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Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair
The benefit of protective bracing after rotator cuff reconstruction has been debated for many years, although immobilization compliance has never been assessed objectively to date. In a previous study, compliance with the wearing of an abduction brace was measured for the first time with use of temp...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Journal of Bone and Joint Surgery, Inc.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071251/ https://www.ncbi.nlm.nih.gov/pubmed/35540728 http://dx.doi.org/10.2106/JBJS.OA.21.00148 |
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author | Grubhofer, Florian Ernstbrunner, Lukas Gerber, Christian Hochreiter, Bettina Schwihla, Ines Wieser, Karl Bouaicha, Samy |
author_facet | Grubhofer, Florian Ernstbrunner, Lukas Gerber, Christian Hochreiter, Bettina Schwihla, Ines Wieser, Karl Bouaicha, Samy |
author_sort | Grubhofer, Florian |
collection | PubMed |
description | The benefit of protective bracing after rotator cuff reconstruction has been debated for many years, although immobilization compliance has never been assessed objectively to date. In a previous study, compliance with the wearing of an abduction brace was measured for the first time with use of temperature-sensitive sensors. The purpose of the present follow-up study was to assess the effect of immobilization compliance on tendon-healing after rotator cuff repair. METHODS: The clinical and radiographic outcomes for 46 consecutive patients with objectively assessed abduction brace wearing compliance after arthroscopic repair of a superior rotator cuff tear were prospectively analyzed. Rotator cuff integrity was examined with ultrasound. Clinical outcomes were assessed with the relative Constant-Murley score (RCS), the Subjective Shoulder Value (SSV), and pain and patient satisfaction ratings. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value of abduction brace compliance for discriminating between shoulders that will and will not have a retear and the association of compliance with the failure of rotator cuff repair. RESULTS: After a mean duration of follow-up of 20 ± 9 months, the odds ratio for having a rotator cuff repair failure was 13-fold higher for patients with a compliance rate of <60% (p = 0.037). The retear rate was 3% (1 of 35 patients) in the high-compliance cohort (≥60% compliance) and 27% (3 of 11) in the low-compliance cohort (<60% compliance) (p = 0.037). No differences in RCS, SSV, pain, or postoperative patient satisfaction were observed between patients with ≥60% compliance and those with <60% compliance. CONCLUSIONS: Patients with a compliance rate of <60% had a 13-fold increase in the risk of rotator cuff retear. The 2 patients with the lowest compliance rates (11% and 22%) both had retears. Due to the small sample size, no final conclusions can be drawn regarding the influence of immobilization compliance on tendon-healing after rotator cuff repair. These findings justify a prospective trial with a larger cohort to confirm or disprove the value of compliance with abduction bracing. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. |
format | Online Article Text |
id | pubmed-9071251 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Journal of Bone and Joint Surgery, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-90712512022-05-09 Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair Grubhofer, Florian Ernstbrunner, Lukas Gerber, Christian Hochreiter, Bettina Schwihla, Ines Wieser, Karl Bouaicha, Samy JB JS Open Access Scientific Articles The benefit of protective bracing after rotator cuff reconstruction has been debated for many years, although immobilization compliance has never been assessed objectively to date. In a previous study, compliance with the wearing of an abduction brace was measured for the first time with use of temperature-sensitive sensors. The purpose of the present follow-up study was to assess the effect of immobilization compliance on tendon-healing after rotator cuff repair. METHODS: The clinical and radiographic outcomes for 46 consecutive patients with objectively assessed abduction brace wearing compliance after arthroscopic repair of a superior rotator cuff tear were prospectively analyzed. Rotator cuff integrity was examined with ultrasound. Clinical outcomes were assessed with the relative Constant-Murley score (RCS), the Subjective Shoulder Value (SSV), and pain and patient satisfaction ratings. Receiver operating characteristic (ROC) curves were used to determine the optimal cutoff value of abduction brace compliance for discriminating between shoulders that will and will not have a retear and the association of compliance with the failure of rotator cuff repair. RESULTS: After a mean duration of follow-up of 20 ± 9 months, the odds ratio for having a rotator cuff repair failure was 13-fold higher for patients with a compliance rate of <60% (p = 0.037). The retear rate was 3% (1 of 35 patients) in the high-compliance cohort (≥60% compliance) and 27% (3 of 11) in the low-compliance cohort (<60% compliance) (p = 0.037). No differences in RCS, SSV, pain, or postoperative patient satisfaction were observed between patients with ≥60% compliance and those with <60% compliance. CONCLUSIONS: Patients with a compliance rate of <60% had a 13-fold increase in the risk of rotator cuff retear. The 2 patients with the lowest compliance rates (11% and 22%) both had retears. Due to the small sample size, no final conclusions can be drawn regarding the influence of immobilization compliance on tendon-healing after rotator cuff repair. These findings justify a prospective trial with a larger cohort to confirm or disprove the value of compliance with abduction bracing. LEVEL OF EVIDENCE: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. Journal of Bone and Joint Surgery, Inc. 2022-05-05 /pmc/articles/PMC9071251/ /pubmed/35540728 http://dx.doi.org/10.2106/JBJS.OA.21.00148 Text en Copyright © 2022 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Scientific Articles Grubhofer, Florian Ernstbrunner, Lukas Gerber, Christian Hochreiter, Bettina Schwihla, Ines Wieser, Karl Bouaicha, Samy Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair |
title | Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair |
title_full | Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair |
title_fullStr | Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair |
title_full_unstemmed | Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair |
title_short | Effect of Abduction Brace Wearing Compliance on the Results of Arthroscopic Rotator Cuff Repair |
title_sort | effect of abduction brace wearing compliance on the results of arthroscopic rotator cuff repair |
topic | Scientific Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9071251/ https://www.ncbi.nlm.nih.gov/pubmed/35540728 http://dx.doi.org/10.2106/JBJS.OA.21.00148 |
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