Comparative analysis of functional outcomes in arthroscopic repair for traumatic and non-traumatic rotator cuff injuries.
Non-traumatic
Prognostic factors
Shoulder cuff repair
Traumatic
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
08 Oct 2024
08 Oct 2024
Historique:
received:
10
06
2024
accepted:
23
09
2024
medline:
9
10
2024
pubmed:
9
10
2024
entrez:
8
10
2024
Statut:
epublish
Résumé
The impact of the etiology of rotator cuff injury (RCI) on outcomes after rotator cuff repair remains unclear. This study aimed to evaluate the postoperative outcomes of patients with RCIs of different etiologies and identify the risk factors affecting prognosis. This study included 73 patients with RCI who underwent arthroscopic rotator cuff repair. The patients were categorized into either a traumatic group or a non-traumatic group based on their history of trauma. Preoperative and postoperative assessments included shoulder range of motion, muscle strength, and physical examination findings specific to the shoulder for both groups. Clinical differences between arthroscopic repair of traumatic and non-traumatic RCIs were evaluated using univariate analysis. Logistic regression analysis determined independent risk factors for rotator cuff repair prognosis. Among the 73 patients, 31 were in the traumatic group and 42 in the non-traumatic group, with a minimum postoperative follow-up of 12 months and a mean follow-up of 13.8 months. The duration of the disease was significantly longer in the non-traumatic group compared with the traumatic group (P < 0.001). The mean tear area was more significant in the traumatic group than in the non-traumatic group (P = 0.003), and the preoperative pain level and functional scores were better in the non-traumatic group compared with the traumatic group. Postoperatively, there were no differences between the two groups regarding scores, joint mobility, strength, and complications. At 12 months postoperatively, multivariate regression analysis indicated that full-layer tear (OR = 5.106, 95% CI: 1.137-22.927, P = 0.033), fat infiltration (OR = 6.020, 95% CI: 1.113-32.554, P = 0.037), and tear area (OR = 6.038, 95% CI: 2.122-17.177, P < 0.001) significantly affected the University of California at Los Angeles (UCLA) score. Compared with non-traumatic RCI, traumatic RCI presents with more pronounced pain and impaired joint function preoperatively yet demonstrates comparable postoperative clinical outcomes. Full-layer tears, fat infiltration, and large tear areas are unfavorable factors affecting rotator cuff repair, and postoperative rehabilitation management of these patients should be emphasized.
Sections du résumé
BACKGROUND
BACKGROUND
The impact of the etiology of rotator cuff injury (RCI) on outcomes after rotator cuff repair remains unclear. This study aimed to evaluate the postoperative outcomes of patients with RCIs of different etiologies and identify the risk factors affecting prognosis.
METHODS
METHODS
This study included 73 patients with RCI who underwent arthroscopic rotator cuff repair. The patients were categorized into either a traumatic group or a non-traumatic group based on their history of trauma. Preoperative and postoperative assessments included shoulder range of motion, muscle strength, and physical examination findings specific to the shoulder for both groups. Clinical differences between arthroscopic repair of traumatic and non-traumatic RCIs were evaluated using univariate analysis. Logistic regression analysis determined independent risk factors for rotator cuff repair prognosis.
RESULTS
RESULTS
Among the 73 patients, 31 were in the traumatic group and 42 in the non-traumatic group, with a minimum postoperative follow-up of 12 months and a mean follow-up of 13.8 months. The duration of the disease was significantly longer in the non-traumatic group compared with the traumatic group (P < 0.001). The mean tear area was more significant in the traumatic group than in the non-traumatic group (P = 0.003), and the preoperative pain level and functional scores were better in the non-traumatic group compared with the traumatic group. Postoperatively, there were no differences between the two groups regarding scores, joint mobility, strength, and complications. At 12 months postoperatively, multivariate regression analysis indicated that full-layer tear (OR = 5.106, 95% CI: 1.137-22.927, P = 0.033), fat infiltration (OR = 6.020, 95% CI: 1.113-32.554, P = 0.037), and tear area (OR = 6.038, 95% CI: 2.122-17.177, P < 0.001) significantly affected the University of California at Los Angeles (UCLA) score.
CONCLUSION
CONCLUSIONS
Compared with non-traumatic RCI, traumatic RCI presents with more pronounced pain and impaired joint function preoperatively yet demonstrates comparable postoperative clinical outcomes. Full-layer tears, fat infiltration, and large tear areas are unfavorable factors affecting rotator cuff repair, and postoperative rehabilitation management of these patients should be emphasized.
Identifiants
pubmed: 39379901
doi: 10.1186/s12891-024-07897-x
pii: 10.1186/s12891-024-07897-x
doi:
Types de publication
Journal Article
Comparative Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
795Informations de copyright
© 2024. The Author(s).
