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Better outcomes observed in primary vs. revision arthroscopic transosseous rotator cuff repair
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The outcomes after arthroscopic transosseous rotator cuff repair were good overall; however, patients who underwent revision repair did not have outcomes as good as those who underwent primary cuff repair, according to study findings.
Researchers retrospectively reviewed data from a surgical procedural database between Jan. 1, 2010, and May 1, 2011, to identify patients who underwent arthroscopic repair with transosseous bone tunnel fixation for full-thickness rotator cuff repair; 20 patients underwent primary rotator cuff repair, and 11 patients underwent revision repair. All patients included in the study had an average follow-up of 26 months. Preoperative data evaluated included subjective shoulder value, VAS pain score and forward elevation range of motion. The researchers also made a note of previous attempts at repair of the rotator cuff, as well as the use of cortical augmentation intraoperatively.
Two years after the initial surgery, the researchers contacted patients and recorded shoulder value, VAS pain score, subjective satisfaction score, and the American Shoulder and Elbow Surgeons (ASES) score. Range of motion was measured at the most recent follow-up, and MRIs were performed only if a re-tear was suspected.
Preoperatively, the average scores for pain level and subjective shoulder value were 5.1 of 10 and 35%, respectively, according to the researchers. Postoperatively, the average scores recorded were a pain level of 0.9 of 10, and 84% subjective shoulder value, 90.6 out of 100 satisfaction score and an ASES score of 86.3. There were three major complications that occurred, as well as two minor complications.
Compared with patients who underwent primary repair, patients who underwent revision rotator cuff repair had significantly worse outcomes; however, cortical augmentation did not have a significant effect on the outcomes in either group, according to the researchers.
Research findings demonstrated cortical augmentation could be utilized as a supplement for fixation, even though it does not affect outcomes. Additionally, patients without augmentation have a higher risk for suture cutout through bone, according to the researchers. ‒ by Monica Jaramillo
Disclosures: Black reports no relevant financial disclosures. Please see the full study for list of all other authors, financial disclosures.
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