Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff
Abstract Background In transtendinous full thickness rotator cuff tears (FTRCT) with remnant cuff, conventionally, cuff remnant of the greater tuberosity (GT) is debrided for better tendon to bone healing. However, larger cuff defect caused overtension on the repaired tendon. The purpose of this stu...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-04-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-024-07431-z |
| _version_ | 1827277418772037632 |
|---|---|
| author | Jae Min Lee Jong-Hun Ji Sang-Eun Park Dongwhan Suh Ki-Jeon Song |
| author_facet | Jae Min Lee Jong-Hun Ji Sang-Eun Park Dongwhan Suh Ki-Jeon Song |
| author_sort | Jae Min Lee |
| collection | DOAJ |
| description | Abstract Background In transtendinous full thickness rotator cuff tears (FTRCT) with remnant cuff, conventionally, cuff remnant of the greater tuberosity (GT) is debrided for better tendon to bone healing. However, larger cuff defect caused overtension on the repaired tendon. The purpose of this study was to compare the clinical outcomes and tendon integrity between remnant preserving and remnant debriding cuff repairs in the transtendinous FTRCT with remnant cuff. Methods From March, 2012 to October, 2017, a total of 127 patients who had the transtendinous FTRCT with remnant cuff were enrolled in this study. Rotator cuff tears were repaired arthroscopically, with patients divided into two groups: group I (n = 63), where rotator cuff remnants were preserved during the repair, and group II (n = 64), where the remnants were debrided during the repair. Clinical outcomes were assessed at the last follow-up (minimum 2 years) using the UCLA score, ASES score, SST score, Constant Shoulder score, and range of motion (ROM). The analysis of structural integrity and tendon quality was performed using the Sugaya classification on postoperative MRI scans at 8 months after surgery. Results At the final follow-up, UCLA, ASES, SST, and CS scores significantly improved from preoperative values to postoperative (all p < 0.05): UCLA (I: 19.6 ± 6.0 to 31.7 ± 3.2, II: 18.0 ± 5.7 to 31.5 ± 3.2), ASES (I: 54.3 ± 10.7 to 86.5 ± 12.5, II: 18.0 ± 5.7 to 85.8 ± 12.4), SST (I: 5.6 ± 2.8 to 10.2 ± 2.0, II: 5.0 ± 2.9 to 10.1 ± 2.5), CS (I: 74.0 ± 17.2 to 87.8 ± 9.7, II: 62.0 ± 19.2 to 88.3 ± 6.2). However, there were no significant differences between the two groups (p > 0.05). Also, remnant preserving cuff repair yielded significantly better tendon quality on postoperative MRI (p < 0.05). The incidence of re-tear (Sugaya’s Type IV and V) was not significantly different between the two groups (I:17% vs. II:19%; p = 0.053). Conclusions Remnant preserving rotator cuff repairs, which facilitate tendon-to-tendon healing, are superior in terms of tendon quality and are the preferred option for transtendinous FTRCT. Trial registration Retrospectively registered. |
| first_indexed | 2024-04-24T07:20:51Z |
| format | Article |
| id | doaj.art-601ca851a9d843f085003d70787c3601 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-04-24T07:20:51Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-601ca851a9d843f085003d70787c36012024-04-21T11:03:39ZengBMCBMC Musculoskeletal Disorders1471-24742024-04-0125111110.1186/s12891-024-07431-zArthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuffJae Min Lee0Jong-Hun Ji1Sang-Eun Park2Dongwhan Suh3Ki-Jeon Song4Department of Orthopedic Surgery, Shinsegae Seoul HospitalDepartment of Orthopedic surgery, College of Medicine, The Catholic University of KoreaDepartment of Orthopedic surgery, College of Medicine, The Catholic University of KoreaDepartment of Orthopedic surgery, College of Medicine, The Catholic University of KoreaDepartment of Orthopedic surgery, College of Medicine, The Catholic University of KoreaAbstract Background In transtendinous full thickness rotator cuff tears (FTRCT) with remnant cuff, conventionally, cuff remnant of the greater tuberosity (GT) is debrided for better tendon to bone healing. However, larger cuff defect caused overtension on the repaired tendon. The purpose of this study was to compare the clinical outcomes and tendon integrity between remnant preserving and remnant debriding cuff repairs in the transtendinous FTRCT with remnant cuff. Methods From March, 2012 to October, 2017, a total of 127 patients who had the transtendinous FTRCT with remnant cuff were enrolled in this study. Rotator cuff tears were repaired arthroscopically, with patients divided into two groups: group I (n = 63), where rotator cuff remnants were preserved during the repair, and group II (n = 64), where the remnants were debrided during the repair. Clinical outcomes were assessed at the last follow-up (minimum 2 years) using the UCLA score, ASES score, SST score, Constant Shoulder score, and range of motion (ROM). The analysis of structural integrity and tendon quality was performed using the Sugaya classification on postoperative MRI scans at 8 months after surgery. Results At the final follow-up, UCLA, ASES, SST, and CS scores significantly improved from preoperative values to postoperative (all p < 0.05): UCLA (I: 19.6 ± 6.0 to 31.7 ± 3.2, II: 18.0 ± 5.7 to 31.5 ± 3.2), ASES (I: 54.3 ± 10.7 to 86.5 ± 12.5, II: 18.0 ± 5.7 to 85.8 ± 12.4), SST (I: 5.6 ± 2.8 to 10.2 ± 2.0, II: 5.0 ± 2.9 to 10.1 ± 2.5), CS (I: 74.0 ± 17.2 to 87.8 ± 9.7, II: 62.0 ± 19.2 to 88.3 ± 6.2). However, there were no significant differences between the two groups (p > 0.05). Also, remnant preserving cuff repair yielded significantly better tendon quality on postoperative MRI (p < 0.05). The incidence of re-tear (Sugaya’s Type IV and V) was not significantly different between the two groups (I:17% vs. II:19%; p = 0.053). Conclusions Remnant preserving rotator cuff repairs, which facilitate tendon-to-tendon healing, are superior in terms of tendon quality and are the preferred option for transtendinous FTRCT. Trial registration Retrospectively registered.https://doi.org/10.1186/s12891-024-07431-zTranstendinous rotator cuff tearsRemnant cuffRemnant preserving rotator cuff repairTendon to tendon healingRepaired tendon quality |
| spellingShingle | Jae Min Lee Jong-Hun Ji Sang-Eun Park Dongwhan Suh Ki-Jeon Song Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff BMC Musculoskeletal Disorders Transtendinous rotator cuff tears Remnant cuff Remnant preserving rotator cuff repair Tendon to tendon healing Repaired tendon quality |
| title | Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff |
| title_full | Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff |
| title_fullStr | Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff |
| title_full_unstemmed | Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff |
| title_short | Arthroscopic cuff repair: footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff |
| title_sort | arthroscopic cuff repair footprint remnant preserving versus debriding rotator cuff repair of transtendinous rotator cuff tears with remnant cuff |
| topic | Transtendinous rotator cuff tears Remnant cuff Remnant preserving rotator cuff repair Tendon to tendon healing Repaired tendon quality |
| url | https://doi.org/10.1186/s12891-024-07431-z |
| work_keys_str_mv | AT jaeminlee arthroscopiccuffrepairfootprintremnantpreservingversusdebridingrotatorcuffrepairoftranstendinousrotatorcufftearswithremnantcuff AT jonghunji arthroscopiccuffrepairfootprintremnantpreservingversusdebridingrotatorcuffrepairoftranstendinousrotatorcufftearswithremnantcuff AT sangeunpark arthroscopiccuffrepairfootprintremnantpreservingversusdebridingrotatorcuffrepairoftranstendinousrotatorcufftearswithremnantcuff AT dongwhansuh arthroscopiccuffrepairfootprintremnantpreservingversusdebridingrotatorcuffrepairoftranstendinousrotatorcufftearswithremnantcuff AT kijeonsong arthroscopiccuffrepairfootprintremnantpreservingversusdebridingrotatorcuffrepairoftranstendinousrotatorcufftearswithremnantcuff |