Does the Literature Confirm Superior Clinical Results in Radiographically Healed Rotator Cuffs After Rotator Cuff Repair?

被引:120
|
作者
Slabaugh, Mark A. [1 ]
Nho, Shane J. [1 ]
Grumet, Robert C. [1 ]
Wilson, Joseph B. [1 ]
Seroyer, Shane T. [1 ]
Frank, Rachel M. [1 ]
Romeo, Anthony A. [1 ]
Provencher, Matthew T. [2 ]
Verma, Nikhil N. [1 ]
机构
[1] Rush Univ, Med Ctr, Dept Orthopaed Surg, Div Sports Med,Rush Med Coll, Chicago, IL 60612 USA
[2] USN, Div Shoulder & Sports Surg, Dept Orthopaed Surg, Med Ctr, San Diego, CA 92152 USA
关键词
2-YEAR FOLLOW-UP; SUPRASPINATUS TENDON REPAIR; SIMPLE SHOULDER TEST; SINGLE-ROW; ARTHROSCOPIC REPAIR; STRUCTURAL INTEGRITY; MASSIVE TEARS; ARTHROGRAPHY; RELIABILITY; VALIDITY;
D O I
10.1016/j.arthro.2009.07.023
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Purpose: Because recurrent or persistent defects in the rotator cuff after repair are common, we sought to systematic review of relevant studies. Methods: Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and the Cochrane Central Register of Controlled Trials were searched for all literature published from January 1966 to December 2008 that used the key words shoulder, rotator cuff, rotator cuff tear, rotator cuff repair, arthroscopic, integrity, healed, magnetic resonance imaging (MRI), computed tomography arthrography (CTA), and ultrasound. The inclusion criteria were studies (Levels I to IV) that reported outcomes after arthroscopic rotator cuff repair in healed and nonhealed repairs based on ultrasound, CTA, and/or MRI. Exclusionary criteria were studies that included open repair or subscapularis repair and studies that did not define outcomes based on healed versus nonhealed but rather used another variable (i.e., repair technique). Data were abstracted from the studies including patient demographics, tear characteristics, surgical procedure, rehabilitation, strength, range of motion, clinical scoring systems, and imaging studies. Results: Thirteen studies were included in the final analysis: 5 used ultrasound, 4 used MRI, 2 used CTA, and 2 used combined CTA/MRI for diagnosis of a recurrent tear. Statistical improvement in patients who had an intact cuff at follow-up was seen in Constant scores in 6 of 9 studies; in University of California, Los Angeles scores in 1 of 2 studies; in American Shoulder and Elbow Surgeons scores in 0 of 3 studies; and in Simple Shoulder Test scores in 0 of 2 studies. Increased range of motion in forward elevation was seen in 2 of 5 studies and increased strength in forward elevation in 5 of 8 studies. Conclusions: The results suggest that some important differences in clinical outcomes likely exist between patients with healed and nonhealed rotator cuff repairs. Further study is needed to conclusively define this difference and identify other important prognostic factors related to clinical outcomes. Level of Evidence: Level IV, systematic review.
引用
收藏
页码:393 / 403
页数:11
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