Références
Curtis AS, Burbank KM, Tierney JJ, et al. The insertional footprint of the rotator cuff: an anatomic study. Arthroscopy. 2006;22(6):609e601.
doi: 10.1016/j.arthro.2006.04.001
Oh LS, Wolf BR, Hall MP, et al. Indications for rotator cuff repair: a systematic review. Clin Orthop Relat Res. 2007;455:52–63.
doi: 10.1097/BLO.0b013e31802fc175
pubmed: 17179786
Godshaw BM, Hughes JD, Boden SA, et al. Comparison of functional outcomes after arthroscopic rotator cuff repair between patients with traumatic and atraumatic tears. Orthop J Sports Med. 2022;10(10):23259671221126551.
pubmed: 36313008
pmcid: 9608059
Keener JD, Patterson BM, Orvets N, et al. Degenerative rotator cuff tears: Refining Surgical indications based on natural History Data. J Am Acad Orthop Surg. 2019;27(5):156–65.
doi: 10.5435/JAAOS-D-17-00480
pubmed: 30335631
pmcid: 6389433
Mall NA, Lee AS, Chahal J, et al. An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy. 2013;29(2):366–76.
doi: 10.1016/j.arthro.2012.06.024
pubmed: 23290186
Paloneva J, Lepola V, Aarimaa V, et al. Increasing incidence of rotator cuff repairs–A nationwide registry study in Finland. BMC Musculoskelet Disord. 2015;16:189.
doi: 10.1186/s12891-015-0639-6
pubmed: 26265152
pmcid: 4531533
Kuhn JE, Dunn WR, Sanders R, et al. Effectiveness of physical therapy in treating atraumatic full-thickness rotator cuff tears: a multicenter prospective cohort study. J Shoulder Elb Surg. 2013;22(10):1371–9.
doi: 10.1016/j.jse.2013.01.026
Franceschi F, Papalia R, Vasta S, et al. Surgical management of irreparable rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2015;23(2):494–501.
doi: 10.1007/s00167-012-2317-7
pubmed: 23212188
Dang A, Davies M. Rotator Cuff Disease: Treatment options and considerations. Sports Med Arthrosc Rev. 2018;26(3):129–33.
doi: 10.1097/JSA.0000000000000207
pubmed: 30059447
Braune C, von Eisenhart-Rothe R, Welsch F, et al. Mid-term results and quantitative comparison of postoperative shoulder function in traumatic and non-traumatic rotator cuff tears. Arch Orthop Trauma Surg. 2003;123(8):419–24.
doi: 10.1007/s00402-003-0548-2
pubmed: 14574601
Tan M, Lam PH, Le BT, et al. Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair. J Shoulder Elb Surg. 2016;25(1):12–21.
doi: 10.1016/j.jse.2015.06.023
Cederqvist S, Flinkkilä T, Sormaala M, Ylinen J, Kautiainen H, Irmola T, et al. Non-surgical and surgical treatments for rotator cuff disease: a pragmatic randomised clinical trial with 2-year follow-up after initial rehabilitation. Ann Rheum Dis. 2021;80(6):796–802.
doi: 10.1136/annrheumdis-2020-219099
pubmed: 33272959
Goutallier D, Postel JM, Bernageau J et al. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res. 1994; (304): 78–83.
Kim YK, Jung KH, Kim JW, et al. Factors affecting rotator cuff integrity after arthroscopic repair for medium-sized or larger cuff tears: a retrospective cohort study. J Shoulder Elb Surg. 2018;27(6):1012–20.
doi: 10.1016/j.jse.2017.11.016
Rashid MS, Cooper C, Cook J, et al. Increasing age and tear size reduce rotator cuff repair healing rate at 1 year. Acta Orthop. 2017;88(6):606–11.
doi: 10.1080/17453674.2017.1370844
pubmed: 28880113
pmcid: 5694804
Diebold G, Lam P, Walton J, et al. Relationship between Age and Rotator Cuff Retear: a study of 1,600 consecutive Rotator Cuff repairs. J Bone Joint Surg Am. 2017;99(14):1198–205.
doi: 10.2106/JBJS.16.00770
pubmed: 28719559
Sugaya H, Maeda K, Matsuki K, Moriishi J. Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Joint Surg Am. 2007;89(5):953–60.
doi: 10.2106/JBJS.F.00512
pubmed: 17473131
Pogorzelski J, Erber B, Themessl A, et al. Definition of the terms acute and traumatic in rotator cuff injuries: a systematic review and call for standardization in nomenclature. Arch Orthop Trauma Surg. 2021;141(1):75–91.
