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KMID : 0950120060050010050
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Jouranl of Korean Orthopaedic Sports Medicine
2006 Volume.5 No. 1 p.50 ~ p.57
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Arthroscopic Repair of Full Thickness Tear of The Supraspinatus; Evaluation of the Clinical Outcome and the Postoperative Rotator Cuff Integrity
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Noh Kyu-Cheol
Yoon Jung-Han
Chung Kook-Jin
Kim Sung-Woo
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Abstract
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Purpose: The purpose of this study was to evaluate the tendon healing of arthroscopic repair in full-thickness supraspinatus tears. We evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement.
Materials and Methods: Thirty consecutive full-thickness supraspinatus tears were repaired arthroscopically in 19 patients with a one row of anchor and 11 patients with two rows of anchors. Patients ranged in age from 51 to 79 years (average 63 years). Average follow-up was 16 month (range, 12 to 28 months). To evaluate the effectiveness of the arthroscopic repair of full-thickness supraspinatus tears by assessing functional improvement, we calculate the Constant, ASES, UCLA scores. The 30 patients had either an MR Arthrogram (25 cases) or an MRI (5 cases), performed between 5 months and 20 months (mean 10 months) after surgery.
Results: The cuff was healed in 21/30 cases (70%) and partially torn in 3 cases (10%) after the arthroscopic repair of full-thickness supraspinatus tear. Although the supraspinatus tendon was totally torn to the tuberosity in 6 cases(20%) after the arthroscopic repair, the size of the tear was smaller than the initial in 5 cases. The Constant score improved from an average of 55.7{±}7.1 points preoperatively to 77.7{±}9.7 points at the last follow-up (p<0.001), and the average ASES score improved from 39.2{±}7.4;→;72.4{±}12.6 (p<0.001), and the average UCLA score improved from 17.9{±}2.2;→;26.8{±}5.0 (p<0.001). Strength of elevation was significantly better (7.1kgs{±}2.4) in the shoulders with a healed tendon that in those with an total or partial re-tear tendon (4.5kgs{±}1.0) (p<0.05). Factors adversely affecting tendon healing were increasing age, Only 41.7% of the repairs completely healed in patients over 65 years (p<0.05).
Conclusion: Arthroscopic repair of isolated full-thickness tear of the supraspinatus leads to completely healing in 70% of the cases. Total or partial re-tear of the repaired rotator cuff is associated with a decreased strength. Older patients had significantly lower healing rates.
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KEYWORD
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Rotator cuff tear, Arthroscopy, Tendon healing, MR Arthrogram
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