Saratov JOURNAL of Medical and Scientific Research

Evaluation results of arthroscopic reconstruction of rotator cuff using single-row anchor fixation

Year: 2018, volume 14 Issue: №3 Pages: 401-407
Heading: Traumatology and Orthopedics Article type: Original article
Authors: Chirkov А.А., Spiridonova O.V., Yakovlev V.N.

The purpose was to evaluate the results of arthroscopic reconstruction of the rotator cuff of a shoulder using the single-row anchor fixation method, to evaluate the dependence of the results of treatment on the size of the rupture of the rotator cuff of the shoulder. Material and Methods. This report provides an analysis of results of surgical treatment of 84 patients with the damage of the rotator cuff of a shoulder, who underwent arthroscopic reconstruction of the rotational cuff of a shoulder using single-row anchor fixation. The size of rupture of the rotator cuff of the shoulder was measured with the use of MRI and during surgery itself. All ruptures were subdivided into small (less than 1 cm), medium (1-3 cm) and large (3-5 cm). The exclusion criteria were patients with a massive rupture of the rotator cuff of a shoulder, with retraction of the tendon to the level of the articular process of the scapula or fatty degeneration of the muscles of the short shoulder rotators. The paper presents the features of operative technique and original algorithm for postoperative rehabilitation at different stages of treatment. Evaluation of the results of treatment was performed according to the rating scale of the Constant score, ASES, UCLA. Results. The average age of the patients was 56.0±7.4 (36-71 years). Of these, 22.6% patients had a small degree of rupture of the rotator cuff of a shoulder, 50% middle and 27.4% patients had a large degree of rupture. The nearest results (up to one year) were evaluated in 5 patients, long-term results in 79 patients (more than a year). The average rating score according to the Constant score was 89,8±9,2; the average value according to the ASES scale was 83,7±17,6; the average value according to the UCLA scale was 29.3±5.9. In all other patients complete recovery was observed in the period from 6 months to a year after the operation, there was a decrease in the pain syndrome, an increase in the volume of movements, an improvement in the quality of life. Conclusion. Arthroscopic reconstruction of the rotator cuff of a shoulder using the method of single-row anchor fixation, if necessary, with the help of seams which reapproximate the edges of the rupture, and with the help of the accompanying procedures, provides good results. Reduction in pain, increase in movement and in muscle strength in the arm were noted in all patients, regardless of the size of the damage to the rotator cuff of the shoulder. The rehabilitative protocol used ensures the creation of favorable conditions for engraftment of the restored tendon and, at the same time, provides prevention of the development of the stiffness of the shoulder joint.

1. Luime JJ, Koes BW, Hendriksen IJM, et al. Prevalence and incidence of shoulder pain in the general population; a systematic review. Scand J Rheumatol 2004; 33 (2): 73-81
2. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elb Surg 2010; 19 (1): 116-20
3. Jain NB, Higgins LD, Losina E, et al. Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. ВМС Musculoskelet Disord 2014; 15: 4
4. Karthikeyan S, Griffin DR, Parsons N, et al. Microvascular blood flow in normal and pathologic rotator cuffs. J Shoulder Elbow Surg 2015; 24 (12): 1954-60. DOI: 10.1016/j.jse.2015.07.0148 5. Boileau P, Ahrens PM, Hadzidakis AM. Entrapment of the long head of the biceps tendon: the hourglass biceps — a cause of pain and locking of the shoulder. J Shoulder Elb Surg 2004; 13 (3): 249-57. DOI: 10.1016/j.jse.2004.01.001
6. Yamaguchi K, Levine WN, Marra G, et al. Transitioning to arthroscopic rotator cuff repair: the pros and cons. Instr Course Lect 2003; 52 (1): 81-92, PMID 12690842
7. Savoie FH, Zunkiewicz M, Field LD, et al. A comparison of functional outcomes in patients undergoing revision arthroscopic repair of massive rotator cuff tears with and without arthroscopic suprascapular nerve release. Open Access J Sports Med 2016; 7: 129-34. DOI: 10.2147/OAJSM.S113020 PMCID: PMC5077237
8. Gerbert C, Wirth SH, Farshad M. Treatment options for massive rotator cuff tears. J Shoulder Elbow Surg 2011; 20 (2): 20-9. DOI:10.1016/j.jse.2010.11.028
9. HeubererPR,Smolen D, PauzenbergerL,etal. Longitudinal Long-term Magnetic Resonance Imaging and Clinical Follow-up after Single-Row Arthroscopic Rotator Cuff Repair: Clinical Superiority of Structural Tendon Integrity. J Sports Med 2017 May; 45 (6): 1283-88. DOI: 10.1177/0363546517689873
10. Kukkonen J, Kauko T, Virolainen P, Drimaa V. The effect of tear size on the treatment outcome of operatively treated rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 2015 Feb; 23 (2): 567-72. DOI: 10.1007/s00167-013-2647-0
11. Zhou XB, Liang JB, Chen ZY Comparison of therapeutic effects of three repair methods for rotator cuff tears under arthroscopy. Zhongguo Gu Shang 2017 Aug 25; 30 (8): 689-94. DOI: 10.3969/j.issn.1003-0034.2017.08.002
12. Sobhy MH, Khater AH, Hassan MR, El Shazly O. Do functional outcomes and cuff integrity correlate after single-versus double-row rotator cuff repair? A systematic review and meta-analysis study. Eur J Orthop Surg Traumatol 2018 Feb 13. DOI: 10.1007/S00590-018-2145-7
13. Hohmann E, Ku,nig A, Kat CJ, et al. Single-versus double-row repair for full-thickness rotator cuff tears using suture anchors. A systematic review and meta-analysis of basic biomechanical studies. Eur J Orthop Surg Traumatol 2017 Dec 21. DOI: 10.1007/S00590-017-2114-6.

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