This article is more than 5 years old. Information may no longer be current.
Partial rotator cuff repair rivals complete repair, study finds
Click Here to Manage Email Alerts
Patients with massive tears who had a partial rotator cuff repair showed improvement similar to those who underwent complete rotator cuff repair, according to a study presented by Nicholas D. Iagulli, MD, at the 2011 Annual Meeting of the American Orthopaedic Society of Sports Medicine.
“Massive rotator cuff tears represent a challenging patient group and cause significant shoulder pain and disability,” Iagulli said. “These tears are sometimes not completely repairable due to the size of the defect, poor tissue quality, tendon retraction or extensive tendon adhesions. In these cases, significant partial repair is usually possible utilizing proper indications and rotator cuff mobilization techniques.”
Large tears
Iagulli and his team hypothesized that patients undergoing partial rotator cuff repair may have comparable outcomes to those undergoing complete repair. The investigators retrospectively reviewed 1,128 rotator cuff repairs. The study included 97 patients had tears measuring 30 cm2 or greater. Eleven patients were lost to follow-up, leaving the team with 86 patients to study.
|
|
One surgeon performed all the repairs, with 45 patients undergoing a complete repair and 41 patients having a partial repair. The average preoperative tear size was 35.20 cm2 in the complete repair group and 39.73 cm2 in the partial repair group. Residual tear size in the partial repair group averaged 5.68 cm2.
“The tear size of the partial repair group was significantly larger than that for the complete repair group,” Iagulli said.
The surgeon assessed the mobility of the rotator cuff intraoperatively and released all adhesions and capsular contractions, Iagulli said. The investigators measured outcomes using the UCLA shoulder score. The average patient follow-up was 24 months.
Complications, outcomes
For the complete repair group, the postoperative UCLA shoulder score averaged 29.64 with 14 excellent, 18 good, 11 fair and two poor results. In the partial repair group, the UCLA shoulder score averaged 29.49 with 12 excellent, 19 good, seven fair and three poor results.
A comparison of the repair groups showed no significant difference between the preoperative and postoperative UCLA scores.
One patient in the complete repair group required revision surgery after a traumatic injury sustained 2 months postoperatively. After revision, the patient’s outcome was rated as fair.
For the partial repair group, three patients required revision surgery. After revision surgery, the results were rated as one excellent, one good and one fair.
“Both complete and partial rotator cuff repair groups improved significantly at short-term follow-up,” Iagulli said. “In addition, complete and partial repair groups improved comparably in these massive cuff tears.” – by Renee Blisard
Reference:
- Iagulli ND, Field LD, Hobgood ER, et al. Comparison of partial vs. complete arthroscopic repair of massive rotator cuff tears. Paper #24. Presented at the 2011 Annual Meeting of the American Orthopaedic Society for Sports Medicine. July 7-10. San Diego.
- Nicholas D. Iagulli, MD, can be reached at Trinity Orthopedics, 809 W. Harwood Rd. Suite 101, Hurst, Texas 76054; 817-283-5252; email: nickiagulli@hotmail.com.
- Disclosure: Iagulli has no relevant financial disclosures.