Long-term results after arthroscopic treatment of symptomatic Ellman grade 2 PASTA lesions.


Journal

Journal of shoulder and elbow surgery
ISSN: 1532-6500
Titre abrégé: J Shoulder Elbow Surg
Pays: United States
ID NLM: 9206499

Informations de publication

Date de publication:
Jul 2019
Historique:
received: 25 09 2018
revised: 03 12 2018
accepted: 11 12 2018
pubmed: 25 3 2019
medline: 7 11 2019
entrez: 25 3 2019
Statut: ppublish

Résumé

The purpose of this retrospective study was to evaluate the clinical and radiologic long-term results of medium-sized (Ellman grade 2) partial-thickness articular-sided supraspinatus tendon avulsion (PASTA) lesions treated arthroscopically. Of 22 patients, 18 (82%) were available for follow-up evaluation after a mean of 15 ± 2 years (range, 12-17 years). The mean age at time of surgery was 55 ± 9 years (range, 35-66 years). The Constant score was used as the primary outcome instrument to evaluate shoulder function. Furthermore, the University of California-Los Angeles shoulder score, the American Shoulder and Elbow Surgeons score, and the Subjective Shoulder Value were collected. The patients' satisfaction with the outcome was investigated. Tendon integrity of the affected shoulder at final follow-up was assessed with magnetic resonance imaging or ultrasound in 89% of the cohort. Overall, 94% of the patients were very satisfied or satisfied with the outcome. The average Constant score of the affected shoulder was 78 ± 21 points; the University of California-Los Angeles score, 31 ± 7 points; the American Shoulder and Elbow Surgeons score, 85 ± 24 points; and the Subjective Shoulder Value, 83% ± 21%. Radiologic evaluation showed progression to a full-thickness rotator cuff tear in 6% (1/16), and 60% of the patients (6/10) showed persistent signs of partial tearing evaluated by magnetic resonance imaging. At long-term follow-up, arthroscopic treatment of medium-sized PASTA lesions resulted in good clinical results together with a high satisfaction level of the patients.

Sections du résumé

BACKGROUND BACKGROUND
The purpose of this retrospective study was to evaluate the clinical and radiologic long-term results of medium-sized (Ellman grade 2) partial-thickness articular-sided supraspinatus tendon avulsion (PASTA) lesions treated arthroscopically.
METHODS METHODS
Of 22 patients, 18 (82%) were available for follow-up evaluation after a mean of 15 ± 2 years (range, 12-17 years). The mean age at time of surgery was 55 ± 9 years (range, 35-66 years). The Constant score was used as the primary outcome instrument to evaluate shoulder function. Furthermore, the University of California-Los Angeles shoulder score, the American Shoulder and Elbow Surgeons score, and the Subjective Shoulder Value were collected. The patients' satisfaction with the outcome was investigated. Tendon integrity of the affected shoulder at final follow-up was assessed with magnetic resonance imaging or ultrasound in 89% of the cohort.
RESULTS RESULTS
Overall, 94% of the patients were very satisfied or satisfied with the outcome. The average Constant score of the affected shoulder was 78 ± 21 points; the University of California-Los Angeles score, 31 ± 7 points; the American Shoulder and Elbow Surgeons score, 85 ± 24 points; and the Subjective Shoulder Value, 83% ± 21%. Radiologic evaluation showed progression to a full-thickness rotator cuff tear in 6% (1/16), and 60% of the patients (6/10) showed persistent signs of partial tearing evaluated by magnetic resonance imaging.
CONCLUSION CONCLUSIONS
At long-term follow-up, arthroscopic treatment of medium-sized PASTA lesions resulted in good clinical results together with a high satisfaction level of the patients.

Identifiants

pubmed: 30904238
pii: S1058-2746(18)30943-1
doi: 10.1016/j.jse.2018.12.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1356-1362

Informations de copyright

Copyright © 2018 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Auteurs

Fabian Plachel (F)

Department of Orthopaedics and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria; Institute of Tendon and Bone Regeneration, Paracelsus Medical University Salzburg, Salzburg, Austria; Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitätsmedizin Berlin, Berlin, Germany. Electronic address: fabian.plachel@charite.de.

Gundobert Korn (G)

Department of Orthopaedics and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria.

Andreas Traweger (A)

Institute of Tendon and Bone Regeneration, Paracelsus Medical University Salzburg, Salzburg, Austria.

Reinhold Ortmaier (R)

Vinzenzgruppe Center of Orthopaedic Excellence, Paracelsus Medical University Salzburg, Linz, Austria.

Herbert Resch (H)

Department of Orthopaedics and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria.

Philipp Moroder (P)

Center for Musculoskeletal Surgery, Campus Virchow, Charité-Universitätsmedizin Berlin, Berlin, Germany.

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Classifications MeSH