Keywords
rotator cuff arthropathy
supraspinatus tendon
shoulder joint
How to Cite
Abstract
Introduction. Treatment of rotator cuff arthropathy (RCA) remains a complex and unresolved problem, particularly in younger patients.
Objective. The aim of the study was to compare the outcomes of different surgical treatment options for patients with stage I RCA according to Hamada.
Materials and Methods. The study included 121 patients with stage I RCA according to Hamada. The age of the patients ranged from 45 to 75 years, with a mean age of 60.9 ± 16.2 years. The patients were divided into two groups depending on the surgical intervention performed: group I included patients with rotator cuff tendon repair (open or arthroscopic), while group II comprised rotator cuff tendon repair (infraspinatus and/or subscapularis) combined with superior capsule reconstruction using a graft from the long head of the biceps tendon or fascia lata (eight-layer technique), performed either through an open approach or arthroscopically.
Results. At 12 months after surgery, patients who underwent arthroscopic rotator cuff repair demonstrated better mean functional outcomes according to the Constant Shoulder Score compared to those who underwent open repair (p=0.063). Similarly, in the group where superior capsule reconstruction was performed arthroscopically, the mean functional outcomes according to the Constant Shoulder Score were better than in the group with open reconstruction (p=0.055).
Conclusions. The mean short-term outcomes (6–12 months) in patients of both groups with stage I RCA according to Hamada improved compared to preoperative values, as assessed by the Constant Shoulder Score and VAS, regardless of the surgical technique used.
References
Rockwood CA, Matsen FA. Rockwood and Matsen’s The Shoulder. 6th ed. Philadelphia: Elsevier; 2022. 1386 p. eBook ISBN: 9780323698368
Mizuki Y, Tamai M, Senjyu T, Tkagishi K. Arthroscopic Extreme Medialized Repair for Massive Rotator Cuff Tear: Resection of Cartilage and Subchondral Bone Over the Top of the Humeral Head. Arthroscopy Techniques. 2022;11(6):965–70.doi:10.1016/j.eats.2022.01.017.
Clifford AL, Hurley E, Anakwenze O, Klifto CS. Rotator Cuff Arthropathy: A Comprehensive Review. J Hand Surg Glob Online. 2024;6(4):458-462. doi:10.1016/j.jhsg.2023.12.014
Ecklund KJ, Lee TQ, Tibone J, Gupta R. Rotator Cuff Tear Arthropathy. Journal of the American Academy of Orthopaedic Surgeons. 2007;15(6):340–9. doi: 10.5435/00124635-200706000-00003.
Cvetanovich GL, Waterman BR, Verma NN, Romeo AA. Management of the Irreparable Rotator Cuff Tear. Journal of the American Academy of Orthopaedic Surgeons. 2019;27(24):909–17. doi: 10.5435/JAAOS-D-18-00199.
Ohta S, Ueda Y, Komai OJ. Postoperative results of arthroscopic superior capsule reconstruction using fascia lata: a retrospective cohort study. Shoulder Elbow Surg. 2024;33(3):686-697. doi: 10.1016/j.jse.2023.07.021.
Zafra M, Uceda P. Arthroscopic superior capsule reconstruction using semitendinosus tendon autograft for irreparable rotator cuff tears: Preliminary results. J Orthop. 2021;28:107-111. doi: 10.1016/j.jor.2021.11.005.
Thacher RR, Heaps BR, Dines JS. Superior Capsule Reconstruction: A Glimpse into the Future? HSS J. 2020;16(Suppl 2):503-506. doi: 10.1007/s11420-020-09796-y.
Rittenschober F, Ortmaier R. Arthroscopic augmentation techniques for superior capsule reconstruction..Oper Orthop Traumatol. 2022;34(1):21-33. doi: 10.1007/s00064-021-00757-0.
Cohn MR, Vadhera AS, Garrigues GE, Verma NN. Superior Capsular Reconstruction: Proposed Biomechanical Advantages. Arthroscopy. 2022;38(1):20-21. doi: 10.1016/j.arthro.2021.11.011.
Sun K, Li Y. Study of arthroscopic superior capsule reconstruction in the treatment of irreparable rotator cuff tears. Front Surg. 2023;9:895571. doi: 10.3389/fsurg.2022.895571.
Eppler MB, Bolia IK, Tibone JE, Gamradt SC, Hatch GF, Omid R, et al. Superior Capsular Reconstruction of the Shoulder. Arthroscopy The Journal of Arthroscopic and Related Surgery. 2021;37(6):1708–10. doi: 10.1016/j.arthro.2021.04.001.
Hsu CH, Chiu CH, Weng CJ, Hsu KY, Chan YS, Chao-Yu Chen A. Arthroscopic Superior Capsule Reconstruction Using Autologous Fascia Lata and Biceps Tendon Augmentation. Arthroscopy Techniques. 2021;10(6):e1411–5. doi: 10.1016/j.eats.2021.02.004.
Furuhata R, Matsumura N, Oki S, Nishikawa T, Kimura H, Suzuki T, et al. Risk factors of radiographic severity of massive rotator cuff tear. Scientific Reports. 2022;12(1):13567. doi: 10.1038/s41598-022-17624-y.
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