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Hurley ET, Calvo E, Collin P, Claro R, Magosch P, Schoierer O, Karelse A, Rasmussen J. European Society for Surgery of the Shoulder and Elbow (SECEC) rotator cuff tear registry Delphi consensus. JSES Int 2024; 8:478-482. [PMID: 38707551 PMCID: PMC11064705 DOI: 10.1016/j.jseint.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
Background The purpose of this study was to establish consensus statements via a Delphi process on the factors that should be included in a registry for those patients undergoing rotator cuff tear treatment. Methods A consensus process on the treatment of rotator cuff utilizing a modified Delphi technique was conducted. Fifty-seven surgeons completed these consensus statements and 9 surgeons declined. The participants were members of the European Society for Surgery of the Shoulder and Elbow committees representing 23 European countries. Thirteen questions were generated regarding the diagnosis and follow-up of rotator cuff tears were distributed, with 3 rounds of questionnaires and final voting occurring. Consensus was defined as achieving 80%-89% agreement, whereas strong consensus was defined as 90%-99% agreement, and unanimous consensus was defined by 100% agreement with a proposed statement. Results Of the 13 total questions and consensus statements on rotator cuff tears, 1 achieved unanimous consensus, 6 achieved strong consensus, 5 achieved consensus, and 1 did not achieve consensus. The statement that reached unanimous consensus was that the factors in the patient history that should be evaluated and recorded in the setting of suspected/known rotator cuff tear are age, gender, comorbidities, smoking, traumatic etiology, prior treatment including physical therapy/injections, pain, sleep disturbance, sports, occupation, workmen's compensation, hand dominance, and functional limitations. The statement that did not achieve consensus was related to the role of ultrasound in the initial diagnosis of patients with rotator cuff tears. Conclusion Nearly all questions reached consensus among 57 European Society for Surgery of the Shoulder and Elbow members representing 23 different European countries. We encourage surgeons to use this minimum set of variables to establish rotator cuff registries and multicenter studies. By adapting and using compatible variables, data can more easily be compared and eventually merged across countries.
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Affiliation(s)
- Eoghan T. Hurley
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Emilio Calvo
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | | | - Rui Claro
- Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | | | | | | | | | - SECEC Committee Members
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
- American Hospital of Paris, Neuilly-sur-Seine, France
- Centro Hospitalar Universitário de Santo António, Porto, Portugal
- University Medical Center, Heidelberg, Germany
- Ghent University Hospital, Ghent, Belgium
- Herlev and Gentofte University Hospital, Hellerup, Denmark
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Chernchujit B, Mendoza CJP, Samsuya KKM. Blended Suture-bridge Technique for Arthroscopic Rotator Cuff Repair. Arthrosc Tech 2023; 12:e569-e574. [PMID: 37138682 PMCID: PMC10150159 DOI: 10.1016/j.eats.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/28/2022] [Accepted: 12/10/2022] [Indexed: 05/05/2023] Open
Abstract
Techniques in rotator cuff repair are constantly evolving, with the main goal of a biologic, stable, and tension-free construct. Significant controversy exists between various methods, and there is no gold standard surgical protocol. We demonstrate an alternative arthroscopic rotator cuff repair technique with 2 key components. First, we performed a transosseous equivalent, suture bridge technique with a combination of triple-loaded medial anchors and knotless lateral anchors. Second, we incorporated 2-strand and 3-strand suture shuttling through the torn rotator cuff and selective medial knot-tying. A total of 6 passes through the tendon are made, comprising 1-2-3-3-2-1 strands each pass. This minimizes the number of passes through the tendon and the overall number of medial knots. Our technique retains the known biomechanical advantages akin to a double-row repair, including less gap formation and wider footprint coverage. In addition, using fewer medial knots with efficient suture passing may result to decreased cuff strangulation and favorable biologic environment for tendon healing. We theorize that this technique may yield lower retear rates while maintaining immediate stability, translating to improved clinical results.
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Affiliation(s)
| | - Christian Julius P. Mendoza
- Address correspondence to Christian Julius P. Mendoza, M.D., Thammasat University Hospital, Pathum Thani, Thailand 12120.
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Fang CJ, Wang JH, Su WR, Kuan FC, Hong CK, Hsu KL. Modified Double-Pulley And Rip-Stop Suture Bridge Technique In Arthroscopic Rotator Cuff Repair. Arthrosc Tech 2023; 12:e301-e305. [PMID: 36879864 PMCID: PMC9984839 DOI: 10.1016/j.eats.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/02/2022] [Indexed: 01/20/2023] Open
Abstract
Numerous techniques have been formulated for increasing the tendon-bone contact area and for providing a better healing environment for the tendon in cases of rotator cuff tear. An ideal rotator cuff repair maximizes the tendon-bone interface and provides the rotator cuff with sufficient biomechanical strength for it to withstand a high load. In this article, we propose a technique with the advantages of both the double-pulley and the rip-stop suture-bridge techniques, which increases the pressurized contact area along the medial row, achieves higher failure loads than non-rip-stop techniques, and reduces tendon cut-through.
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Affiliation(s)
- Chi-Jung Fang
- Department of Orthopaedic Surgery, An Nan Hospital, China Medical University, Tainan
| | - Jou-Hua Wang
- Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Wei-Ren Su
- Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | - Fa-Chuan Kuan
- Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.,Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.,Department of Biomedical Engineering, National Cheng Kung University, and the Division of Traumatology, National Cheng Kung University Medical Center, Tainan.,Division of Orthopaedics, Department of Surgery, National Cheng Kung University Hospital Dou Liou Branch, National Cheng Kung University, Yunlin, Taiwan
| | - Chih-Kai Hong
- Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.,Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.,Division of Orthopaedics, Department of Surgery, National Cheng Kung University Hospital Dou Liou Branch, National Cheng Kung University, Yunlin, Taiwan
| | - Kai-Lan Hsu
- Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.,Skeleton Materials and Bio-compatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan.,Department of Biomedical Engineering, National Cheng Kung University, and the Division of Traumatology, National Cheng Kung University Medical Center, Tainan
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Brand JC, Rossi MJ, Lubowitz JH. Arthroscopy Honors Award-Winning Articles and Authors: Our Annual Research Awards. Arthroscopy 2023; 39:1-6. [PMID: 36543414 DOI: 10.1016/j.arthro.2022.10.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 12/23/2022]
Abstract
With genuine gratitude to the AANA Education Foundation for their unstinting support, it is our honor to announce Arthroscopy's Annual Awards for the best Clinical Research, Basic Science Research, Resident/Fellow Research, and Systematic Reviews published in 2022, as well as the Most Downloaded and Most Cited papers published 5 years ago. And as is customary in January, our editors update their disclosures of potential conflicts of interest, as we require of authors, and we update our masthead to introduce new members of our Editorial Board and Social Media Board.
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