3, 4] so anatomical and biomechanical are better than with the single row technique [4,5,6,7,8]
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