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Arthroscopic Rotator Cuff Repair Using the Undersurface Technique: A 2-Year Comparative Study in 257 Patients.

Rubenis I, Lam PH, Murrell GA - Orthop J Sports Med (2015)

Bottom Line: At each time point, patients completed a modified L'Insalata questionnaire to assess patient-ranked pain scores and were clinically examined using standardized tests.At 2 years postoperatively, patients in both cohorts had significantly less pain and less difficulty with overhead activities compared with preoperative levels (P < .001).At 2 years, both groups also had similar retear rates (21% for bursal side, 23% for undersurface).

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, Australia.

ABSTRACT

Background: Arthroscopic rotator cuff repair has traditionally been performed in the subacromial space from the bursal side of the tendon. The undersurface rotator cuff repair technique involves the arthroscope remaining in the glenohumeral joint, thus viewing the tendon from its undersurface during repair without a bursectomy or acromioplasty.

Purpose: To compare the clinical and structural outcomes of undersurface rotator cuff repair with bursal-side repair.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective analysis of prospectively collected data was conducted on 2 cohorts of patients who had undergone arthroscopic rotator cuff repair with knotless suture anchors configured in a single-row formation using inverted mattress-style sutures from either the bursal side (n = 100) or undersurface (n = 165) of the supraspinatus tendon. Data were collected preoperatively, intraoperatively, and at 1 week, 6 weeks, 3 months, 6 months, and 2 years postoperatively. At each time point, patients completed a modified L'Insalata questionnaire to assess patient-ranked pain scores and were clinically examined using standardized tests. Ultrasound examination was performed at 6 months and 2 years to assess the integrity of the repair.

Results: At 2 years postoperatively, patients in both cohorts had significantly less pain and less difficulty with overhead activities compared with preoperative levels (P < .001). The type of repair performed (bursal or undersurface) did not affect the ability to perform overhead activities at 2 years. At 2 years, both groups also had similar retear rates (21% for bursal side, 23% for undersurface). The mean operative time for the arthroscopic rotator cuff repair was 32 minutes when performed from the bursal side and 20 minutes when performed from the undersurface (P < .001).

Conclusion: Arthroscopic rotator cuff repair, whether performed from the subacromial space or glenohumeral joint, resulted in decreased levels of pain and difficulty with overhead activities at 2 years. The major difference between the 2 techniques was operative time, with the undersurface technique being performed significantly faster than the bursal-side repair technique.

No MeSH data available.


Effect of surgical technique on supraspinatus strength. ***P < .001. The black significance line equals improvement across both cohorts. Comparison completed using the Student t test.
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fig5-2325967115605801: Effect of surgical technique on supraspinatus strength. ***P < .001. The black significance line equals improvement across both cohorts. Comparison completed using the Student t test.

Mentions: The groups were well matched in terms of supraspinatus and adduction strength prior to surgery. Both groups had significantly improved supraspinatus and adduction strength at 2 years postoperatively compared with preoperative strength (P < .001). However, at 2 years, there was no significant difference between the groups (Figure 5 and Table 3).


Arthroscopic Rotator Cuff Repair Using the Undersurface Technique: A 2-Year Comparative Study in 257 Patients.

Rubenis I, Lam PH, Murrell GA - Orthop J Sports Med (2015)

Effect of surgical technique on supraspinatus strength. ***P < .001. The black significance line equals improvement across both cohorts. Comparison completed using the Student t test.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License 1 - License 2 - License 3
Show All Figures
getmorefigures.php?uid=PMC4622290&req=5

fig5-2325967115605801: Effect of surgical technique on supraspinatus strength. ***P < .001. The black significance line equals improvement across both cohorts. Comparison completed using the Student t test.
Mentions: The groups were well matched in terms of supraspinatus and adduction strength prior to surgery. Both groups had significantly improved supraspinatus and adduction strength at 2 years postoperatively compared with preoperative strength (P < .001). However, at 2 years, there was no significant difference between the groups (Figure 5 and Table 3).

Bottom Line: At each time point, patients completed a modified L'Insalata questionnaire to assess patient-ranked pain scores and were clinically examined using standardized tests.At 2 years postoperatively, patients in both cohorts had significantly less pain and less difficulty with overhead activities compared with preoperative levels (P < .001).At 2 years, both groups also had similar retear rates (21% for bursal side, 23% for undersurface).

View Article: PubMed Central - PubMed

Affiliation: Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, Australia.

ABSTRACT

Background: Arthroscopic rotator cuff repair has traditionally been performed in the subacromial space from the bursal side of the tendon. The undersurface rotator cuff repair technique involves the arthroscope remaining in the glenohumeral joint, thus viewing the tendon from its undersurface during repair without a bursectomy or acromioplasty.

Purpose: To compare the clinical and structural outcomes of undersurface rotator cuff repair with bursal-side repair.

Study design: Cohort study; Level of evidence, 3.

Methods: A retrospective analysis of prospectively collected data was conducted on 2 cohorts of patients who had undergone arthroscopic rotator cuff repair with knotless suture anchors configured in a single-row formation using inverted mattress-style sutures from either the bursal side (n = 100) or undersurface (n = 165) of the supraspinatus tendon. Data were collected preoperatively, intraoperatively, and at 1 week, 6 weeks, 3 months, 6 months, and 2 years postoperatively. At each time point, patients completed a modified L'Insalata questionnaire to assess patient-ranked pain scores and were clinically examined using standardized tests. Ultrasound examination was performed at 6 months and 2 years to assess the integrity of the repair.

Results: At 2 years postoperatively, patients in both cohorts had significantly less pain and less difficulty with overhead activities compared with preoperative levels (P < .001). The type of repair performed (bursal or undersurface) did not affect the ability to perform overhead activities at 2 years. At 2 years, both groups also had similar retear rates (21% for bursal side, 23% for undersurface). The mean operative time for the arthroscopic rotator cuff repair was 32 minutes when performed from the bursal side and 20 minutes when performed from the undersurface (P < .001).

Conclusion: Arthroscopic rotator cuff repair, whether performed from the subacromial space or glenohumeral joint, resulted in decreased levels of pain and difficulty with overhead activities at 2 years. The major difference between the 2 techniques was operative time, with the undersurface technique being performed significantly faster than the bursal-side repair technique.

No MeSH data available.