NDLI: Prognostic Factors Affecting Rotator Cuff Healing After Arthroscopic Repair in Small to Medium-sized Tears.

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Prognostic Factors Affecting Rotator Cuff Healing After Arthroscopic Repair in Small to Medium-sized Tears.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Park, Ji Soon Park, Hyung Jun Kim, Sae Hoon Oh, Joo Han
Description	Country affiliation: South Korea Author Affiliation: Park JS ( Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, South Korea.); Park HJ ( Department of Orthopaedic Surgery, Korea University Anam Hospital, Seoul, South Korea.); Kim SH ( Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea.); Oh JH ( Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea ohjh1@snu.ac.kr.)
Abstract	BACKGROUND: Small and medium-sized rotator cuff tears usually have good clinical and anatomic outcomes. However, healing failure still occurs in some cases. PURPOSE: To evaluate prognostic factors for rotator cuff healing in patients with only small to medium-sized rotator cuff tears. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: Data were prospectively collected from 339 patients with small to medium-sized rotator cuff tears who underwent arthroscopic repair by a single surgeon between March 2004 and August 2012 and who underwent magnetic resonance imaging or computed tomographic arthrography at least 1 year after surgery. The mean age of the patients was 59.8 years (range, 39-80 years), and the mean follow-up time was 20.8 months (range, 12-66 months). The functional evaluation included the visual analog scale (VAS) for pain, American Shoulder and Elbow Surgeons score, Constant-Murley score, and Simple Shoulder Test. RESULTS: Postoperative VAS for pain and functional scores improved significantly compared with preoperative values (P < .001). Forty-five healing failures occurred (13.3%), and fatty degeneration of the infraspinatus muscle, tear size (anteroposterior dimension), and age were significant factors affecting rotator cuff healing (P < .001, = .018, and = .011, respectively) in multivariate logistic regression analysis. Grade II and higher infraspinatus fatty degeneration correlated with a higher failure rate. The failure rate was also significantly higher in patients with a tear >2 cm in size (34.2%) compared with patients with a tear ≤2 cm (10.6%) (P < .001). A receiver operating characteristic curve was used to determine the predictive cut-off value for the oldest age and the largest tear size for successful healing, which were calculated as 69 years and 2 cm, respectively, with a specificity of 90%. CONCLUSION: In small to medium-sized rotator cuff tears, grade II fatty degeneration of the infraspinatus muscle according to the Goutallier classification could be a reference point for successful healing, and anatomic outcomes might be better if repair is performed before the patient is 69 years old and the tear size exceeds 2 cm.
File Format	HTM / HTML
ISSN	03635465
Issue Number	10
Volume Number	43
e-ISSN	15523365
Journal	The American Journal of Sports Medicine
Language	English
Publisher	SAGE Publications
Publisher Date	2015-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Humans Middle Aged Tomography, X-ray Computed Rupture Rotator Cuff Male Treatment Outcome Wound Healing Aged, 80 And Over Tendon Injuries Journal Article Magnetic Resonance Imaging Arthroscopy Arthrography Surgery Adult Female Aged Retrospective Studies Diagnosis Discipline Sports Medicine Methods
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Physical Therapy, Sports Therapy and Rehabilitation Sports Science

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