- Volume 6 Issue 1
Purpose: To compare the results of arthroscopic rotator cuff repair and subacromial decompression in partial thickness rotator cuff tear (PTRCT) with those in full thickness rotator cuff tear (FTRCT). Subjects and method: Of the 46 patients who were rested of the rotator cuff tear based on the operational findings, 42 patients who were able to receive a serial follow-up for 2 years were selected as the study subjects. The average age of the patients at the time of the operation was 55 years, and the mean duration of the follow-up was 34 months. The subjects included 22 cases of PTRCT and 20 cases of FTRCT. In terms of rotator cuff repair, the average number of tendon to tendon repair (TTR) was 1 in both PTRCT and FTRCT, and that of tendon to bone repair (TBR) was 1 and 3 in PTRCT and FTRCT, respectively. The average number of use of suture anchor was 1 and 2 in PTRCT and FTRCT, respectively. The level of shoulder pain and function of the subjects were measured using shoulder functional evaluation score of American shoulder and elbow society (ASES score) at before and 2 years following the operation. Results: At the final follow-up following the operation, PTRCT group showed changes in scores from 7.2 to 0.9 on average pain score and 34 to 91 on ASES score, whereas FTRCT group showed changes in scores from 7.6 to 1.2 on pain score and 29 to 88 on ASES score. There were no significant differences between the two groups (P > 0.05). The average range of motion of shoulder significantly increased in both groups at the final follow-up in comparison with the pre-operative time point. The evaluation at the final follow-up showed that 93% of the total subjects showed good or excellent results, and 95％ showed satisfactory results from the procedure with regard to pain reduction and functional outcomes. Two cases of the 3 fair results were caused by acromioclavicular arthritis. Conclusion: It may be anticipated that arthroscopic rotator cuff repair and subacromial decompression may bring satisfactory post-operative outcomes in both PTRCT and FTRCT on pain relief and functional recovery. However, careful preoperative examination of the acromioclavicular joint is critical to avoid failures of these procedures.
Rotator cuff;Partial thickness tear;Full thickness tear;Arthroscopic rotator cuff repair;Arthroscopy;Shoulder
- Bigliani, L.; Cordasco, F.; McIlveen, S.; and Musso, E.: Operative repair of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg, 1: 120-130, 1992. https://doi.org/10.1016/1058-2746(92)90089-L
- Binder, A.; Parr, G.; Hazleman, B.; and Fitton-Jackson, S.: Pulsed electromagnetic field therapy of persistent rotator cuff tendinitis. A double-blind controlled assessment. Lancet, 1(8379): 695-8, 1984.
- Blevins, F.; Warren, R.; Cavo, C.; Altchek, D.; Dines, D.; Palletta, G.; and Wickiewicz, T.: Arthroscopic assisted rotator cuff repair: results using a mini-open deltoid splitting approach. Arthroscopy, 12: 50-59, 1996. https://doi.org/10.1016/S0749-8063(96)90219-4
- Buford, D., Jr.; Mologne, T.; McGrath, S.; Heinen, G.; and Snyder, S.: Midterm results of arthroscopic co-planing of the acromioclavicular joint. J Shoulder Elbow Surg, 9(6): 498-501, 2000. https://doi.org/10.1067/mse.2000.109560
- Burkhart, S.; JL, J. D.-P.; MA, M. W. and al, e.: Cyclic loading of anchor based rotator cuff repairs: Confirmation of the tension overload phenomenon and comparison of suture anchor fixation with transosseous fixation. Arthroscopy, 13: 720-724,1997. https://doi.org/10.1016/S0749-8063(97)90006-2
- Burkhart, S. S.: Arthroscopic treatment of massive rotator cuff tears. Clin Orthop, (390): 107-18, 2001.
- Burkhart, S. S.; Danaceau, S. M.; and Pearce, C. E., Jr.: Arthroscopic rotator cuff repair: Analysis of results by tear size and by repair technique-margin convergence versus direct tendon-to-bone repair. Arthroscopy, 17(9): 905-12, 2001. https://doi.org/10.1053/jars.2001.26821
- Codman, E. A.: Complete rupture of the suprasupinatus tendon: operative treatment with report of two successful cases. Boston Med Surg J, 164: 708-710, 1911. https://doi.org/10.1056/NEJM191105181642002
- Codman, E. A.: The shoulder. Edited, 123-177, Boston, Thomas Todd, 1934.
- Cofield, R.: Current concept review. Rotator cuff disease of the shoulder. J Bone Joint Surg Am, 67: 974-979, 1985.
- Cordasco, F. A.; Backer, M.; Craig, E. V.; Klein, D.; and Warren, R. F.: The partial-thickness rotator cuff tear: is acromioplasty without repair sufficient? Am J Sports Med, 30(2): 257-60, 2002.
- DeOrio, J., and Cofield, R.: Results of a second attempt at surgical repair of a failed initial ratator-cuff repair. J Bone Joint Surg Am, 66: 563-567, 1984.
