1
|
De Giorgi S, Ottaviani G, Bianchi FP, Delmedico M, Suma M, Moretti B. Single-row versus transosseous technique in the arthroscopic treatment of rotator cuff tears: a meta-analysis. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY & TRAUMATOLOGY : ORTHOPEDIE TRAUMATOLOGIE 2024; 34:31-38. [PMID: 37561195 PMCID: PMC10771355 DOI: 10.1007/s00590-023-03657-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/25/2023] [Indexed: 08/11/2023]
Abstract
PURPOSE This study aims to compare single-row suture-anchors (SA) versus transosseous arthroscopic (TO) technique in the treatment of patients with rotator cuff tears in terms of clinical structural outcomes at atleast 24 months of follow-up. METHODS The systematic review was performed according to "PRISMA guidelines" (Preferred Reporting Items for Systematic Reviews and Meta-analyses), in order to identify all the studies comparing clinical, both subjective and objective, outcomes with 24 months follow-up minimum in patients undergoing arthroscopic RC repair with the SR and TO technique. OVID-MEDLINE®, Cochrane, SCOPUS and PubMed were searched from January 2010 to October 2022 to identify relevant studies, using the following key words, that were combined together to achieve maximum search strategy sensitivity: "Rotator cuff tear" OR "repair" OR "shoulder" OR "reconstruction" OR "suture" OR "arthroscopic" OR "single-row" OR "transosseous". RESULTS Six papers were finally analyzed in this meta-analysis. The weighted mean difference on Constant scores and for ASES for studies considering suture-anchors (SA) group showed good outcomes. The weighted mean difference of Constant scores and of ASES for TO (transosseous) group showed good outcomes. The weighted mean difference of CONSTANT for TO versus SA groups showed no differences in the outcomes of SA and TO techniques for the repair of Rotator Cuff Tears at minimum 24 months follow-up. CONCLUSIONS The Arthroscopic transosseous rotator cuff repair technique and SA (suture-anchor) technique both lead to significant short-term improvement and satisfactory subjective outcome scores with low complication/failure rates. No differences were found in the final outcome between the two techniques.
Collapse
Affiliation(s)
- S De Giorgi
- Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy.
| | - G Ottaviani
- Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - F P Bianchi
- Interdisciplinary Department of Medicine, University of Bari, Bari, Italy
| | - M Delmedico
- Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - M Suma
- Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - B Moretti
- Department of Translational Biomedicine and Neuroscience "DiBraiN", School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124, Bari, Italy
| |
Collapse
|
2
|
Yanke A, Dandu N, Credille K, Damodar D, Wang Z, Cole BJ. Indications and Technique: Rotator Cuff Repair Augmentation. J Am Acad Orthop Surg 2023; 31:1205-1210. [PMID: 37816190 DOI: 10.5435/jaaos-d-23-00101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 08/20/2023] [Indexed: 10/12/2023] Open
Abstract
Rotator cuff repair (RCR) augmentation is often considered for patients with large-to-massive rotator cuff tears or chronic tears with poor tissue quality. Augmentation can provide mechanical stability and improved biology to improve the likelihood of a successful repair. This article discusses the indications, diagnosis, surgical techniques, and outcomes for RCR augmentation using an acellular dermal allograft, partially demineralized cancellous allograft, dermal xenograft, bone marrow aspirate concentrate, and platelet-rich plasma.
Collapse
Affiliation(s)
- Adam Yanke
- From the Midwest Orthopedics at Rush, Chicago, IL (Yanke, Damodar, Wang, and Cole), the Department of Orthopedics, University of Illinois Chicago, Chicago, IL (Dandu), and the Department of Orthopedics, Houston Methodist Hospital, Houston, TX (Credille)
| | | | | | | | | | | |
Collapse
|
3
|
Storti TM, Ribeiro TDS, Faria RSS, Simionatto JE, Simionatto C, Paniago AF. Artroplastia reversa de ombro: Avaliação dos resultados clínicos e funcionais de acordo com a etiologia. Rev Bras Ortop 2022; 57:868-875. [PMID: 36226219 PMCID: PMC9550372 DOI: 10.1055/s-0041-1731674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/11/2021] [Indexed: 11/30/2022] Open
Abstract
Objective
The present study aimed to evaluate the clinical outcomes of reverse shoulder arthroplasty to treat several conditions.
