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KMID : 0361620230580060505
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Journal of the Korean Orthopaedic Association
2023 Volume.58 No. 6 p.505 ~ p.513
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A Comparison of Clinical Outcome and Structural Integrity of Bursal Side Partial Thickness Rotator Cuff Tear after Arthroscopic in situ Repair: Retracted versus Non Retracted
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Cheon Sang-Jin
Moon Kyu-Pill
Kang Jun-Ho
Seo Han-Eol
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Abstract
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Purpose: Patients with bursal side partial thickness rotator cuff tears (PTRCTs) were divided into a retracted group and a non-retracted group. The clinical and structural outcomes after arthroscopic in situ repair were compared.
Materials and Methods: From July 2008 to May 2020, 51 patients diagnosed with an Ellman grade III bursal side PTRCT and underwent arthroscopic in situ repair and were followed up for more than two years were included in the study. Thirty-three cases were classified as the retracted group according to the degree of retraction of the torn edge of the tendon, and eighteen cases as the non-retracted group.
The shoulder rating scale of the University of California at Los Angeles (UCLA score), Constant-Murley score, and visual analogue scale were used to assess the clinical outcomes before surgery and at the final follow-up. The structural outcomes of the repaired tendon were compared and analyzed using Sugaya’s classification in a postoperative 6-month magnetic resonance imaging (MRI).
Results: The range of motion of the shoulder measured under anesthesia immediately before surgery was 145.2° (110°?150°; ±11.22°) in forward elevation and 143.1° (80°?150°; ±17.34°) in abduction in the retraction group and 136.5° (80°?150°; ±19.67°) in the forward elevation and 125.7° (80°?150°; ±37.84°) in abduction in the non-retraction group, which were statistically significant differences between the 2 groups (forward elevation, p=0.015; abduction, p=0.019). After surgery, the UCLA and constant scores were improved to 13.04 and 20.70 points in the retracted group and 13.39 and 26.51 points in the non-retracted group, respectively (UCLA retracted, p=0.012; nonretracted,p=0.007; constant score retracted, p=0.018; non-retracted, p=0.018). No significant difference was observed between the 2 groups in the postoperative clinical scores (UCLA score, p=0.774; constant, p=0.331). Postoperative 6-month MRI showed 2 re-tears in each group. There was no statistically significant difference in assessing the postoperative structural integrity of the cuff tendon using Sugaya’s classification between the retracted and non-retracted group (p=0.118).
Conclusion: Arthroscopic in situ repair using suture anchors can lead to satisfactory clinical and structural outcomes regardless of the degree of retraction of the Ellman grade III bursal side PTRCT.
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KEYWORD
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bursal side partial thickness rotator cuff tear, retracted type, non-retracted type, arthroscopic in situ repair
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