Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice
Abstract Background The definition of irreparable rotator cuff tear (IRCT) is controversial. This scoping review provides definitions used to describe IRCT in the literature. This scoping review (1) identified criteria used in the definition of IRCT and (2) investigated the current state of those cr...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-07067-5 |
| _version_ | 1797398257271308288 |
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| author | Fa-Chuan Kuan Chien-An Shih Wei-Ren Su Ausberto Velasquez Garcia Tomoyuki Kuroiwa Naoya Iida Kai-Lan Hsu |
| author_facet | Fa-Chuan Kuan Chien-An Shih Wei-Ren Su Ausberto Velasquez Garcia Tomoyuki Kuroiwa Naoya Iida Kai-Lan Hsu |
| author_sort | Fa-Chuan Kuan |
| collection | DOAJ |
| description | Abstract Background The definition of irreparable rotator cuff tear (IRCT) is controversial. This scoping review provides definitions used to describe IRCT in the literature. This scoping review (1) identified criteria used in the definition of IRCT and (2) investigated the current state of those criteria in prospective surgical therapeutic trials. Methods This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Scopus, and Web of Science were searched in March 2023. Studies were screened against predetermined inclusion and exclusion criteria. Criteria regarding clinical symptoms, preoperative images, and intraoperative findings were captured respectively. Results A total of 41 prospective studies were eligible for inclusion, and 35 studies (85.4%) defined IRCT. IRCT was defined on the basis of the following main criteria: preoperative image findings (28/35), intraoperative findings (24/35), and symptoms (16/35). With regard to preoperative images, IRCT was mainly defined on the basis of retraction of the tendon in the coronal plane (22/28), the severity of fatty degeneration (19/28), and ruptured tendon number or width of the defect in the sagittal plane (17/28). Conclusion This scoping review highlights the lack of a standardized definition for IRCT in clinical practice, with common predictive criteria including a duration of over 6 months, retraction beyond 5 cm, Goutallier grade 3 fatty infiltration, and the rupture of two or more tendons. However, surgeons should apply more than one criterion when examining preoperative images and confirm reparability during surgery. A more objective manner of evaluating intraoperative reparability is necessary. |
| first_indexed | 2024-03-09T01:23:01Z |
| format | Article |
| id | doaj.art-f864d0ff6cc44f63b760ebf21f3baf13 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-09T01:23:01Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-f864d0ff6cc44f63b760ebf21f3baf132023-12-10T12:04:17ZengBMCBMC Musculoskeletal Disorders1471-24742023-12-0124111110.1186/s12891-023-07067-5Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practiceFa-Chuan Kuan0Chien-An Shih1Wei-Ren Su2Ausberto Velasquez Garcia3Tomoyuki Kuroiwa4Naoya Iida5Kai-Lan Hsu6Department of Orthopaedic Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityDepartment of Orthopaedic Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityDepartment of Orthopedic Surgery, Mayo ClinicDepartment of Orthopedic Surgery, Mayo ClinicDepartment of Orthopedic Surgery, Mayo ClinicDepartment of Orthopaedic Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung UniversityAbstract Background The definition of irreparable rotator cuff tear (IRCT) is controversial. This scoping review provides definitions used to describe IRCT in the literature. This scoping review (1) identified criteria used in the definition of IRCT and (2) investigated the current state of those criteria in prospective surgical therapeutic trials. Methods This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. PubMed, Scopus, and Web of Science were searched in March 2023. Studies were screened against predetermined inclusion and exclusion criteria. Criteria regarding clinical symptoms, preoperative images, and intraoperative findings were captured respectively. Results A total of 41 prospective studies were eligible for inclusion, and 35 studies (85.4%) defined IRCT. IRCT was defined on the basis of the following main criteria: preoperative image findings (28/35), intraoperative findings (24/35), and symptoms (16/35). With regard to preoperative images, IRCT was mainly defined on the basis of retraction of the tendon in the coronal plane (22/28), the severity of fatty degeneration (19/28), and ruptured tendon number or width of the defect in the sagittal plane (17/28). Conclusion This scoping review highlights the lack of a standardized definition for IRCT in clinical practice, with common predictive criteria including a duration of over 6 months, retraction beyond 5 cm, Goutallier grade 3 fatty infiltration, and the rupture of two or more tendons. However, surgeons should apply more than one criterion when examining preoperative images and confirm reparability during surgery. A more objective manner of evaluating intraoperative reparability is necessary.https://doi.org/10.1186/s12891-023-07067-5Irreparable rotator cuff tearRetractionPatte gradeFatty degenerationTangent sign |
| spellingShingle | Fa-Chuan Kuan Chien-An Shih Wei-Ren Su Ausberto Velasquez Garcia Tomoyuki Kuroiwa Naoya Iida Kai-Lan Hsu Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice BMC Musculoskeletal Disorders Irreparable rotator cuff tear Retraction Patte grade Fatty degeneration Tangent sign |
| title | Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice |
| title_full | Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice |
| title_fullStr | Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice |
| title_full_unstemmed | Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice |
| title_short | Definition of irreparable rotator cuff tear: a scoping review of prospective surgical therapeutic trials to evaluate current practice |
| title_sort | definition of irreparable rotator cuff tear a scoping review of prospective surgical therapeutic trials to evaluate current practice |
| topic | Irreparable rotator cuff tear Retraction Patte grade Fatty degeneration Tangent sign |
| url | https://doi.org/10.1186/s12891-023-07067-5 |
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