Cutting-through at the Greater Tuberosity

Chuncheon Sacred Heart Hospital95 enrolled

Overview

The investigators evaluated the correlation between cutting-through at the greater tuberosity (GT) just medial to the lateral knotless anchor in arthroscopic suture-bridge rotator cuff repair and the bone mineral density (BMD) of the lumbar spine, hip and GT of the proximal humerus and to evaluate factors and clinical outcomes related to cutting-through at the GT.

Seventy-eight patients who underwent arthroscopic suture-bridge rotator cuff repair and who had undergone dual energy X-ray absorptiometry (DEXA) scans before surgery were included. Patients were divided into two groups: patients who had cutting-through (46, group I) and patients who did not (32, group II). Clinical and radiological data including demographics, BMDs, fatty infiltration of rotator cuff muscles, tear size, tear involvement, VAS pain score, and ASES score were analyzed.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Rotator Cuff Tears

Interventions

Arthroscopic suture-bridge rotator cuff repairPROCEDURE

Arthroscopic suture-bridge repair is a widely used and universal surgical method for symptomatic rotator cuff tear patients. It is arthroscopic surgery to reattach ruptured rotator cuff tendons to the original insertion (greater tuberosity) using medial and lateral row anchors.

Eligibility

Sex: ALLMin age: 50 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Primary arthroscopic repair for a symptomatic full-thickness rotator cuff tear identified by preoperative MRI 2. Dual energy X-ray absorptiometry (DEXA) to evaluate the BMD of the lumbar spine and hip, as a standardized measurement, and the GT of the affected proximal humerus 3. Follow up for a minimum of 2 years after the primary surgery. Exclusion Criteria: 1. Primary arthroscopic repair due to partial-thickness rotator cuff tear or an isolated subscapularis tear 2. Primary suture-bridge repair with 3 or more lateral-knotless anchors 3. Previous history of fractures or surgeries on the affected shoulder 4. Shoulder instability 5. Glenohumeral osteoarthritis 6. Neurologic or systemic disease diseases influencing the shoulder joint 7 History of infection of the shoulder joint

Outcomes

Primary Outcomes

The occurrence of cutting-through

The occurrence of cortical breakage of the GT just medial to the lateral knotless anchor hole due to the tension of the sutures from the medial anchor

Time frame: During the surgery

Visual Analog Scale (VAS) Pain Score

The VAS pain score was based on a scale from 0 to 10, where 0 indicated no pain and 10 indicated severe pain

Time frame: 2 years after surgery

American Shoulder and Elbow Surgeons (ASES) score

American Shoulder and Elbow Surgeons score for estimating shoulder function was based on a score from 0 to 100, where 0 indicated poor outcome and 100 indicated excellent outcome.

Time frame: 2 years after surgery

Greater tuberosity bone mineral density

GT BMD was measured using the predefined region of interest (ROI). Dividing the humeral head into three columns of even width, we defined a 1x1-cm2-sized square in the center of the lateral column as ROI.

Time frame: preoperatively

Lumbar spine bone mineral density

Measured by using standard techniques according to the manufacturer and the International Society for Clinical Densitometry guidelines.

Time frame: preoperatively

Hip bone mineral density

Measured by using standard techniques according to the manufacturer and the International Society for Clinical Densitometry guidelines.

Time frame: preoperatively

Data from ClinicalTrials.gov

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