Methods
Retrospective, longitudinal study analyzing the Constant and University of California at Los Angeles (UCLA) scores and range of motion of patients undergoing reverse shoulder arthroplasty.
Results
In total, 28 patients were analyzed, with a mean age of 75.6 years old. The mean duration of follow-up was 45 months. Overall, there was a significant variation (
p
< 0.0001) between the preoperative (10.2 points) and the postoperative UCLA scores (29.6 points), corresponding to a relative increase of approximately 200%. In addition, the mean Constant score was 67.8, and the complication rate was 17.8%. As for functional outcomes per etiology, fracture sequelae cases presented the best mean elevation (165°), Constant score (79 points), postoperative UCLA score (32.5 points), and absolute delta UCLA score increase (22 points), but with no statistical significance. However, cases operated for fracture sequelae showed significantly higher elevation (
p
= 0.027) and Constant score (
p
= 0.047) compared to rotator cuff arthropathy cases. In addition, the lowest mean postoperative Constant and UCLA scores were observed for the following etiologies: primary arthrosis, acute fracture, and arthroplasty revision.
Conclusion
Reverse shoulder arthroplasty showed satisfactory functional outcomes and may be a treatment option not only for rotator cuff arthropathy but for several other conditions.
Collapse
Affiliation(s)
- Thiago Medeiros Storti
- Instituto do Ombro de Brasília, Brasília, DF, Brasil
- Hospital Ortopédico e Medicina Especializada (HOME), Instituto de Pesquisa e Ensino (IPE-HOME), Brasília, DF, Brasil
| | | | | | | | | | - Alexandre Firmino Paniago
- Instituto do Ombro de Brasília, Brasília, DF, Brasil
- Hospital Ortopédico e Medicina Especializada (HOME), Instituto de Pesquisa e Ensino (IPE-HOME), Brasília, DF, Brasil
| |
Collapse
|
4
|
Chen HS, Yau YC, Ko PT, Yen BLJ, Ho CT, Hung SC. Mesenchymal Stem Cells From a Hypoxic Culture Can Improve Rotator Cuff Tear Repair. Cell Transplant 2022; 31:9636897221089633. [PMID: 35438571 PMCID: PMC9021471 DOI: 10.1177/09636897221089633] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A rotator cuff tear is an age-related common cause of pain and disability. Studies including our previously published ones have demonstrated that mesenchymal stem cells cultured under hypoxic conditions [hypoxic multipotent stromal cells (MSCs)] facilitate the retention of transplanted cells and promote wound healing. However, there are very few, if any, reports targeting the punctured supraspinatus tendons to create more or equally serous wounds as age-related tears of rotator cuff. It remains to be determined whether transplantation of bone-marrow-derived hypoxic MSCs into the punctured supraspinatus tendon improves tendon repair and, when combined with ultrasound-guided delivery, could be used for future clinical applications. In this study, we used a total of 33 Sprague-Dawley rats in different groups for normal no-punched control, hypoxic MSC treatment, nontreated vehicle control, and MSC preparation, and then evaluated treatment outcomes by biomechanical testing and histological analysis. We found that the ultimate failure load of the hypoxic MSC-treated group was close to that of the normal tendon and significantly greater than that of the nontreated vehicle control group. In vivo tracking of cells labeled with superparamagnetic iron oxide (SPIO) nanoparticles revealed an enhanced retention of transplanted cells at the tear site. Our study demonstrates that hypoxic MSCs improve rotator cuff tear repair in a rat model.
