2017 ISAKOS Biennial Congress ePoster #2261

 

Outcome Comparison Between In Situ Repair Versus Tear Completion Repair for Partial Thickness Rotator Cuff Tears

Yang-Soo Kim, MD, PhD, Prof., Seoul KOREA, REPUBLIC OF
Hyo-Jin Lee, MD, Prof., Seoul KOREA, REPUBLIC OF
In Park, MD, Seoul KOREA, REPUBLIC OF
Hong-Ki Jin, MD, Busan KOREA, REPUBLIC OF
Dong-Hyuk Sun, MD, Seoul, Seoul KOREA, REPUBLIC OF
Sung-Ryeoll Park, MD, Seoul KOREA, REPUBLIC OF
Jin Hong Kim, MD, Seoul KOREA, REPUBLIC OF
Dongjin Kim, MD, Seoul KOREA, REPUBLIC OF
Jong-Ho Kim, MD, Seoul KOREA, REPUBLIC OF

Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, KOREA, REPUBLIC OF

FDA Status Cleared

Summary

In this prospective comparative study, both in situ repair and completion repair for the treatment of PT-RCT provided functional improvements and pain relief. However, the retear rate for bursal-sided PT-RCT was higher in completion repair group than in situ repair, although the retear rate for the articular-sided PT-RCT was not different between two surgical techniques.

Abstract

Introduction

Partial-thickness rotator cuff tears (PT-RCTs) are more frequent than full-thickness tears, but no consensus exists about appropriate treatment for PT-RCTs. The purpose of this study was to compare the clinical outcomes of arthroscopic in situ repair with the tear completion repair technique for PT-RCTs.

Methods

We prospectively enrolled 100 cases with articular-sided and bursal-sided PT-RCTs exceeding 50% of tendon thickness and allocated them randomly. An in situ repair was performed in group 1 (n=50). Completion of the remaining cuff tissue and repair were performed in group 2 (n=50). The medial row was knotted as transosseous repair (suture-bridge technique) in all cases. American Shoulder Elbow Society (ASES) score, Constant shoulder (CS) score, Simple shoulder (SS) score,, and visual analog scale (VAS) for pain and range of motion were assessed at 3, 6, and 12 months and at the last visit. Repaired tendon integrity was determined at 6 to 12 months by magnetic resonance imaging.

Results

Eight cases were lost to follow-up. Ultimately, 92 cases were analyzed. The average follow-up was 19.1 months (range, 12 to 42 months). Significant improvementsin the VAS for pain and functional outcomes were observed in both groups postoperatively (P=.001 for VAS; P < .001 for ASES score; P < .001 for CS score; P=.001 for SS score). No significant difference in theclinical results was observed at any time between the groups. No difference of retear rate on articular-sided PT-RCT was observed between the groups (P=.34). Retears on the bursal-sided PT-RCT were more frequent in group 2 (P=.02).

Conclusion

Arthroscopic repair of PT-RCT provided functional improvements and pain relief regardless of the repair technique. The retear rate for bursal-sided PT-RCT was higher in group 2, although the retear rate for the articular-sided PT-RCT was not different. Due to the reason, in situ repair technique is recommended for the treatment of bursal side PTRCT.