Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction
Purpose: To evaluate the outcome of revision rotator cuff bridging reconstruction (BR) as compared to primary BR in a large cohort of patients. Methods: A retrospective chart review was conducted for patients who underwent BR using dermal allograft for large/massive rotator cuff tears between 2010 a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Arthroscopy, Sports Medicine, and Rehabilitation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666061X23002201 |
| _version_ | 1797302490490732544 |
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| author | Jillian Karpyshyn, M.D., F.R.C.S.C. Sara Sparavalo, M.A.Sc. Jie Ma, M.E.S. John-Paul King, M.D. Ivan Wong, M.D., F.R.C.S.C., M.A.C.M., F.A.A.N.A. |
| author_facet | Jillian Karpyshyn, M.D., F.R.C.S.C. Sara Sparavalo, M.A.Sc. Jie Ma, M.E.S. John-Paul King, M.D. Ivan Wong, M.D., F.R.C.S.C., M.A.C.M., F.A.A.N.A. |
| author_sort | Jillian Karpyshyn, M.D., F.R.C.S.C. |
| collection | DOAJ |
| description | Purpose: To evaluate the outcome of revision rotator cuff bridging reconstruction (BR) as compared to primary BR in a large cohort of patients. Methods: A retrospective chart review was conducted for patients who underwent BR using dermal allograft for large/massive rotator cuff tears between 2010 and 2018. Patients who completed Western Ontario Rotator Cuff Index (WORC) and Disability of the Arm, Shoulder, and Hand (DASH) scores both pre- and postoperatively were included. Pre- and postoperative magnetic resonance imaging scans were compared to assess for differences in fatty infiltration, muscle atrophy, and graft status. Results: Eighty patients met the inclusion criteria, including 43 patients who underwent BR as a primary surgery and 37 patients who underwent revision BR. The mean follow-up duration was 5.7 ± 1.9 years in the primary group and 5.8 ± 2.0 years in the revision group. Both WORC and DASH scores significantly improved from pre- to postoperatively for both the primary and revision groups (P < .05). The primary group had significantly better postoperative WORC and DASH scores at 6 months, 1 year, and final follow-up (P < .05). Failure rate of the graft was higher in the revision group compared to primary group (14.3% vs 6.1%, respectively; P = .337), and the amount of fatty infiltration of supraspinatus and infraspinatus muscles significantly improved in patients who received primary BR compared to revision BR (P < .05). Conclusions: BR using dermal allograft for large/massive irreparable rotator cuff tears showed improvement of functional outcomes, with primary cases resulting in better improvement in patient-reported outcomes compared to revision cases. Primary BR was also associated with better postoperative fatty infiltration of supraspinatus and infraspinatus muscles. Level of Evidence: Level III, retrospective cohort study. |
| first_indexed | 2024-03-07T23:38:33Z |
| format | Article |
| id | doaj.art-aa4d28a63ec645009a36c068b5afaee8 |
| institution | Directory Open Access Journal |
| issn | 2666-061X |
| language | English |
| last_indexed | 2024-03-07T23:38:33Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy, Sports Medicine, and Rehabilitation |
| spelling | doaj.art-aa4d28a63ec645009a36c068b5afaee82024-02-20T04:19:52ZengElsevierArthroscopy, Sports Medicine, and Rehabilitation2666-061X2024-02-0161100869Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging ReconstructionJillian Karpyshyn, M.D., F.R.C.S.C.0Sara Sparavalo, M.A.Sc.1Jie Ma, M.E.S.2John-Paul King, M.D.3Ivan Wong, M.D., F.R.C.S.C., M.A.C.M., F.A.A.N.A.4Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaDivision of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaDivision of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaDivision of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaAddress correspondence to Ivan Wong, M.D., F.R.C.S.C., M.A.C.M., F.A.A.N.A., Orthopaedic Surgery–Sports Medicine, QEII Health Sciences Centre–Veterans Memorial Site, 2106-5955 Veterans Memorial Lane, Halifax, NS, Canada B3H 2E1.; Division of Orthopaedics, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, CanadaPurpose: To evaluate the outcome of revision rotator cuff bridging reconstruction (BR) as compared to primary BR in a large cohort of patients. Methods: A retrospective chart review was conducted for patients who underwent BR using dermal allograft for large/massive rotator cuff tears between 2010 and 2018. Patients who completed Western Ontario Rotator Cuff Index (WORC) and Disability of the Arm, Shoulder, and Hand (DASH) scores both pre- and postoperatively were included. Pre- and postoperative magnetic resonance imaging scans were compared to assess for differences in fatty infiltration, muscle atrophy, and graft status. Results: Eighty patients met the inclusion criteria, including 43 patients who underwent BR as a primary surgery and 37 patients who underwent revision BR. The mean follow-up duration was 5.7 ± 1.9 years in the primary group and 5.8 ± 2.0 years in the revision group. Both WORC and DASH scores significantly improved from pre- to postoperatively for both the primary and revision groups (P < .05). The primary group had significantly better postoperative WORC and DASH scores at 6 months, 1 year, and final follow-up (P < .05). Failure rate of the graft was higher in the revision group compared to primary group (14.3% vs 6.1%, respectively; P = .337), and the amount of fatty infiltration of supraspinatus and infraspinatus muscles significantly improved in patients who received primary BR compared to revision BR (P < .05). Conclusions: BR using dermal allograft for large/massive irreparable rotator cuff tears showed improvement of functional outcomes, with primary cases resulting in better improvement in patient-reported outcomes compared to revision cases. Primary BR was also associated with better postoperative fatty infiltration of supraspinatus and infraspinatus muscles. Level of Evidence: Level III, retrospective cohort study.http://www.sciencedirect.com/science/article/pii/S2666061X23002201 |
| spellingShingle | Jillian Karpyshyn, M.D., F.R.C.S.C. Sara Sparavalo, M.A.Sc. Jie Ma, M.E.S. John-Paul King, M.D. Ivan Wong, M.D., F.R.C.S.C., M.A.C.M., F.A.A.N.A. Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction Arthroscopy, Sports Medicine, and Rehabilitation |
| title | Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction |
| title_full | Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction |
| title_fullStr | Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction |
| title_full_unstemmed | Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction |
| title_short | Primary Rotator Cuff Bridging Reconstruction Shows Better Clinical and Radiographic Results Than Revision Bridging Reconstruction |
| title_sort | primary rotator cuff bridging reconstruction shows better clinical and radiographic results than revision bridging reconstruction |
| url | http://www.sciencedirect.com/science/article/pii/S2666061X23002201 |
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