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Technique for Margin Convergence in Rotator Cuff Repair

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HSS Journal ®

Abstract

The purpose of the present study is to describe the technique of margin convergence for U-shaped rotator cuff tears and report the clinical outcomes and ultrasonography with a minimum of 2 years follow-up. Three hundred eleven patients with a rotator cuff tear were prospectively enrolled in a registry at one institution. Inclusion criteria included any patient undergoing arthroscopic margin convergence for a rotator cuff tear. Exclusion criteria included open or mini-open rotator cuff repairs or suture anchor fixation to the cuff insertion without margin convergence. The outcome measurements included physical examination, manual muscle testing, the American Shoulder and Elbow Surgeons (ASES) score, and ultrasonography. Nineteen patients met the study criteria and 13 were available for 2-year follow-up (68.4%). The mean age of this cohort was 62.2 ± 7.5 years with a mean pre-operative rotator cuff tear size of 4.0 ± 1.6 cm. The ASES score increased significantly from 50.0 ± 17.7 before surgery to 83.3 ± 19.5 at 2 years (P = 0.01). The active forward elevation also improved from 156.2 ± 11.9° before surgery to 168.0 ± 12.1 at 2 years (P = 0.03). The active external rotation 54.4 ± 14.5 at baseline and improved to 57.1 ± 19.1 at 2 years (P = 0.04). The strength also increased significantly from 6.7 ± 6.4 to 10.6 ± 4.9 lb at 1 year (P = 0.048). The post-operative ultrasound demonstrated that 46.2% of rotator cuff tears were healed at 2 years. In conclusion, margin convergence is a useful technique for U-shaped tears that are difficult to mobilize.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Michael K. Shindle MD, Shane J. Nho MD, Denis Nam MD, John D. MacGillivray MD, Frank A. Cordasco MD, David W. Altchek MD & Russell F. Warren MD

  2. Department of Radiology and Imaging, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Ronald S. Adler MD, PhD

  3. Summit Medical Group, 95 Madison Avenue, Morristown, NJ, 07960, USA

    Michael K. Shindle MD

Authors
  1. Michael K. Shindle MD
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  2. Shane J. Nho MD
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  3. Denis Nam MD
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  4. John D. MacGillivray MD
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  5. Frank A. Cordasco MD
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  6. Ronald S. Adler MD, PhD
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  7. David W. Altchek MD
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  8. Russell F. Warren MD
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Correspondence to Michael K. Shindle MD.

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Each author certifies that he or she has no commercial associations (e.g., consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his or her institution has approved the reporting of this study, that all investigations were conducted in conformity with ethical principles of research.

Level of Evidence: Level IV: Case Series

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Shindle, M.K., Nho, S.J., Nam, D. et al. Technique for Margin Convergence in Rotator Cuff Repair. HSS Jrnl 7, 208–212 (2011). https://doi.org/10.1007/s11420-011-9222-3

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  • DOI: https://doi.org/10.1007/s11420-011-9222-3

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