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Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears
INTRODUCTION: Current evidence is controversial about the outcomes after the repair of the delaminated versus nondelaminated rotator cuff tears. The objective of this study was to evaluate the factors affecting delamination of the cuff and clinical and structural outcomes after en masse arthroscopic...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501617/ https://www.ncbi.nlm.nih.gov/pubmed/31080276 http://dx.doi.org/10.4103/ortho.IJOrtho_440_18 |
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author | Pandey, Vivek Joseph, C J Mathai, Naveen J Acharya, Kiran K V Karegowda, Lakshmikanth H Willems, W Jaap |
author_facet | Pandey, Vivek Joseph, C J Mathai, Naveen J Acharya, Kiran K V Karegowda, Lakshmikanth H Willems, W Jaap |
author_sort | Pandey, Vivek |
collection | PubMed |
description | INTRODUCTION: Current evidence is controversial about the outcomes after the repair of the delaminated versus nondelaminated rotator cuff tears. The objective of this study was to evaluate the factors affecting delamination of the cuff and clinical and structural outcomes after en masse arthroscopic repair of delaminated versus nondelaminated cuff of varying sizes. MATERIALS AND METHODS: A total of 233 patients with full-thickness posterosuperior cuff tears were divided in two groups: Group 1: Delaminated tears (n = 131) and Group 2: Nondelaminated tears (n = 102) of medium, large, and massive sizes. Both groups were evaluated by clinical scores (Constant–Murley [CM], American shoulder and elbow score [ASES]) and ultrasonography (USG), at a minimum followup of 2 years. RESULTS: The mean followup was 45.47 months. There was a weak but statistically significant linear correlation (P = 0.02) between the increasing size of tear and delamination, whereas increasing age and duration of symptoms did not correlate with increasing tendency of delamination. Final followup USG analysis revealed that there was no significant difference (P = 0.55) between healing rates of Group 1 and Group 2. Further taking various tear sizes into account, USG revealed no significant difference between the healing rates of two groups. The mean overall final postoperative CM and ASES scores of two groups did not show any significant difference (CM; P = 0.36, ASES; P = 0.4). However, the clinical outcome was significantly better in the completely healed group as compared to partially healed or retear group. CONCLUSIONS: A weak linear correlation between delamination and increasing size of the tear was noted. Although overall structural and clinical outcome is no different between two groups, the clinical outcomes of completely healed tear are better than partially healed ones. LEVEL OF EVIDENCE: Level III, Retrospective comparative. |
format | Online Article Text |
id | pubmed-6501617 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-65016172019-05-10 Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears Pandey, Vivek Joseph, C J Mathai, Naveen J Acharya, Kiran K V Karegowda, Lakshmikanth H Willems, W Jaap Indian J Orthop Original Article INTRODUCTION: Current evidence is controversial about the outcomes after the repair of the delaminated versus nondelaminated rotator cuff tears. The objective of this study was to evaluate the factors affecting delamination of the cuff and clinical and structural outcomes after en masse arthroscopic repair of delaminated versus nondelaminated cuff of varying sizes. MATERIALS AND METHODS: A total of 233 patients with full-thickness posterosuperior cuff tears were divided in two groups: Group 1: Delaminated tears (n = 131) and Group 2: Nondelaminated tears (n = 102) of medium, large, and massive sizes. Both groups were evaluated by clinical scores (Constant–Murley [CM], American shoulder and elbow score [ASES]) and ultrasonography (USG), at a minimum followup of 2 years. RESULTS: The mean followup was 45.47 months. There was a weak but statistically significant linear correlation (P = 0.02) between the increasing size of tear and delamination, whereas increasing age and duration of symptoms did not correlate with increasing tendency of delamination. Final followup USG analysis revealed that there was no significant difference (P = 0.55) between healing rates of Group 1 and Group 2. Further taking various tear sizes into account, USG revealed no significant difference between the healing rates of two groups. The mean overall final postoperative CM and ASES scores of two groups did not show any significant difference (CM; P = 0.36, ASES; P = 0.4). However, the clinical outcome was significantly better in the completely healed group as compared to partially healed or retear group. CONCLUSIONS: A weak linear correlation between delamination and increasing size of the tear was noted. Although overall structural and clinical outcome is no different between two groups, the clinical outcomes of completely healed tear are better than partially healed ones. LEVEL OF EVIDENCE: Level III, Retrospective comparative. Wolters Kluwer - Medknow 2019 /pmc/articles/PMC6501617/ /pubmed/31080276 http://dx.doi.org/10.4103/ortho.IJOrtho_440_18 Text en Copyright: © 2019 Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Pandey, Vivek Joseph, C J Mathai, Naveen J Acharya, Kiran K V Karegowda, Lakshmikanth H Willems, W Jaap Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears |
title | Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears |
title_full | Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears |
title_fullStr | Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears |
title_full_unstemmed | Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears |
title_short | Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears |
title_sort | clinical and structural outcomes after arthroscopic repair of medium- to massive-sized delaminated and nondelaminated rotator cuff tears |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6501617/ https://www.ncbi.nlm.nih.gov/pubmed/31080276 http://dx.doi.org/10.4103/ortho.IJOrtho_440_18 |
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