doi: 10.1007/s00402-020-03656-4
pubmed: 33130936
Loew M, Magosch P, Lichtenberg S, et al. How to discriminate between acute traumatic and chronic degenerative rotator cuff lesions: an analysis of specific criteria on radiography and magnetic resonance imaging. J Shoulder Elb Surg. 2015;24(11):1685–93.
doi: 10.1016/j.jse.2015.06.005
Moorthy V, Chen JY, Lee M, et al. The UCLA Shoulder score is a Better Predictor of Treatment Success than the Constant and Oxford Shoulder scores after arthroscopic rotator cuff repair: a 2-Year Follow-Up study. Arthrosc Sports Med Rehabil. 2021;3(2):e485–90.
doi: 10.1016/j.asmr.2020.11.003
pubmed: 34027459
pmcid: 8129435
Somerson JS, Hsu JE, Gorbaty JD, Gee AO. Classifications in brief: Goutallier classification of fatty infiltration of the Rotator Cuff musculature. Clin Orthop Relat Res. 2016;474(5):1328–32.
doi: 10.1007/s11999-015-4630-1
pubmed: 26584800
Guevara BG. Editorial Commentary: in contrast to Chronic, degenerative rotator cuff tears, the critical shoulder Angle in traumatic rotator cuff tears can be ignored. Arthroscopy. 2023;39(2):232–3.
doi: 10.1016/j.arthro.2022.10.025
pubmed: 36603993
Bedi A, Bishop J, Keener J, et al. Rotator cuff tears. Nat Rev Dis Primers. 2024;10(1):8.
doi: 10.1038/s41572-024-00492-3
pubmed: 38332156
Lenza M, Buchbinder R, Takwoingi Y, et al. Magnetic resonance imaging, magnetic resonance arthrography and ultrasonography for assessing rotator cuff tears in people with shoulder pain for whom surgery is being considered. Cochrane Database Syst Rev. 2013;20139. CD009020.
Jenssen KK, Lundgreen K, Madsen JE, et al. Prognostic factors for functional Outcome after Rotator Cuff Repair: a prospective cohort study with 2-Year follow-up. Am J Sports Med. 2018;46(14):3463–70.
doi: 10.1177/0363546518803331
pubmed: 30383411
Ohzono H, Gotoh M, Nakamura H, et al. Effect of preoperative fatty degeneration of the Rotator Cuff muscles on the clinical outcome of patients with Intact tendons after arthroscopic rotator cuff repair of Large/Massive Cuff tears. Am J Sports Med. 2017;45(13):2975–81.
doi: 10.1177/0363546517724432
pubmed: 28906128
Teratani T. Comparison of the epidemiology and outcomes of traumatic and nontraumatic rotator cuff tears. J Orthop. 2017;14(1):166–70.
doi: 10.1016/j.jor.2016.12.007
pubmed: 28070148
pmcid: 5219609
Jensen AR, Taylor AJ, Sanchez-Sotelo J. Factors influencing the Reparability and Healing Rates of Rotator Cuff tears. Curr Rev Musculoskelet Med. 2020;13(5):572–83.
doi: 10.1007/s12178-020-09660-w
pubmed: 32681307
pmcid: 7474726
Mall NA, Tanaka MJ, Choi LS, et al. Factors affecting rotator cuff healing. J Bone Joint Surg Am. 2014;96(9):778–88.
doi: 10.2106/JBJS.M.00583
pubmed: 24806015
Park JS, Park HJ, Kim SH, et al. Prognostic factors affecting Rotator Cuff Healing after arthroscopic repair in small to medium-sized tears. Am J Sports Med. 2015;43(10):2386–92.
doi: 10.1177/0363546515594449
pubmed: 26286879
Raman J, Walton D, MacDermid JC, et al. Predictors of outcomes after rotator cuff repair-A meta-analysis. J Hand Ther. 2017;30(3):276–92.
doi: 10.1016/j.jht.2016.11.002
pubmed: 28237073
Fermont AJ, Wolterbeek N, Wessel RN, et al. Prognostic factors for recovery after arthroscopic rotator cuff repair: a prognostic study. J Shoulder Elb Surg. 2015;24(8):1249–56.
doi: 10.1016/j.jse.2015.04.013
Osborne JD, Gowda AL, Wiater B, Wiater JM. Rotator cuff rehabilitation: current theories and practice. Phys Sportsmed. 2016;44(1):85–92.
doi: 10.1080/00913847.2016.1108883
pubmed: 26548634
Lee BG, Cho NS, Rhee YG. Effect of two rehabilitation protocols on range of motion and healing rates after arthroscopic rotator cuff repair: aggressive versus limited early passive exercises. Arthroscopy. 2012;28(1):34–42.
doi: 10.1016/j.arthro.2011.07.012
pubmed: 22014477