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Clinical and Imaging Outcomes After Revision Open Rotator Cuff Repair: A Retrospective Review of a Midterm Follow-Up Study

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Abstract

Background

Revision open rotator cuff repair (ORCR) has been associated with unpredictable functional outcome with concerns of deltoid detachment. The aim of this study was to evaluate the clinical and imaging outcomes of revision ORCR.

Materials and Methods

The study retrospectively reviewed 30 consecutive patients (mean age 60.4 ± 7.2 years) who underwent revision ORCR after failed rotator cuff repair. Pain visual analog scale (VAS), Constant and American Shoulder Elbow Surgeon (ASES) score were assessed preoperatively and at mean 58-month follow-up (range 24–120 months). The acromio-humeral distance (AHD) was measured on pre- and postoperative radiograph. Tear size and fatty infiltration of rotator cuff were evaluated by preoperative magnetic resonance imaging (MRI) study. The retear rate, change of fatty infiltration and deltoid origin integrity were evaluated by postoperative MRI.

Results

There was significant improvement of pain VAS and functional outcome scores (all p < 0.001). AHD showed no significant change after surgery. On postoperative MRI, the retear rate was 43% (13/30). However, the size of the tendon defect was smaller than that of pre-revision tear (p = 0.006). The patients who had intact tendon had significantly better functional outcomes than those with retear. The intact group had significantly higher AHD both pre- and postoperatively than the retear group. There was no change of fatty infiltration after surgery. Four patients (13%, 4/30) showed thinning of deltoid origin on postoperative MRI, but showed no weakness on clinical examination.

Conclusion

Revision ORCR resulted in improved outcomes in pain relief and shoulder function, with low rate of subclinical deltoid thinning.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, National Police Hospital, Seoul, South Korea

    Sungjoon Lim

  2. Department of Orthopaedics, NKP Salve Institute of Medical Sciences, Nagpur, India

    Aashay Kekatpure

  3. Department of Orthopaedic Surgery, Korean Armed Forces Capital Hospital, Songnam, South Korea

    Jae-Myeung Chun

  4. Department of Orthopaedic Surgery, St. Carolus Hospital, Jakarta, Indonesia

    Erica Kholinne

  5. Department of Orthopaedic Surgery, Asan Medical Center, College of Medicine, University of Ulsan, 86 Asanbyeongwon-gil, Songpa-gu, Seoul, 05505, South Korea

    Erica Kholinne, Jeong-Hee Park & In-Ho Jeon

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  1. Sungjoon Lim
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  2. Aashay Kekatpure
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  3. Jae-Myeung Chun
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  4. Erica Kholinne
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  5. Jeong-Hee Park
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  6. In-Ho Jeon
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Correspondence to In-Ho Jeon.

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AMC IRB 2017-1097.

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Lim, S., Kekatpure, A., Chun, JM. et al. Clinical and Imaging Outcomes After Revision Open Rotator Cuff Repair: A Retrospective Review of a Midterm Follow-Up Study. JOIO 54, 639–646 (2020). https://doi.org/10.1007/s43465-020-00104-8

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  • DOI: https://doi.org/10.1007/s43465-020-00104-8

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