engleski

Arthroscopic rotator cuff repair

Rotator cuff tears are common lesion of the shoulder. We evaluated two groups of patients who underwent arthroscopic rotator cuff repair for partial supraspinatus tear and full-thickness tears with or without acromioplasty. Material and Methods: Three hundred thirty patients were underwent arthroscopic rotator cuff repair in Akromion hospital. Two hundred seventy four patients had full-thickness rotator cuff tears (Group A) and fifty-six patients had partial supraspinatus tears (Group B). The patients were assessed with preoperative and postoperative physical examination and ultrasound. Group A, 274 patients (109 women, 165 men ; mean age 60 years ; range 23 to 81 years) with full- thickness tears were treated by arthroscopic rotator cuff repair, with or without acromioplasty, in a period of 45 months. The average follow-up was 22 months. 90 patients had a history of trauma. One hundred one patients underwent acromioplasty in combination with rotator cuff repair. Supraspinatus tendon was involved in 254 cases ; supraspinatus and subscapularis were involved in 21 patients and isolated subscapularis in 6 patients. Group B, 56 patients (27 women, 29 men ; mean age 55 years ; range 32 to 79 years) with partial rotator cuff tears were treated by arthroscopic repair, with or without acromioplasty, in a period of 45 months. The average follow-up was 22 months. Twenty-three patients had a history of trauma. Intraoperativelly partial thickness supraspinatus tears were classified according to Habermeyer. Twenty-four patients underwent acromioplasty in combination with suture anchor technique repair. Seven cases were treated by transosseous suture anchor technique, seventeen by transtendon suture anchor technique, one case with combined transosseus and transtendon suture anchor technique, one case with combined transtendon and single-row suture anchor technique, and the others with single or double-row suture anchor technique. The transosseus technique was used in cases where a conversion from partial to complete tendon rupture was done intraoperatively. The technique we used was determined by rupture type and size and by tendon quality. Results: There were no intraoperative complications. In group B with partial tears one patient had a mild inflammatory reaction around the anterior portal in the early postoperative period. One patient had a supraspinatus tendon rerupture, and he underwent a second tendon reconstruction procedure. The transtendon fixation was superior to other types of fixation. In group B with full-thickness tears five patients had retears and they were underwent for arthroscopic revision. Conclusion: Rotator cuff tears are causing many problems to patients, concerning both functionality and pain. Arthroscopic rotator cuff repair improved outcomes with regard to pain and shoulder function. Patient with partial supraspinatus tears had better functional results.

rotator cuff repair; arthroscopy; shoulder

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