- Ellman, H.: Arthroscopic subacromial decompression: analysis of one- to three-year results. Arthroscopy, 3(3): 173-81, 1987. https://doi.org/10.1016/S0749-8063(87)80061-0
- Ellman, H.: Rotator cuff disorders. In Arthroscopic shoulder surgery and related disorders, pp. 98-119. Edited by Ellman, R., and Gartsman, G., 98-119, Philadelphia, Lea & Febiger, 1993.
- Gartsman, G. M.: All arthroscopic rotator cuff repairs. Orthop Clin North Am, 32(3): 501-10, x, 2001. https://doi.org/10.1016/S0030-5898(05)70219-4
- Gartsman, G. M.: Arthroscopic assessment of rotator cuff tear reparability. Arthroscopy, 12(5): 546-9, 1996. https://doi.org/10.1016/S0749-8063(96)90192-9
- Gartsman, G. M.: Arthroscopic rotator cuff repair. Clin Orthop, (390): 95-106, 2001.
- Gartsman, G. M.: Arthroscopic treatment of rotator cuff disease. J Shoulder Elbow Surg, 4(3): 228-41, 1995. https://doi.org/10.1016/S1058-2746(05)80056-4
- Gartsman, G. M., and Hammerman, S. M.: Full-thickness tears: arthroscopic repair. Orthop Clin North Am, 28(1): 83-98, 1997. https://doi.org/10.1016/S0030-5898(05)70267-4
- Gartsman, G. M.; Khan, M.; and Hammerman, S. M.: Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am, 80(6): 832-40, 1998.
- Gartsman, G. M., and Milne, J. C.: Articular surface partial-thickness rotator cuff tears. J Shoulder Elbow Surg, 4(6): 409-15, 1995. https://doi.org/10.1016/S1058-2746(05)80031-X
- Itoi, E., and Tabata, S.: Conservative treatment of rotator cuff tear. Clin Orthop, 275: 165-173, 1992.
- Martin, S. D.; Baumgarten, T. E.; and Andrews, J. R.: Arthroscopic resection of the distal aspect of the clavicle with concomitant subacromial decompression. J Bone Joint Surg Am, 83-A(3): 328-35, 2001.
- McLaughlin, H.: Rupture of the rotator cuff. J Bone Joint Surg Am, 44: 979, 1962.
- Murray, T. F., Jr.; Lajtai, G.; Mileski, R. M.; and Snyder, S. J.: Arthroscopic repair of medium to large full-thickness rotator cuff tears: outcome at 2- to 6-year follow-up. J Shoulder Elbow Surg, 11(1): 19-24, 2002. https://doi.org/10.1067/mse.2002.120142
- Neer, C. I.: Anterior acromioplasty for the chronic impingement syndrome in the shoulder. J Bone Joint Surg Am, 54: 41-50, 1972.
- Neviaser, J.: Ruptures of the rotator cuff. Clin Orthop, 3: 92-103, 1954.
- Park, J. Y.; Levine, W. N.; Marra, G.; Pollock, R. G.; Flatow, E. L.; and Bigliani, L. U.: Portal-extension approach for the repair of small and medium rotator cuff tears. Am J Sports Med, 28(3): 312-6, 2000.
- Paulos, L. E., and Kody, M. H.: Arthroscopically enhanced "miniapproach" to rotator cuff repair. Am J Sports Med, 22(1): 19-25, 1994. https://doi.org/10.1177/036354659402200104
- Payne, L. Z.; Altchek, D. W.; Craig, E. V.; and Warren, R. F.: Arthroscopic treatment of partial rotator cuff tears in young athletes. A preliminary report. Am J Sports Med, 25(3): 299-305, 1997. https://doi.org/10.1177/036354659702500305
- Research committee, A. S. E. S.; Richard, R.; An, K.; LU, L. B.; and ai, e.: A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg, 3: 347-252, 1994. https://doi.org/10.1016/S1058-2746(09)80019-0
- Snyder, S. J.: Evaluation and treatment of the rotator cuff. Orthop Clin North Am, 24(1): 173-92, 1993.
- Snyder, S. J.: Technique of arthroscopic rotator cuff repair using implantable 4-mm Revo suture anchors, suture Shuttle Relays, and no. 2 nonabsorb able mattress sutures. Orthop Clin North Am, 28(2): 267-75, 1997. https://doi.org/10.1016/S0030-5898(05)70285-6
- Tauro, J. C.: Arthroscopic rotator cuff repair: analysis of technique and results at 2- and 3-year follow-up. Arthroscopy, 14(1): 45-51, 1998. https://doi.org/10.1016/S0749-8063(98)70119-7
- Weber, S. C.: Arthroscopic debridement and acromioplasty versus mini-open repair in the treatment of significant partial-thickness rotator cuff tears. Arthroscopy, 15(2): 126-31, 1999. https://doi.org/10.1053/ar.1999.v15.0150121
- Wilson, F.; Hinov, V.; and Adams, G.: Arthroscopic repair of full-thickness tears of the rotator cuff: 2- to 14-year follow-up. Arthroscopy, 18(2): 136-44, 2002. https://doi.org/10.1053/jars.2002.30443