Collapse
Affiliation(s)
- Hsin-Shui Chen
- PhD Program for Aging, College of Medicine, China Medical University, Taichung.,Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital Yunlin Branch, Yunlin
| | - Yun-Chain Yau
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei
| | - Pin-Tsou Ko
- Department of Pathology, An-Nan Hospital, China Medical University, Tainan
| | - Betty Lin-Ju Yen
- Institute of Cellular & System Medicine, Regenerative Medicine Research Group, National Health Research Institutes, Zhunan
| | - Chun-Te Ho
- Institute of New Drug Development, China Medical University, Taichung.,Integrative Stem Cell Center, China Medical University Hospital, Taichung
| | - Shih-Chieh Hung
- Institute of New Drug Development, China Medical University, Taichung.,Integrative Stem Cell Center, China Medical University Hospital, Taichung
| |
Collapse
|
5
|
Teixeira DC, Alves L, Gutierres M. The role of scapular dyskinesis on rotator cuff tears: a narrative review of the current knowledge. EFORT Open Rev 2021; 6:932-940. [PMID: 34760292 PMCID: PMC8559559 DOI: 10.1302/2058-5241.6.210043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Scapular dyskinesis can be present in healthy individuals as in patients with shoulder pathology.Altered patterns of scapular kinematics can cause or exacerbate rotator cuff tear pathology. However, more research is needed.Regardless of the cause or the consequence of rotator cuff tear, scapular dyskinesis impairs shoulder function, worsens the symptoms, and compromises the success of clinical intervention.The available literature suggests physical therapy as the first treatment for degenerative cuff tears, and scapular dyskinesis should be addressed if present. Non-responsive cases or traumatic tears may require surgery.Postsurgical physical therapy protocols after rotator cuff repair must consider scapular dyskinesia to improve the outcomes. Cite this article: EFORT Open Rev 2021;6:932-940. DOI: 10.1302/2058-5241.6.210043.
Collapse
Affiliation(s)
- Diana Cabral Teixeira
- Faculty of Medicine, University of Porto, Porto, Portugal
- These authors contributed equally to the article and should all be considered first authors
| | - Luís Alves
- Orthopaedic and Traumatology Department, São João Hospital Center, Porto, Portugal
- These authors contributed equally to the article and should all be considered first authors
| | - Manuel Gutierres
- Orthopaedic and Traumatology Department, São João Hospital Center, Porto, Portugal
- These authors contributed equally to the article and should all be considered first authors
| |
Collapse
|
6
|
Pancholi N, Gregory JM. Biologic Augmentation of Arthroscopic Rotator Cuff Repair Using Minced Autologous Subacromial Bursa. Arthrosc Tech 2020; 9:e1519-e1524. [PMID: 33134054 PMCID: PMC7587230 DOI: 10.1016/j.eats.2020.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 06/07/2020] [Indexed: 02/03/2023] Open
Abstract
Failure of rotator cuff repair surgery can be attributed to a variety of factors, including insufficient biologic environment to support healing. The subacromial bursal tissue has been shown to have a reservoir of mesenchymal stem cells and is a potential source for biologic augmentation during rotator cuff repair. We have developed a technique to capture the subacromial bursal tissue during subacromial bursectomy and then reimplant the tissue on the bursal surface of the rotator cuff tendon after rotator cuff repair. Our goal is to describe our technique of subacromial tissue collection and reimplantation that obviates the need of suturing a whole sleeve of bursal tissue while improving cell yield for rotator cuff healing.
