Background: The purpose of this study is to report the outcomes in patients undergoing arthroscopic tuberoplasty for symptomatic irreparable rotator cuff tear (RCT).
Methods: This is a retrospective cohort study comparing preoperative and postoperative data of patients undergoing arthroscopic tuberoplasty for symptomatic irreparable RCT. Exclusion criteria included open tuberoplasty, concomitant partial RCT repair, glenohumeral arthritis, concomitant ipsilateral extremity fractures, <12 months follow-up, or pseudoparalysis. Demographics, shoulder range of motion (ROM), RCT morphology, re-operation rates, satisfaction and outcome scores were collected from medical records and questionnaires. Outcome scores included Patient Reported Outcome Measurement Information System Upper Extremity (PROMIS), American Shoulder and Elbow Surgeons score (ASES), Subjective Shoulder Value (SSV), and pain Visual Analog Score (VAS).
Results: Out of 28 patients identified between 2012 and 2019, 20 (21 shoulders) were available for follow-up at a mean of 43.3 ± 20.9 months. Mean age was 64.6 ± 8.8 years. Mean PROMIS was 37.7 ± 7.3, ASES was 82.9 ± 13.8, and SVV was 67.1 ± 19.4. VAS with activity decreased from 5.0 ± 2.9 preoperatively to 2.3 ± 2.6 ( = .0029). Pre- and post-operative ROM were unchanged. There were 4 failures requiring revision. The remaining 17 patients reported high satisfaction scores (3.4 ± 0.7) and 15 (88.2%) answered "yes" to getting the procedure again, with 3/4 failures stating they would also undergo arthroscopic tuberoplasty again.
Conclusion: Arthroscopic tuberoplasty demonstrates high levels of satisfaction and pain reduction in symptomatic irreparable RCT. In appropriately indicated patients, this treatment should be considered prior to other salvage options.
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http://dx.doi.org/10.1016/j.jseint.2022.06.007 | DOI Listing |
Arthrosc Tech
October 2024
Department of Orthopaedic Surgery, Missouri Orthopaedic Institute, University of Missouri, Columbia, Missouri, U.S.A.
Recent attention has turned toward the prevention of acromiohumeral abutment in the treatment of irreparable rotator cuff tears (IRCTs). This can be achieved through tendon transfer with a bridging allograft, superior capsular reconstruction, dermal allograft application to the greater tuberosity (biologic tuberoplasty), bursal acromial reconstruction, or subacromial balloon spacer placement. Recent literature has demonstrated increased graft thickness is associated with improved clinical outcomes after superior capsular reconstruction, suggesting a potential role of a direct bone-to-bone contact between the greater tuberosity and acromion in symptom generation in patients with IRCTs.
View Article and Find Full Text PDFJ Orthop Surg Res
June 2024
Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Yong'an road, Xicheng District, Beijing, 101149, China.
Medicina (Kaunas)
March 2024
Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan 31116, Republic of Korea.
An irreparable rotator cuff tear is a challenging condition to treat, and various treatment modalities are being introduced. Medialization in the partial repair method has the limitation of exposing the tuberosity, while tension-free biologic interposition tuberoplasty using acellular dermal matrix has the limitation of exposing the humeral head. The authors believe that by combining these two techniques, it is possible to complement each other's limitations.
View Article and Find Full Text PDFJ Orthop
May 2024
Department of Orthopaedic Surgery, Dankook University College of Medicine, Cheonan, South Korea.
Background: Recently, among the various method for irreparable rotator cuff tears, the "tension-free allodermis graft technique" has been introduced as a method for arthroscopic biologic tuberoplasty(ABT) and bursal acromial reconstruction(BAR).The objective was to analyze the outcomes of ABT and BAR combination surgical technique.
Methods: Eighteen cases who underwent simultaneous ABT and BAR procedures were retrospectively recruited.
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