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Ultrasonic evaluation of the repair integrity can predict functional outcomes after arthroscopic double-row rotator cuff repair

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Despite proven accuracy of US for the evaluation of rotator cuff integrity, there is no US-based classification for this purpose. This study aimed to assess US for the evaluation of rotator cuff repair integrity in accordance with a well-established MRI classification.

Methods

The authors retrospectively reviewed 257 patients who underwent arthroscopic double-row suture anchor repair for rotator cuff tears. Post-operative function was rated using the Constant score, the UCLA rating and the SSV, whereas repair integrity was assessed using US as described in the MRI classification of Sugaya et al.

Results

A total of 212 patients aged 55.6 ± 9.8 years had complete functional and radiographic assessments at a mean follow-up of 36.8 ± 11.6 months. Using all three ratings, repairs of Type I had highest scores, repairs of Type II had discernibly lower scores, whereas repairs of Types III, IV and V had similar intermediate scores.

Conclusion

Comparison of the UCLA scores with those of Sugaya et al. revealed similar scores for repairs of Type I and of Type V. The scores are less comparable for repairs of Types II, III and IV, because US does not allow identification of partial tears if shielded by bony structures and because partial tears correspond to minimal impairment. The study reveals that US is an adequate imaging modality to classify rotator cuff repair integrity, which could reduce economic and practical burdens of CTA, MRI or MRA. The results also confirm that post-operative repair integrity and functional outcome depend on pre-operative tear size and fatty infiltration, which provides clinicians with reasoning for early surgical repair and warning of the risks of strenuous activity for patients with larger tears.

Level of evidence

Prognostic study, Level IV.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Centre Osteoarticulaire des Cèdres, Grenoble, France

    Johannes Barth & Elias Fotiadis

  2. Department of Radiology, Clinique du Mail, Grenoble, France

    Renaud Barthelemy

  3. Department of Medical Research, Alliance Scientifique SAS, Venon, France

    Sophie Genna & Mo Saffarini

  4. Department of Medical Technology, Accelerate Innovation Management SA, 1 rue de la Navigation, 1201, Geneva, Switzerland

    Mo Saffarini

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  1. Johannes Barth
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  2. Elias Fotiadis
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  4. Sophie Genna
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  5. Mo Saffarini
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Correspondence to Mo Saffarini.

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Barth, J., Fotiadis, E., Barthelemy, R. et al. Ultrasonic evaluation of the repair integrity can predict functional outcomes after arthroscopic double-row rotator cuff repair. Knee Surg Sports Traumatol Arthrosc 23, 376–385 (2015). https://doi.org/10.1007/s00167-015-3505-z

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  • DOI: https://doi.org/10.1007/s00167-015-3505-z

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