Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results
<p>Abstract</p> <p>Background</p> <p>Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR) repair methods achieved only partial restor...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2013-01-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | http://www.biomedcentral.com/1471-2474/14/43 |
| _version_ | 1828744917595193344 |
|---|---|
| author | Tudisco Cosimo Bisicchia Salvatore Savarese Eugenio Fiori Roberto Bartolucci Dario A Masala Salvatore Simonetti Giovanni |
| author_facet | Tudisco Cosimo Bisicchia Salvatore Savarese Eugenio Fiori Roberto Bartolucci Dario A Masala Salvatore Simonetti Giovanni |
| author_sort | Tudisco Cosimo |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR) repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR) repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA), showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques.</p> <p>Methods</p> <p>The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS), the Simple Shoulder Test (SST) scores, surgical time and implant expense.</p> <p>Results</p> <p>The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients.</p> <p>Conclusions</p> <p>To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant expense, despite no difference in clinical outcomes. We think that leakage of the contrast medium is due to an incomplete tendon-to-bone sealing, which is not a re-tear. This phenomenon could have important medicolegal implications.</p> <p>Level of evidence III. Treatment study: Case–control study.</p> |
| first_indexed | 2024-04-14T03:53:08Z |
| format | Article |
| id | doaj.art-091f3705177d447d99bb8572468bc946 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-14T03:53:08Z |
| publishDate | 2013-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-091f3705177d447d99bb8572468bc9462022-12-22T02:13:56ZengBMCBMC Musculoskeletal Disorders1471-24742013-01-011414310.1186/1471-2474-14-43Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography resultsTudisco CosimoBisicchia SalvatoreSavarese EugenioFiori RobertoBartolucci Dario AMasala SalvatoreSimonetti Giovanni<p>Abstract</p> <p>Background</p> <p>Arthroscopic rotator cuff repair has become popular in the last few years because it avoids large skin incisions and deltoid detachment and dysfunction. Earlier arthroscopic single-row (SR) repair methods achieved only partial restoration of the original footprint of the tendons of the rotator cuff, while double-row (DR) repair methods presented many biomechanical advantages and higher rates of tendon-to-bone healing. However, DR repair failed to demonstrate better clinical results than SR repair in clinical trials. MR imaging at 3 Tesla, especially with intra-articular contrast medium (MRA), showed a better diagnostic performance than 1.5 Tesla in the musculoskeletal setting. The objective of this study was to retrospectively evaluate the clinical and 3 Tesla MRA results in two groups of patients operated on for a medium-sized full-thickness rotator cuff tear with two different techniques.</p> <p>Methods</p> <p>The first group consisted of 20 patients operated on with the SR technique; the second group consisted of 20 patients operated on with the DR technique. All patients were evaluated at a minimum of 3 years after surgery. The primary end point was the re-tear rate at 3 Tesla MRA. The secondary end points were the Constant-Murley Scale (CMS), the Simple Shoulder Test (SST) scores, surgical time and implant expense.</p> <p>Results</p> <p>The mean follow-up was 40 months in the SR group and 38.9 months in the DR group. The mean postoperative CMS was 70 in the SR group and 68 in the DR group. The mean SST score was 9.4 in the SR group and 10.1 in the DR group. The re-tear rate was 60% in the SR group and 25% in the DR group. Leakage of the contrast medium was observed in all patients.</p> <p>Conclusions</p> <p>To the best of our knowledge, this is the first report on 3 Tesla MRA in the evaluation of two different techniques of rotator cuff repair. DR repair resulted in a statistically significant lower re-tear rate, with longer surgical time and higher implant expense, despite no difference in clinical outcomes. We think that leakage of the contrast medium is due to an incomplete tendon-to-bone sealing, which is not a re-tear. This phenomenon could have important medicolegal implications.</p> <p>Level of evidence III. Treatment study: Case–control study.</p>http://www.biomedcentral.com/1471-2474/14/43ShoulderRotator cuff tearArthroscopic repairMR arthrographyClinical result |
| spellingShingle | Tudisco Cosimo Bisicchia Salvatore Savarese Eugenio Fiori Roberto Bartolucci Dario A Masala Salvatore Simonetti Giovanni Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results BMC Musculoskeletal Disorders Shoulder Rotator cuff tear Arthroscopic repair MR arthrography Clinical result |
| title | Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results |
| title_full | Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results |
| title_fullStr | Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results |
| title_full_unstemmed | Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results |
| title_short | Single-row vs. double-row arthroscopic rotator cuff repair: clinical and 3 Tesla MR arthrography results |
| title_sort | single row vs double row arthroscopic rotator cuff repair clinical and 3 tesla mr arthrography results |
| topic | Shoulder Rotator cuff tear Arthroscopic repair MR arthrography Clinical result |
| url | http://www.biomedcentral.com/1471-2474/14/43 |
| work_keys_str_mv | AT tudiscocosimo singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults AT bisicchiasalvatore singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults AT savareseeugenio singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults AT fioriroberto singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults AT bartoluccidarioa singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults AT masalasalvatore singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults AT simonettigiovanni singlerowvsdoublerowarthroscopicrotatorcuffrepairclinicaland3teslamrarthrographyresults |