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Trans-cuff portals heal by 6 weeks: an ultrasonography-based study

BACKGROUND: Various arthroscopic portals have been described for repair of superior labrum anterior-posterior (SLAP) lesions. The difficulty in doing repair through the rotator interval and the problems in direction and placement of anchors still persist. Functional outcomes of the patients after tr...

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Autores principales: Nair, Ayyappan V., Jangale, Ajit, Kumar, M. Praveen, Reddy, Premsai, kuntwad, Vikas, Goud, Naresh, Murthy, Raghu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568988/
https://www.ncbi.nlm.nih.gov/pubmed/34766087
http://dx.doi.org/10.1016/j.jseint.2021.07.012
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author Nair, Ayyappan V.
Jangale, Ajit
Kumar, M. Praveen
Reddy, Premsai
kuntwad, Vikas
Goud, Naresh
Murthy, Raghu
author_facet Nair, Ayyappan V.
Jangale, Ajit
Kumar, M. Praveen
Reddy, Premsai
kuntwad, Vikas
Goud, Naresh
Murthy, Raghu
author_sort Nair, Ayyappan V.
collection PubMed
description BACKGROUND: Various arthroscopic portals have been described for repair of superior labrum anterior-posterior (SLAP) lesions. The difficulty in doing repair through the rotator interval and the problems in direction and placement of anchors still persist. Functional outcomes of the patients after treating them using trans-cuff portal are well established in literature, but the actual healing of the portal is not clear. We made a sincere effort to identify healing of the trans-cuff portal with ultrasound guidance and functional outcome using American Shoulder and Elbow Surgeons Shoulder Score (ASES score), Constant Shoulder Score, and Oxford Shoulder Score. MATERIAL AND METHODS: Twenty-two patients with SLAP or labral tears and normal contralateral shoulders were included. Surgery was performed using the trans-cuff portal as a viewing or working portal for biceps repair and labral repair. Rehabilitation was initiated from day 1 and followed up on 6 weeks, 3 months and, 6 months with a maximum follow-up duration of 2 years. Ultrasound was used to measure the depth of healing and graded at 6 weeks of follow-up postoperatively. Functional outcomes were measured using ASES score, Constant Shoulder Score, and Oxford Shoulder Score measured at 6 months. RESULTS: Seventeen patients were of grade 1 (complete healing); 1 patient was of grade 2 (more than 50% healing); 1 of grade 3 (less than 50% healing), and 3 were lost to follow-up. Fourteen patients out of 19 had excellent ASES scores, 4 patients had good scores, and 1 patient was considered as poor with an average ASES score of 84.51 (range 93-48) and standard deviation of 10.37. The ASES score indicated that healing of the rotator cuff portal is directly related to the functional outcome of the shoulder. The Constant Shoulder Score and Oxford Shoulder Score on the contrary were statistically not significant indicating no relation of the Oxford and Constant scores with healing of the rotator cuff portals. CONCLUSION: Trans-cuff portal is safe, gives proper angle for insertion of anchors, and can be used for repair of SLAP lesions with ease. Ultrasonography helps in confirming the healing of portal.
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spelling pubmed-85689882021-11-10 Trans-cuff portals heal by 6 weeks: an ultrasonography-based study Nair, Ayyappan V. Jangale, Ajit Kumar, M. Praveen Reddy, Premsai kuntwad, Vikas Goud, Naresh Murthy, Raghu JSES Int Shoulder BACKGROUND: Various arthroscopic portals have been described for repair of superior labrum anterior-posterior (SLAP) lesions. The difficulty in doing repair through the rotator interval and the problems in direction and placement of anchors still persist. Functional outcomes of the patients after treating them using trans-cuff portal are well established in literature, but the actual healing of the portal is not clear. We made a sincere effort to identify healing of the trans-cuff portal with ultrasound guidance and functional outcome using American Shoulder and Elbow Surgeons Shoulder Score (ASES score), Constant Shoulder Score, and Oxford Shoulder Score. MATERIAL AND METHODS: Twenty-two patients with SLAP or labral tears and normal contralateral shoulders were included. Surgery was performed using the trans-cuff portal as a viewing or working portal for biceps repair and labral repair. Rehabilitation was initiated from day 1 and followed up on 6 weeks, 3 months and, 6 months with a maximum follow-up duration of 2 years. Ultrasound was used to measure the depth of healing and graded at 6 weeks of follow-up postoperatively. Functional outcomes were measured using ASES score, Constant Shoulder Score, and Oxford Shoulder Score measured at 6 months. RESULTS: Seventeen patients were of grade 1 (complete healing); 1 patient was of grade 2 (more than 50% healing); 1 of grade 3 (less than 50% healing), and 3 were lost to follow-up. Fourteen patients out of 19 had excellent ASES scores, 4 patients had good scores, and 1 patient was considered as poor with an average ASES score of 84.51 (range 93-48) and standard deviation of 10.37. The ASES score indicated that healing of the rotator cuff portal is directly related to the functional outcome of the shoulder. The Constant Shoulder Score and Oxford Shoulder Score on the contrary were statistically not significant indicating no relation of the Oxford and Constant scores with healing of the rotator cuff portals. CONCLUSION: Trans-cuff portal is safe, gives proper angle for insertion of anchors, and can be used for repair of SLAP lesions with ease. Ultrasonography helps in confirming the healing of portal. Elsevier 2021-09-14 /pmc/articles/PMC8568988/ /pubmed/34766087 http://dx.doi.org/10.1016/j.jseint.2021.07.012 Text en © 2021 Published by Elsevier Inc. on behalf of American Shoulder and Elbow Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Shoulder
Nair, Ayyappan V.
Jangale, Ajit
Kumar, M. Praveen
Reddy, Premsai
kuntwad, Vikas
Goud, Naresh
Murthy, Raghu
Trans-cuff portals heal by 6 weeks: an ultrasonography-based study
title Trans-cuff portals heal by 6 weeks: an ultrasonography-based study
title_full Trans-cuff portals heal by 6 weeks: an ultrasonography-based study
title_fullStr Trans-cuff portals heal by 6 weeks: an ultrasonography-based study
title_full_unstemmed Trans-cuff portals heal by 6 weeks: an ultrasonography-based study
title_short Trans-cuff portals heal by 6 weeks: an ultrasonography-based study
title_sort trans-cuff portals heal by 6 weeks: an ultrasonography-based study
topic Shoulder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8568988/
https://www.ncbi.nlm.nih.gov/pubmed/34766087
http://dx.doi.org/10.1016/j.jseint.2021.07.012
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