Collapse
Affiliation(s)
| | - James M. Gregory
- Address correspondence to James M. Gregory, M.D., McGovern Medical School, University of Texas Health Science Center at Houston, 4600 Fannin St., Suite 1700, Houston, TX 77030.
| |
Collapse
|
7
|
Guevara JA, Entezari V, Ho JC, Derwin KA, Iannotti JP, Ricchetti ET. An Update on Surgical Management of the Repairable Large-to-Massive Rotator Cuff Tear. J Bone Joint Surg Am 2020; 102:1742-1754. [PMID: 32740266 DOI: 10.2106/jbjs.20.00177] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Jonathan A Guevara
- Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Vahid Entezari
- Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Jason C Ho
- Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Kathleen A Derwin
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio
| | - Joseph P Iannotti
- Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Eric T Ricchetti
- Department of Orthopaedic Surgery, Orthopaedic and Rheumatologic Institute, Cleveland Clinic, Cleveland, Ohio
| |
Collapse
|
8
|
Roldán-Jiménez C, Cuadros-Romero M, Bennett P, McPhail S, Kerr GK, Cuesta-Vargas AI, Martin-Martin J. Assessment of abduction motion in patients with rotator cuff tears: an analysis based on inertial sensors. BMC Musculoskelet Disord 2019; 20:597. [PMID: 31830985 PMCID: PMC6909443 DOI: 10.1186/s12891-019-2987-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 12/03/2019] [Indexed: 01/10/2023] Open
Abstract
Background Reduced range of motion in the shoulder can be a source of functional limitation. The use of inertial sensors to quantify movement in addition to more common clinical assessments of the shoulder may allow clinicians to understand that they are potentially unnoticed by visual identification. The aim of this study was to generate an explanatory model for shoulder abduction based on data from inertial sensors. Method A cross-sectional study was carried out to generate an explanatory model of shoulder abduction based on data from inertial sensors. Shoulder abduction of thirteen older adults suffering from shoulder dysfunction was recorded with two inertial sensors placed on the humerus and scapula. Movement variables (maximum angular mobility, angular peak of velocity, peak of acceleration) were used to explain the functionality of the upper limb assessed using the Upper Limb Functional Index (ULFI). The abduction movement of the shoulder was explained by six variables related to the mobility of the shoulder joint complex. A multivariate analysis of variance (MANOVA) was used to explain the results obtained on the functionality of the upper limb. Results The MANOVA model based on angular mobility explained 69% of the variance of the ULFI value (r-squared = 0.69). The most relevant variables were the abduction-adduction of the humerus and the medial/lateral rotation of the scapula. Conclusions The method used in the present study reveals the potential importance of the analysis of the scapular and humeral movements for comprehensive evaluation of the upper limb. Further research should include a wider sample and may seek to use this assessment technique in a range of potential clinical applications.
Collapse
Affiliation(s)
- Cristina Roldán-Jiménez
- Department of Psychiatry and Physiotherapy, University of Malaga, Faculty of Health Sciences, Arquitecto Francisco Peñalosa 3, Campus de Teatinos, 29071, Málaga, Spain.,Clinimetric Group F-14 Biomedical Research Institute of Malaga, (IBIMA), Málaga, Spain
| | - Miguel Cuadros-Romero
- Unit of Upper Limb Orthopedic Surgery of Hospital at University of Malaga, Málaga, Spain
| | - Paul Bennett
- Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University Technology, Brisbane, Australia
| | - Steven McPhail
- Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University Technology, Brisbane, Australia.,Centre for Functioning and Health Research, Metro South Health, Brisbane, Australia
| | - Graham K Kerr
- Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University Technology, Brisbane, Australia
| | - Antonio I Cuesta-Vargas
- Department of Psychiatry and Physiotherapy, University of Malaga, Faculty of Health Sciences, Arquitecto Francisco Peñalosa 3, Campus de Teatinos, 29071, Málaga, Spain. .,Clinimetric Group F-14 Biomedical Research Institute of Malaga, (IBIMA), Málaga, Spain. .,Institute of Health & Biomedical Innovation, Faculty of Health, Queensland University Technology, Brisbane, Australia.
| | - Jaime Martin-Martin
- Clinimetric Group F-14 Biomedical Research Institute of Malaga, (IBIMA), Málaga, Spain.,Department of Human Anatomy, Legal Medicine and History of Science. Legal Medicine Area, University of Malaga, Faculty of Medicine, Malaga, Spain
| |
Collapse
|