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Clinical outcome and prognostic factors of revision arthroscopic rotator cuff tear repair

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study was to evaluate the clinical outcome of arthroscopic rotator cuff revision surgery in a cohort of patients and to identify prognostic factors for this procedure.

Methods

Fifty-one consecutive patients undergoing revision arthroscopic rotator cuff repair were prospectively followed over a minimum period of one year. Radiologic findings and clinical data regarding primary and revision surgery were collected. Clinical evaluation was performed pre- and post-operatively by means of Constant Score and Simple Shoulder Test.

Results

Median age at the time of revision surgery was 60 years (range 36–77 years). Median follow-up was 25 months (range 12–58 months). There were 17 men (33.3%) and 34 women (66.7%). The majority of the tears affected the supraspinatus tendon alone (51%) or both the supra- and infraspinatus tendons (35.3%). Significant improvements were seen in terms of active forward elevation, active external rotation, pain, Simple Shoulder Test score, Constant Score, and post-operative satisfaction—age, gender, and time to revision surgery did not show significant predictive value. A smaller tear size and pre-operative elevation greater than 90° were demonstrated to be independent prognostic factors for better outcome. However, the mean increase in Constant Score was not related to the size of the tear, range of motion, or age.

Conclusion

The results of this study indicate that arthroscopic revision rotator cuff repair results in reliable improvement in shoulder function, pain, and satisfaction. Pre-operative active range of motion and tear size seem to determine final outcome. A similar increase in mean Constant Score can be achieved even in large tears in patients aged over 65 years.

Level of evidence

IV.

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References

  1. Abrams JS (2010) Management of the failed rotator cuff surgery: causation and management. Sports Med Arthrosc 18(3):188–197

    Article  PubMed  Google Scholar 

  2. Anderson K, Boothby M, Aschenbrener D, van Holsbeeck M (2016) Outcome and structural integrity after arthroscopic rotator cuff repair using 2 rows of fixation: minimum 2-year follow-up. Am J Sports Med 34(12):1899–1905

    Article  Google Scholar 

  3. Burkhart SS, Barth JR, Richards DP, Zlatkin MB, Larsen M (2007) Arthroscopic repair of massive rotator cuff tears with stage 3 and 4 fatty degeneration. Arthroscopy 23(4):347–354

    Article  PubMed  Google Scholar 

  4. Chuang MJ, Jancosko J, Nottage WM (2014) Clinical outcomes of single-row arthroscopic revision rotator cuff repair. Orthopedics 37:e692–e698

    Article  PubMed  Google Scholar 

  5. Cole BJ, McCarty LP, Kang RW, Alford W, Lewis PB, Hayden JK (2007) Arthroscopic rotator cuff repair: prospective functional outcome and repair integrity at minimum 2-year follow-up. J Shoulder Elbow Surg 16(5):579–585

    Article  PubMed  Google Scholar 

  6. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    Google Scholar 

  7. Denard PJ, Burkhart SS (2011) Arthroscopic revision rotator cuff repair. J Am Acad Orthop Surg 19(11):657–666

    Article  PubMed  Google Scholar 

  8. DeOrio JK, Cofield RH (1984) Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 66(4):563–567

    Article  CAS  PubMed  Google Scholar 

  9. Djurasovic M, Marra G, Arroyo JS, Pollock RG, Flatow EL, Bigliani LU (2001) Revision rotator cuff repair: factors influencing results. J Bone Joint Surg Am 83-A(12):1849–1855

    Article  CAS  PubMed  Google Scholar 

  10. Dwyer R, Razmjou H, Holtby R (2015) Full thickness rotator cuff tears in patients younger than 55 years: clinical outcome of arthroscopic repair in comparison with older patients. Knee Surg Sports Traumatol Arthrosc 23(2):508–513

    Article  PubMed  Google Scholar 

  11. Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C (1999) Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 8(6):599–605

    Article  CAS  PubMed  Google Scholar 

  12. Hartzler RU, Sperling JW, Schleck CD, Cofield RH (2013) Clinical and radiographic factors influencing the results of revision rotator cuff repair. Int J Shoulder Surg 7(2):41–45

