Factors associated with needle breakage of antegrade suture passer and effect of intratendinous remnant needle tip on clinical outcomes after arthroscopic rotator cuff repair.
Aged
Arthroscopy
/ adverse effects
Equipment Failure Analysis
Female
Humans
Magnetic Resonance Imaging
/ methods
Male
Middle Aged
Needles
/ adverse effects
Pain, Postoperative
/ diagnosis
Postoperative Period
Retrospective Studies
Risk Factors
Rotator Cuff Injuries
/ surgery
Suture Techniques
/ instrumentation
Tendinopathy
/ diagnosis
Tendons
/ diagnostic imaging
Time Factors
Treatment Outcome
Ultrasonography
/ methods
Antegrade suture passer
Clinical outcome Level of Evidence: Level III, Therapeutic Study
Needle breakage
Rotator cuff repair
Journal
Acta orthopaedica et traumatologica turcica
ISSN: 2589-1294
Titre abrégé: Acta Orthop Traumatol Turc
Pays: Turkey
ID NLM: 9424806
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
received:
13
04
2018
revised:
14
12
2018
accepted:
19
12
2018
pubmed:
19
1
2019
medline:
14
8
2019
entrez:
19
1
2019
Statut:
ppublish
Résumé
The aim of this study was to evaluate factors associated with the needle breakage of antegrade suture passer and the effect of intratendinous remnant needle tip on clinical outcomes after rotator cuff repair. We retrospectively reviewed 283 patients (138 men and 145 women; mean age: 59.7 ± 9.3 years) who underwent arthroscopic repair for full-thickness rotator cuff tear. We evaluated the characteristics of 16 patients in whose needle tip had been broken and embedded and remained in the rotator cuff (remnant needle group) and compared them with the remaining 267 patients (control group). Afterwards, another 64 patients were selected from control group (1:4 matching) after propensity score matching (PSM). The groups were compared anatomically with MRI or ultrasonography and functionally (serial pain VAS and ROM; ASES, Constant, UCLA and SST scores) at a minimum follow-up of 1 year. The remnant needle group showed preoperative thicker tendon (6.72 mm vs 5.33 mm, p = 0.047), higher tendinosis (mean grade, 1.88 vs. 1.43, p = 0.029), and more frequent delaminated tears (p = 0.035) compared with control group. When we compare the clinical outcomes after PSM, the initial pain VAS of the remnant needle tip group was higher up to 3 months (pain VAS: 4.13 ± 2.07 vs 2.48 ± 1.61 (p = 0.032) at 5 weeks and 3.79 ± 2.12 vs 2.25 ± 1.76 (p = 0.044) at 3 months), however the difference disappeared after 6 months postoperatively. In final evaluation, there was no significant differences in every outcome parameters (all p > 0.05). Breakage of the needle of the antegrade suture passer occurred more frequently in the thicker tendon, higher tendinosis, and delaminated tears. The retained broken needle tip was associated with higher pain scores during the early postoperative period, but revealed no difference in final outcomes by using PSM. Level III, Therapeutic Study.
Identifiants
pubmed: 30655093
pii: S1017-995X(18)30167-6
doi: 10.1016/j.aott.2018.12.006
pmc: PMC6510669
pii:
doi:
Types de publication
Journal Article
Langues
eng
Pagination
106-114Informations de copyright
Copyright © 2018 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.
Références
J Shoulder Elbow Surg. 1999 Nov-Dec;8(6):599-605
pubmed: 10633896
J Bone Joint Surg Am. 2000 Apr;82(4):505-15
pubmed: 10761941
J Shoulder Elbow Surg. 2001 Mar-Apr;10(2):109-15
pubmed: 11307072
Clin Sports Med. 1992 Oct;11(4):851-70
pubmed: 1423702
J Bone Joint Surg Am. 2004 Feb;86(2):219-24
pubmed: 14960664
Am J Obstet Gynecol. 2004 Dec;191(6):1961-70
pubmed: 15592278
Clin Microbiol Infect. 2005 Jan;11(1):3-8
pubmed: 15649297
Surgery. 2005 May;137(5):571-3
pubmed: 15855932
Br J Sports Med. 2007 Aug;41(8):e9
pubmed: 17289860
Skeletal Radiol. 2007 May;36(5):411-6
pubmed: 17334761
J Bone Joint Surg Am. 2007 May;89(5):953-60
pubmed: 17473131
Arthroscopy. 2008 Sep;24(9):983-91
pubmed: 18760204
J Shoulder Elbow Surg. 2008 Nov-Dec;17(6):881-5
pubmed: 18774738
Arthroscopy. 2008 Dec;24(12):1430-2
pubmed: 19038716
Emerg Themes Epidemiol. 2010 May 11;7(1):1
pubmed: 20459823
Injury. 2012 Sep;43(9):1614-6
pubmed: 21641596
Am J Sports Med. 2012 Mar;40(3):631-9
pubmed: 22190415
Arthroscopy. 2013 Feb;29(2):290-300
pubmed: 23290184
Orthopedics. 2013 May;36(5):e606-12
pubmed: 23672913
Acta Biomater. 2013 Sep;9(9):8440-8
pubmed: 23747323
Br J Anaesth. 2013 Jul;111(1):26-37
pubmed: 23794642
Acta Clin Croat. 2013 Dec;52(4):492-6
pubmed: 24697001
Am J Sports Med. 2015 Mar;43(3):588-96
pubmed: 25535097
Int J Shoulder Surg. 2015 Apr-Jun;9(2):47-51
pubmed: 25937714
Acta Orthop Traumatol Turc. 2016 Aug;50(4):448-51
pubmed: 27492582
BMC Musculoskelet Disord. 2018 Jun 21;19(1):197
pubmed: 30037322
J Bone Joint Surg Am. 1984 Apr;66(4):563-7
pubmed: 6707035
Clin Orthop Relat Res. 1994 Jul;(304):78-83
pubmed: 8020238
J Bone Joint Surg Am. 1993 Dec;75(12):1795-803
pubmed: 8258550