2015 ISAKOS Biennial Congress ePoster #2411

Clinical Outcomes and Structural Integrity of the Anterosuperior Rotator Cuff Tear after Arthroscopic Repair: In Continuity versus Disrupting the Tear Margin Between Subscapularis and Supraspinatus

Sung-Jae Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Sung-Hwan Kim, MD, PhD, Seoul KOREA, REPUBLIC OF
Min Jung, MD, PhD, Seoul KOREA, REPUBLIC OF
Jong-Min Kim, MD, Incheon, Gyeonggi KOREA, REPUBLIC OF
Yong-Min Chun, MD, PhD, Assoc. Prof., Seoul KOREA, REPUBLIC OF

Arthroscopy and Joint Research Institute, Severance Hospital, Yonsei University College of Medicine, Seoul, KOREA

FDA Status Not Applicable

Summary: If the cuff muscle in anterosuperior rotator cuff tear is good, it does not appear to be important whether the tear margin between the subscapularis and supraspinatus is preserved or disrupted.

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Abstract:

Introduction

Few studies have examined clinical outcomes and structural integrity after arthroscopic repair of anterosuperior rotator cuff tears. The purpose of this study is to compare the clinical outcomes and structural integrity after arthroscopic anterosuperior rotator cuff repair using two techniques: in continuity or disrupting the tear margin.

Methods

This study included 59 patients who underwent arthroscopic repair of an anterosuperior rotator cuff tear by either disrupting the tear margin between the subscapularis and supraspinatus (Group A) or performing the repair in continuity, without disrupting the margin (Group B). Clinical outcomes were assessed by 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 shoulder active range of motion (ROM). Subscapularis strength was assessed using the modified belly-press test. Magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed at 6 months after surgery to assess the structural integrity.

Results

At 2-year follow-up, VAS pain score, SSVs, ASES scores, UCLA shoulder scores, subscapularis strength, and active ROM improved significantly in both groups, compared to preoperatively. There were no significant differences between groups for any of these follow-up measurements. On follow-up MRA or CTA, the overall re-tear rate was 22% (5/23) in Group A and 19% (6/32) in Group B, which were not significantly different.

Conclusions

For arthroscopic repair of anterosuperior rotator cuff tears involving full-thickness subscapularis and supraspinatus tears, the technique of in continuity (without disrupting the tear margin between the subscapularis and supraspinaptus) did not produce better clinical outcomes or structural integrity than the technique involving the disruption of the tear margin. If the cuff muscle in anterosuperior rotator cuff tear is good, it therefore does not appear to be important whether the tear margin between the subscapularis and supraspinatus is preserved or disrupted.