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Medialization, non-medialization yielded clinical improvements in full-thickness rotator cuff tears
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Although patients with full-thickness rotator cuff tears experienced clinical improvement postoperatively whether they underwent medialization or not, patients who underwent medialization had a lower retear rate.
Among 195 patients who underwent arthroscopic double-row modified Mason-Allen repair for large, full-thickness rotator cuff tears, researchers categorized 60 patients based on whether they underwent medialization (n=24) or not undergo this step (n=36). To assess cuff integrity, researchers performed MRI at a minimum of 6 months postoperatively. Researchers used VAS, the American Shoulder and Elbow Surgeons score, the University of California, Los Angeles (UCLA) Shoulder Rating Scale score and Constant score to clinically evaluate patients at least 1 year postoperatively.
Results showed a mean medialization length on MRI of 10.5 mm. Patients in the medialization group had a retear rate of 8.3% vs. 31% in the non-medialization group. Researchers found patients in the medialization group had a significant improvement in the mean VAS from approximately 5.3 to 1.8, in the ASES score from approximately 38.5 to 85.3, in the UCLA Shoulder Rating Scale score from approximately 22.5 to 31.8 and in Constant scores from approximately 41.7 to 90.2 at last follow-up. Similarly, results showed the non-medialization group had significant improvements in mean VAS from approximately 4 to 1.4, ASES scores from approximately 51.5 to 88.6, UCLA Shoulder Rating Scale score from approximately 20 to 31 and Constant scores from approximately 55.9 to 89.4. However, researchers noted the groups had no significant differences.
“Medialization of approximately 10.5 mm reliably shows good clinical results, and medializing rotator cuff tendons should be considered as a treatment option for repairing rotator cuff tears with chronic retracted tendons,” the authors wrote. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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