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Abstract
Purpose
We evaluated the functional outcomes after arthroscopic repair of a massive tear between the tendon to tendon (TT) repair technique and the tendon to tendon and bone to tendon (TTBT) repair technique.
Materials and Methods
From March, 2002 to January, 2007, 43 cases of arthroscopic massive rotator cuff repair were evaluated. 12 were repaired by TT repair and 31 were repaired by TTBT repair. At 1year follow-up, the functional results were assessed by the KSS, ASES, UCLA and Constant scoring system and the P-VAS (Pain visual analogue score). Post-operative integrity was evaluated by an ultrasound examination 6 months after the operation.
Results
In TTBT repair group, the improvement of the KSS, ASES, UCLA and Constant scores were 15.4 (50.5 to 65.9), 28 (55.6 to 83.6), 9.6 (21.1 to 30.7) and 11 (40.7 to 51.7), respectively. The pain improvement was 2.7 (VAS, 3.8 to 1.1) and the retear rate was 62%. In the TT repair group, the functional improvements were 29.2 (33.7 to 62.9), 42.7 (38.6 to 81.3), 13.4 (16.4 to 29.8) and 19.7 (29.6 to 49.3), respectively. The pain improvement was 4.2 (VAS, 5.5 to 1.3) and the retear rate was 75%.
Figures and Tables
Fig. 1
Post-operative findings after arthroscopic massive rotator cuff repair. (A) Tight repair without gap formation after tendon to tendon and bone to tendon repair. (B) Margin convergence technique with partial tendon to tendon repair which remains gap at the glenohumeral insertion portion.
Fig. 2
Supraspinatus long axis view in ultrasonographic evaluation for massive tear. (A) Preoperative USG reveals rotator cuff massive tear. (B) Postoperative 6 months follow up USG of tendon to tendon repair revealed reteared rotator cuff. (C) Preoperative USG reveals rotator cuff massive tear. (D) Postoperative 6 months follow up USG of tendon to tendon repair revealed remained gap. Arrow in figure A, B, C: stump of rotator cuff tear. Arrow in figure D: remained gap.
Fig. 3
Functional evaluation after rotator cuff repair. (A) Korean shoulder society (KSS) scoring system. (B) American Shoulder and Elbow Society (ASES) scoring system. (C) University of California Los Angeles (UCLA) scoring system. (D) Constant scoring system. TT: tendon to tendon repair, TTBT: tendon to tendon repair and bone to tendon repair.
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