Effectiveness of measuring tension during arthroscopic rotator cuff repair
Abstract Purpose Arthroscopic rotator cuff repair (ARCR) for relatively small rotator cuff tears (RCTs) has shown promising results; however, such surgery for larger tears often results in failure and poor clinical outcomes. One cause of failure is over‐tension at the repair site that will be covere...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Journal of Experimental Orthopaedics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40634-021-00341-2 |
| _version_ | 1797321306758184960 |
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| author | Shin Yokoya Yoshihiro Nakamura Yohei Harada Hiroshi Negi Ryosuke Matsushita Norimasa Matsubara Yasuhiko Sumimoto Nobuo Adachi |
| author_facet | Shin Yokoya Yoshihiro Nakamura Yohei Harada Hiroshi Negi Ryosuke Matsushita Norimasa Matsubara Yasuhiko Sumimoto Nobuo Adachi |
| author_sort | Shin Yokoya |
| collection | DOAJ |
| description | Abstract Purpose Arthroscopic rotator cuff repair (ARCR) for relatively small rotator cuff tears (RCTs) has shown promising results; however, such surgery for larger tears often results in failure and poor clinical outcomes. One cause of failure is over‐tension at the repair site that will be covered with the tendon stump. Reports on the clinical outcomes using ARCR with tension ≤ 30 N are lacking. This study aimed to evaluate ARCR outcomes and failure rates using less tension (30 N) and to assess the prognostic factors for failure. Methods Our study group comprised of 118 patients who underwent ARCR for full‐thickness RCTs with full tendon stump coverage of the footprint with a tension of ≤ 30 N, measured using a tension meter; no additional procedures, such as margin convergence or footprint medialisation, were performed. The failure rate was calculated, and the prognostic factor for failure was assessed using multivariate regression analyses. Results There were seven cases of failure in the study group. Postoperatively, flexion and internal rotation ranges of motion, acromiohumeral interval, muscle strength, and clinical results improved significantly. Using multivariate regression analyses, intraoperative concomitant subscapularis tendon lesion and pre‐operative infraspinatus tendon retraction, assessed using radial‐sequence magnetic resonance imaging, were significantly correlated with post‐ARCR failure using less tension (p = 0.030 and p = 0.031, respectively). Conclusion ARCR is likely to succeed for RCTs that can be extracted using tension ≤ 30 N. However, cases with more severe subscapularis tendon lesions and those with high infraspinatus tendon retraction may show surgical failure. Level of evidence LEVEL IV Retrospective case series |
| first_indexed | 2024-03-08T04:55:40Z |
| format | Article |
| id | doaj.art-9bad3cf33cb64db5a8a2acb2628f83d3 |
| institution | Directory Open Access Journal |
| issn | 2197-1153 |
| language | English |
| last_indexed | 2024-03-08T04:55:40Z |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Experimental Orthopaedics |
| spelling | doaj.art-9bad3cf33cb64db5a8a2acb2628f83d32024-02-07T15:16:41ZengWileyJournal of Experimental Orthopaedics2197-11532021-01-0181n/an/a10.1186/s40634-021-00341-2Effectiveness of measuring tension during arthroscopic rotator cuff repairShin Yokoya0Yoshihiro Nakamura1Yohei Harada2Hiroshi Negi3Ryosuke Matsushita4Norimasa Matsubara5Yasuhiko Sumimoto6Nobuo Adachi7Department of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanDepartment of Orthopaedic SurgeryGraduate School of Biomedical and Health SciencesHiroshima UniversityKasumi 1‐2‐3, Minami‐kuHiroshimaJapanAbstract Purpose Arthroscopic rotator cuff repair (ARCR) for relatively small rotator cuff tears (RCTs) has shown promising results; however, such surgery for larger tears often results in failure and poor clinical outcomes. One cause of failure is over‐tension at the repair site that will be covered with the tendon stump. Reports on the clinical outcomes using ARCR with tension ≤ 30 N are lacking. This study aimed to evaluate ARCR outcomes and failure rates using less tension (30 N) and to assess the prognostic factors for failure. Methods Our study group comprised of 118 patients who underwent ARCR for full‐thickness RCTs with full tendon stump coverage of the footprint with a tension of ≤ 30 N, measured using a tension meter; no additional procedures, such as margin convergence or footprint medialisation, were performed. The failure rate was calculated, and the prognostic factor for failure was assessed using multivariate regression analyses. Results There were seven cases of failure in the study group. Postoperatively, flexion and internal rotation ranges of motion, acromiohumeral interval, muscle strength, and clinical results improved significantly. Using multivariate regression analyses, intraoperative concomitant subscapularis tendon lesion and pre‐operative infraspinatus tendon retraction, assessed using radial‐sequence magnetic resonance imaging, were significantly correlated with post‐ARCR failure using less tension (p = 0.030 and p = 0.031, respectively). Conclusion ARCR is likely to succeed for RCTs that can be extracted using tension ≤ 30 N. However, cases with more severe subscapularis tendon lesions and those with high infraspinatus tendon retraction may show surgical failure. Level of evidence LEVEL IV Retrospective case serieshttps://doi.org/10.1186/s40634-021-00341-2Rotator cuff tearArthroscopic rotator cuff repairRepair tensionFailure rateTension meterPrognostic factor |
| spellingShingle | Shin Yokoya Yoshihiro Nakamura Yohei Harada Hiroshi Negi Ryosuke Matsushita Norimasa Matsubara Yasuhiko Sumimoto Nobuo Adachi Effectiveness of measuring tension during arthroscopic rotator cuff repair Journal of Experimental Orthopaedics Rotator cuff tear Arthroscopic rotator cuff repair Repair tension Failure rate Tension meter Prognostic factor |
| title | Effectiveness of measuring tension during arthroscopic rotator cuff repair |
| title_full | Effectiveness of measuring tension during arthroscopic rotator cuff repair |
| title_fullStr | Effectiveness of measuring tension during arthroscopic rotator cuff repair |
| title_full_unstemmed | Effectiveness of measuring tension during arthroscopic rotator cuff repair |
| title_short | Effectiveness of measuring tension during arthroscopic rotator cuff repair |
| title_sort | effectiveness of measuring tension during arthroscopic rotator cuff repair |
| topic | Rotator cuff tear Arthroscopic rotator cuff repair Repair tension Failure rate Tension meter Prognostic factor |
| url | https://doi.org/10.1186/s40634-021-00341-2 |
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