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Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results

BACKGROUND: Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR) repair methods achieved only partial restoration of the original footprint of the tendons of the r...

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Autores principales: Tudisco, Cosimo, Bisicchia, Salvatore, Savarese, Eugenio, Fiori, Roberto, Bartolucci, Dario A, Masala, Salvatore, Simonetti, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576341/
https://www.ncbi.nlm.nih.gov/pubmed/23351978
http://dx.doi.org/10.1186/1471-2474-14-43
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author Tudisco, Cosimo
Bisicchia, Salvatore
Savarese, Eugenio
Fiori, Roberto
Bartolucci, Dario A
Masala, Salvatore
Simonetti, Giovanni
author_facet Tudisco, Cosimo
Bisicchia, Salvatore
Savarese, Eugenio
Fiori, Roberto
Bartolucci, Dario A
Masala, Salvatore
Simonetti, Giovanni
author_sort Tudisco, Cosimo
collection PubMed
description BACKGROUND: Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR) repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR) repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA), showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques. METHODS: The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS), the Simple Shoulder Test (SST) scores, surgical time and implant expense. RESULTS: The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients. CONCLUSIONS: To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant expense, despite no difference in clinical outcomes. We think that leakage of the contrast medium is due to an incomplete tendon-to-bone sealing, which is not a re-tear. This phenomenon could have important medicolegal implications. Level of evidence III. Treatment study: Case–control study.
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spelling pubmed-35763412013-02-20 Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results Tudisco, Cosimo Bisicchia, Salvatore Savarese, Eugenio Fiori, Roberto Bartolucci, Dario A Masala, Salvatore Simonetti, Giovanni BMC Musculoskelet Disord Research Article BACKGROUND: Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR) repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR) repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA), showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques. METHODS: The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS), the Simple Shoulder Test (SST) scores, surgical time and implant expense. RESULTS: The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients. CONCLUSIONS: To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant expense, despite no difference in clinical outcomes. We think that leakage of the contrast medium is due to an incomplete tendon-to-bone sealing, which is not a re-tear. This phenomenon could have important medicolegal implications. Level of evidence III. Treatment study: Case–control study. BioMed Central 2013-01-27 /pmc/articles/PMC3576341/ /pubmed/23351978 http://dx.doi.org/10.1186/1471-2474-14-43 Text en Copyright ©2013 Tudisco et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Tudisco, Cosimo
Bisicchia, Salvatore
Savarese, Eugenio
Fiori, Roberto
Bartolucci, Dario A
Masala, Salvatore
Simonetti, Giovanni
Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
title Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
title_full Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
title_fullStr Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
title_full_unstemmed Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
title_short Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
title_sort single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 tesla mr arthrography results
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3576341/
https://www.ncbi.nlm.nih.gov/pubmed/23351978
http://dx.doi.org/10.1186/1471-2474-14-43
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