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Anterior rotator cable disruption does not affect outcomes in rotator cuff tear with subscapularis involvement

Authors
 Tae-Hwan Yoon  ;  Sung-Jae Kim  ;  Yun-Rak Choi  ;  Ju-Cheol Shin  ;  Sager-Holyl Alruwaili  ;  Yong-Min Chun 
Citation
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY, Vol.29(1) : 154-161, 2021-01 
Journal Title
 KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY 
ISSN
 0942-2056 
Issue Date
2021-01
MeSH
Aged ; Arthrography ; Arthroscopy / methods* ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Muscle Strength ; Range of Motion, Articular ; Rotation ; Rotator Cuff / diagnostic imaging ; Rotator Cuff / physiopathology ; Rotator Cuff / surgery ; Rotator Cuff Injuries / diagnostic imaging ; Rotator Cuff Injuries / physiopathology* ; Rotator Cuff Injuries / surgery* ; Tomography, X-Ray Computed ; Treatment Outcome
Keywords
Anterior cable ; Re-tear ; Rotator cable ; Rotator cuff tear ; Subscapularis
Abstract
Purpose: The purpose of this study was to compare clinical and radiological outcomes after arthroscopic repair of two different rotator cuff tear configurations: anterosuperior rotator cuff tear and rotator cuff tears with subscapularis involvement. It was hypothesized that, although both tear configurations would show significant improvement in clinical outcomes after arthroscopic repair, the rotator cuff tears with subscapularis involvement where the anterior rotator cable maintains its integrity would have better clinical outcomes and structural integrity. Methods: This study included 226 patients who underwent arthroscopic repair of anterosuperior rotator cuff tears (n = 107, group A) and rotator cuff tears with subscapularis involvement (n = 119, group B). The visual analog scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeons (ASES) score, University of California at Los Angeles (UCLA) shoulder score, and active range of motion (ROM) were assessed. Modified belly press test was performed to assess the strength of the subscapularis muscle. Cuff integrity was evaluated using magnetic resonance arthrography or computed tomographic arthrography at 6 months after operation. Results: At 3-year follow-up, the VAS score, SSVs, ASES scores, UCLA shoulder scores, active ROM, and modified belly press test showed significant improvement in both groups (p < 0.001). However, these improvements showed no statistical significance between the two groups. On follow-up radiologic evaluations, no significant difference in re-tear rates between group A (25 of 107, 23.4%) and group B (23 of 119, 19.3%) was observed. Conclusions: The presence of anterior cable involvement of the anterosuperior rotator cuff tear did not affect postoperative clinical outcomes and re-tear rate compared to rotator cuff tears with subscapularis involvement where the anterior cable integrity was maintained, although the anterosuperior rotator cuff tear was associated with more significant preoperative supraspinatus fatty infiltration. Therefore, the present study determined that it would not be necessary to differentiate treatment protocols between these patterns. Level of evidence: Level III.
Full Text
https://link.springer.com/article/10.1007/s00167-020-05891-z
DOI
10.1007/s00167-020-05891-z
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Yoon, Tae Hwan(윤태환) ORCID logo https://orcid.org/0000-0002-2859-5240
Chun, Yong Min(천용민) ORCID logo https://orcid.org/0000-0002-8147-6136
Choi, Yun Rak(최윤락)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182196
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