J Korean Orthop Assoc.  2013 Jun;48(3):213-221. 10.4055/jkoa.2013.48.3.213.

Choice of Initial Operation and Functional Outcome in Rotator Cuff Repair on Both Shoulder

• Chang HJ
• Choi CH
• Eom YS

• KMID: 2106675
• DOI: http://doi.org/10.4055/jkoa.2013.48.3.213

Abstract

PURPOSE
We evaluated the influencing factors in selection of initial operation and outcomes after operative treatment of symptomatic rotator cuff tear including both sides.
MATERIALS AND METHODS
From December 2000 to March 2011, 60 shoulders of 30 patients underwent arthroscopic rotator cuff repair by a single experienced shoulder surgeon in our clinic. We retrospectively compared outcome by operation order according to hand dominance, tear size and by operation timing, operation method, and tear size. Symptom period was 10 months until the first operation and 19 months until the second operation. Interval between first and second operation was nine months.
RESULTS
In comparison by operation order according to hand dominance and tear size, the functional scores did not differ significantly between the initial repair and delayed repair group (p>0.05). In comparison in a total of 60 cases, the functional outcome according to the operation timing and method of operation was not significantly different (p>0.05). The smaller sized tear group showed significantly better functional outcome, compared to the larger sized tear group (p<0.05).
CONCLUSION
In cases of both-side symptomatic rotator cuff tear, most operations were performed on the more symptomatic side and the dominant arm first. The functional outcome showed improvement, regardless of operation order according to hand dominance and tear size, and regardless of operation timing and operation method as well. Tear size was the only significant factor influencing functional outcome.

Keyword

shoulder; rotator cuff tear; both sides; arthroscopic repair

MeSH Terms

Arm
Hand
Humans
Retrospective Studies
Rotator Cuff
Shoulder

Reference

1. Lehman C, Cuomo F, Kummer FJ, Zuckerman JD. The incidence of full thickness rotator cuff tears in a large cadaveric population. Bull Hosp Jt Dis. 1995; 54:30–31.

2. Mantone JK, Burkhead WZ Jr, Noonan J Jr. Nonoperative treatment of rotator cuff tears. Orthop Clin North Am. 2000; 31:295–311.

3. Gartsman GM, Khan M, Hammerman SM. Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 1998; 80:832–840.

4. Gartsman GM, Brinker MR, Khan M. Early effectiveness of arthroscopic repair for full-thickness tears of the rotator cuff: an outcome analysis. J Bone Joint Surg Am. 1998; 80:33–40.

5. Hersch JC, Sgaglione NA. Arthroscopically assisted miniopen rotator cuff repairs. Functional outcome at 2- to 7-year follow-up. Am J Sports Med. 2000; 28:301–311.

6. Warner JJ, Tétreault P, Lehtinen J, Zurakowski D. Arthroscopic versus mini-open rotator cuff repair: a cohort comparison study. Arthroscopy. 2005; 21:328–332.

7. Wolf EM, Pennington WT, Agrawal V. Arthroscopic rotator cuff repair: 4- to 10-year results. Arthroscopy. 2004; 20:5–12.

8. Bittar ES. Arthroscopic management of massive rotator cuff tears. Arthroscopy. 2002; 18:9 Suppl 2. 104–106.

9. Yamaguchi K, Tetro AM, Blam O, Evanoff BA, Teefey SA, Middleton WD. Natural history of asymptomatic rotator cuff tears: a longitudinal analysis of asymptomatic tears detected sonographically. J Shoulder Elbow Surg. 2001; 10:199–203.

10. Marx RG, Koulouvaris P, Chu SK, Levy BA. Indications for surgery in clinical outcome studies of rotator cuff repair. Clin Orthop Relat Res. 2009; 467:450–456.

11. Petersen SA, Murphy TP. The timing of rotator cuff repair for the restoration of function. J Shoulder Elbow Surg. 2011; 20:62–68.

12. Björnsson HC, Norlin R, Johansson K, Adolfsson LE. The influence of age, delay of repair, and tendon involvement in acute rotator cuff tears: structural and clinical outcomes after repair of 42 shoulders. Acta Orthop. 2011; 82:187–192.

13. Kim YK. Controversy in pathophysiology of rotator cuff tear: degenerative tear. J Korean Shoulder Elbow Soc. 2008; 11:71–76.

14. Hashimoto T, Nobuhara K, Hamada T. Pathologic evidence of degeneration as a primary cause of rotator cuff tear. Clin Orthop Relat Res. 2003; 415:111–120.

15. Tempelhof S, Rupp S, Seil R. Age-related prevalence of rotator cuff tears in asymptomatic shoulders. J Shoulder Elbow Surg. 1999; 8:296–299.

16. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995; 77:10–15.

17. Kim DH, Elattrache NS, Tibone JE, et al. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med. 2006; 34:407–414.

18. Lorbach O, Bachelier F, Vees J, Kohn D, Pape D. Cyclic loading of rotator cuff reconstructions: single-row repair with modified suture configurations versus double-row repair. Am J Sports Med. 2008; 36:1504–1510.

19. Ma CB, Comerford L, Wilson J, Puttlitz CM. Biomechanical evaluation of arthroscopic rotator cuff repairs: double-row compared with single-row fixation. J Bone Joint Surg Am. 2006; 88:403–410.

20. Nelson CO, Sileo MJ, Grossman MG, Serra-Hsu F. Single-row modified mason-allen versus double-row arthroscopic rotator cuff repair: a biomechanical and surface area comparison. Arthroscopy. 2008; 24:941–948.

21. Smith CD, Alexander S, Hill AM, et al. A biomechanical comparison of single and double-row fixation in arthroscopic rotator cuff repair. J Bone Joint Surg Am. 2006; 88:2425–2431.

22. Burks RT, Crim J, Brown N, Fink B, Greis PE. A prospective randomized clinical trial comparing arthroscopic single- and double-row rotator cuff repair: magnetic resonance imaging and early clinical evaluation. Am J Sports Med. 2009; 37:674–682.

23. Mazzocca AD, Millett PJ, Guanche CA, Santangelo SA, Arciero RA. Arthroscopic single-row versus double-row suture anchor rotator cuff repair. Am J Sports Med. 2005; 33:1861–1868.

24. Nho SJ, Slabaugh MA, Seroyer ST, et al. Does the literature support double-row suture anchor fixation for arthroscopic rotator cuff repair? A systematic review comparing double-row and single-row suture anchor configuration. Arthroscopy. 2009; 25:1319–1328.

25. Park JY, Lhee SH, Choi JH, Park HK, Yu JW, Seo JB. Comparison of the clinical outcomes of single- and double-row repairs in rotator cuff tears. Am J Sports Med. 2008; 36:1310–1316.

26. Sugaya H, Maeda K, Matsuki K, Moriishi J. Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation. Arthroscopy. 2005; 21:1307–1316.

27. Kim HM, Dahiya N, Teefey SA, Keener JD, Galatz LM, Yamaguchi K. Relationship of tear size and location to fatty degeneration of the rotator cuff. J Bone Joint Surg Am. 2010; 92:829–839.

28. Gladstone JN, Bishop JY, Lo IK, Flatow EL. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med. 2007; 35:719–728.

29. Goutallier D, Postel JM, Gleyze P, Leguilloux P, Van Driessche S. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full-thickness tears. J Shoulder Elbow Surg. 2003; 12:550–554.