    Article  PubMed  PubMed Central  Google Scholar 

  13. Katolik LI, Romeo AA, Cole BJ, Verma NN, Hayden JK, Bach BR (2005) Normalization of the constant score. J Shoulder Elbow Surg 14(3):279–285

    Article  PubMed  Google Scholar 

  14. Keener JD, Wei AS, Kim HM, Paxton ES, Teefey SA, Galatz LM, Yamaguchi K (2010) Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome. J Bone Joint Surg Am 92(3):590–598

    Article  PubMed  Google Scholar 

  15. Kowalsky MS, Keener JD (2011) Revision arthroscopic rotator cuff repair: repair integrity and clinical outcome: surgical technique. J Bone Joint Surg Am 93(Suppl 1):62–74

    Article  PubMed  Google Scholar 

  16. Kukkonen J, Kauko T, Virolainen P, Äärimaa V (2015) The effect of tear size on the treatment outcome of operatively treated rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 23(2):567–572

    Article  PubMed  Google Scholar 

  17. Lädermann A, Denard PJ, Burkhart SS (2011) Midterm outcome of arthroscopic revision repair of massive and nonmassive rotator cuff tears. Arthroscopy 27(12):1620–1627

    Article  PubMed  Google Scholar 

  18. Lädermann A, Denard PJ, Burkhart SS (2016) Management of failed rotator cuff repair: a systematic review. J ISAKOS 1(1):32–37

    Article  PubMed  PubMed Central  Google Scholar 

  19. Lo IK, Burkhart SS (2004) Arthroscopic revision of failed rotator cuff repairs: technique and results. Arthroscopy 20(3):250–267

    Article  PubMed  Google Scholar 

  20. Oh JH, Kim SH, Ji HM, Jo KH, Bin SW, Gong HS (2009) Prognostic factors affecting anatomic outcome of rotator cuff repair and correlation with functional outcome. Arthroscopy 25(1):30–39

    Article  PubMed  Google Scholar 

  21. Oh JH, Kim SH, Shin SH, Chung SW, Kim JY, Kim SH, Kim SJ (2011) Outcome of rotator cuff repair in large-to-massive tear with pseudoparalysis: a comparative study with propensity score matching. Am J Sports Med 39(7):1413–1420

    Article  PubMed  Google Scholar 

  22. Parnes N, DeFranco M, Wells JH, Higgins LD, Warner JJ (2013) Complications after arthroscopic revision rotator cuff repair. Arthroscopy 29(9):1479–1486

    Article  PubMed  Google Scholar 

  23. Piasecki DP, Verma NN, Nho SJ, Bhatia S, Boniquit N, Cole BJ et al (2010) Outcomes after arthroscopic revision rotator cuff repair. Am J Sports Med 38(1):40–46

    Article  PubMed  Google Scholar 

  24. Shamsudin A, Lam PH, Peters K, Rubenis I, Hackett L, Murrell G (2015) Revision versus primary arthroscopic rotator cuff repair: a 2-year analysis of outcomes in 360 patients. Am J Sports Med 43(3):557–564

    Article  PubMed  Google Scholar 

  25. Strauss EJ, McCormack RA, Onyekwelu I, Rokito AS (2012) Management of failed arthroscopic rotator cuff repair. J Am Acad Orthop Surg 20(5):301–309

    PubMed  Google Scholar 

  26. Visotsky JL, Basamania C, Seebauer L, Rockwood CA, Jensen KL (2004) Cuff tear arthropathy: pathogenesis, classification, and algorithm for treatment. J Bone Joint Surg Am 86-A(Suppl 2):35–40

    Article  Google Scholar 

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Correspondence to Emilio Calvo.

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Conflict of interest

Authors declare that they have no conflict of interest.

Funding

No outside funding or grants related to the research presented in this manusctipt were received.

Ethical approval

The Institutional Review Board of Hospital Universitario Fundación Jiménez Díaz (Universidad Autónoma de Madrid) approved the study (No. 06/2016).

Informed consent

Informed consent was obtained in all patients.

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Valencia Mora, M., Morcillo Barrenechea, D., Martín Ríos, M.D. et al. Clinical outcome and prognostic factors of revision arthroscopic rotator cuff tear repair. Knee Surg Sports Traumatol Arthrosc 25, 2157–2163 (2017). https://doi.org/10.1007/s00167-016-4392-7

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