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Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears

OBJECTIVES: Early results following arthroscopic superior capsular reconstruction(SCR) in patients with massive, irreparable rotator cuff tears are promising. However, no studies have compared patient reported outcomes between SCR or reverse total shoulder(rTSA) and rotator cuff debridement for thes...

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Autores principales: Tokish, John M., Kissenberth, Michael J., Shanley, Ellen, Tolan, Stefan John, Adams, Kyle J., Alexander, Ryan, Babrowicz, Sarah A., Hawkins, Richard J., Thigpen, Charles A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094716/
http://dx.doi.org/10.1177/2325967118S00101
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author Tokish, John M.
Kissenberth, Michael J.
Shanley, Ellen
Tolan, Stefan John
Adams, Kyle J.
Alexander, Ryan
Babrowicz, Sarah A.
Hawkins, Richard J.
Thigpen, Charles A.
author_facet Tokish, John M.
Kissenberth, Michael J.
Shanley, Ellen
Tolan, Stefan John
Adams, Kyle J.
Alexander, Ryan
Babrowicz, Sarah A.
Hawkins, Richard J.
Thigpen, Charles A.
author_sort Tokish, John M.
collection PubMed
description OBJECTIVES: Early results following arthroscopic superior capsular reconstruction(SCR) in patients with massive, irreparable rotator cuff tears are promising. However, no studies have compared patient reported outcomes between SCR or reverse total shoulder(rTSA) and rotator cuff debridement for these patients. Therefore, the purpose of this study was to compare 1-year outcomes between patients with massive irreparable rotator cuff tears who underwent a SCR, rTSA, or rotator cuff debridement with a concurrent biceps tenotomy or tenodesis. METHODS: Patients(n=63) who underwent either SCR(n=21), rTSA(21), or cuff debridement(n=21) and biceps tenotomy or tenodesis for a massive, irreparable rotator cuff tear treated with a minimum 1-year follow up were retrospectively reviewed. Age, sex, BMI, smoking status, Charlson Index, Hamada classification, and ASES scores were recorded and compared using a multivariate ANOVA were used to compare between surgical approaches. A Chi Square analyses were used to compare sex distribution and the Charlson Deyo Index between groups (α=0.05). RESULTS: Overall, patients across the 3 groups were not statistically different in age or follow up ASES score at minimum 14 month follow up (P> 0.05). There was a significant interaction effect between surgery group and sex (P=0.02) on ASES score but not age (P=0.08). Univariate F tests revealed that male patients who received an SCR displayed a 10-14% better outcome at follow up compared to other groups (Table 1) which exceeds the reported ASES score MCID. CONCLUSION: Our results show comparable results across surgical options for massive irreparable cuff tears with good patient reported outcomes. Male patients displayed clinically important greater ASES scores at 1 year follow up. Future studies should evaluate these preliminary results to assess if these preliminary results hold up at longer follow up times.
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spelling pubmed-60947162018-08-23 Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears Tokish, John M. Kissenberth, Michael J. Shanley, Ellen Tolan, Stefan John Adams, Kyle J. Alexander, Ryan Babrowicz, Sarah A. Hawkins, Richard J. Thigpen, Charles A. Orthop J Sports Med Article OBJECTIVES: Early results following arthroscopic superior capsular reconstruction(SCR) in patients with massive, irreparable rotator cuff tears are promising. However, no studies have compared patient reported outcomes between SCR or reverse total shoulder(rTSA) and rotator cuff debridement for these patients. Therefore, the purpose of this study was to compare 1-year outcomes between patients with massive irreparable rotator cuff tears who underwent a SCR, rTSA, or rotator cuff debridement with a concurrent biceps tenotomy or tenodesis. METHODS: Patients(n=63) who underwent either SCR(n=21), rTSA(21), or cuff debridement(n=21) and biceps tenotomy or tenodesis for a massive, irreparable rotator cuff tear treated with a minimum 1-year follow up were retrospectively reviewed. Age, sex, BMI, smoking status, Charlson Index, Hamada classification, and ASES scores were recorded and compared using a multivariate ANOVA were used to compare between surgical approaches. A Chi Square analyses were used to compare sex distribution and the Charlson Deyo Index between groups (α=0.05). RESULTS: Overall, patients across the 3 groups were not statistically different in age or follow up ASES score at minimum 14 month follow up (P> 0.05). There was a significant interaction effect between surgery group and sex (P=0.02) on ASES score but not age (P=0.08). Univariate F tests revealed that male patients who received an SCR displayed a 10-14% better outcome at follow up compared to other groups (Table 1) which exceeds the reported ASES score MCID. CONCLUSION: Our results show comparable results across surgical options for massive irreparable cuff tears with good patient reported outcomes. Male patients displayed clinically important greater ASES scores at 1 year follow up. Future studies should evaluate these preliminary results to assess if these preliminary results hold up at longer follow up times. SAGE Publications 2018-07-27 /pmc/articles/PMC6094716/ http://dx.doi.org/10.1177/2325967118S00101 Text en © The Author(s) 2018 http://creativecommons.org/licenses/by-nc-nd/4.0/ This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.
spellingShingle Article
Tokish, John M.
Kissenberth, Michael J.
Shanley, Ellen
Tolan, Stefan John
Adams, Kyle J.
Alexander, Ryan
Babrowicz, Sarah A.
Hawkins, Richard J.
Thigpen, Charles A.
Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears
title Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears
title_full Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears
title_fullStr Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears
title_full_unstemmed Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears
title_short Arthroscopic Superior Capsular Reconstruction in Males Provides Superior Outcomes to Reverse Total Shoulder or Debridement for Irreparable Rotator Cuff Tears
title_sort arthroscopic superior capsular reconstruction in males provides superior outcomes to reverse total shoulder or debridement for irreparable rotator cuff tears
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6094716/
http://dx.doi.org/10.1177/2325967118S00101
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