Arthroscopic treatment for intratendinous rotator cuff tear results in satisfactory clinical outcomes and structural integrity
- 164 Downloads
This study aimed to evaluate the clinical outcomes and structural integrity of arthroscopic repair of intratendinous rotator cuff tear.
Patients who were diagnosed with an intratendinous tear but in whom conservative treatment failed were selected and underwent arthroscopic repair. Between 2008 and 2014, a total of 30 patients (6 men, 24 women; mean age, 59 ± 3.7 years) met the inclusion criteria and were followed up. The mean follow-up period was 26.3 ± 0.7 months. The results were evaluated using the University of California at Los Angeles (UCLA) score, the Society of the American Shoulder and Elbow Surgeons rating scale (ASES) questionnaire, and the visual analog scale (VAS) and range of motion (ROM) were measured preoperatively and at final follow-up. Magnetic resonance imaging (MRI) was performed preoperatively and at 6.7 ± 0.2 months postoperatively. Postoperative MRI was performed on 27 out of 30 patients and analysed using the Sugaya classification.
Corresponding to the preoperative MRI findings, arthroscopic findings of intratendinous tears were observed in all 30 patients. The mean active forward elevation ROM was 137.3° ± 15.4° before surgery and 168.8° ± 15.2° at the final follow-up. The internal and external rotations at abduction were 31.7° ± 5.1° and 63.0° ± 11.6° before surgery, respectively, and 60.5° ± 8.0° and 75.2° ± 10.8° after surgery, respectively. The UCLA score improved from of 20.1 ± 7.4 points preoperative to 28.4 ± 5.5 points at the final follow-up. The ASES score improved from 55.7 ± 15.3 points preoperative to 82.6 ± 9.7 points postoperatively. The VAS for pain score decreased from 6.4 ± 1.2 points preoperative to 1.6 ± 0.9 points postoperative. Satisfactory outcomes (excellent/good) in terms of UCLA and ASES scores were observed in 29 of 30 patients. Based on Sugaya classification, grades I, II, and III structural integrities were observed in 9, 14, and 4 patients, respectively.
Successful clinical outcomes and structural integrity can be achieved with arthroscopic repair of intratendinous rotator cuff tears involving more than half thickness (> 50%). Therefore, arthroscopic repair is a practical next treatment option for patients with intratendinous rotator cuff tears in whom conservative treatment fails.
Level of evidence
KeywordsRotator cuff Intratendinous tear Arthroscopic repair Clinical outcome Structural integrity
This study was supported by (Bio)Medical Research Institute Grant 2006-47 from Pusan National University.
Compliance with ethical standards
Conflict of interest
The authors, their immediate families, and research foundations with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article.
This study received ethical approval from the institutional review board (PNUH-IRB No. E-2016073).
- 1.Boileau P, Brassart N, Watkinson DJ, Michel C et al (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Jt Surg Am 87:1229–1240Google Scholar
- 3.Donohue NK, Nickel BT, Grindel SI (2016) High-grade articular, bursal, and intratendinous partial-thickness rotator cuff tears: a retrospective study comparing functional outcomes after completion and repair. Am J Orthop Belle Mead NJ 45:E254-260Google Scholar
- 5.Ellman H (1990) Diagnosis and treatment of incomplete rotator cuff tears. Clin Orthop Relat Res 254:64–74Google Scholar
- 14.Malavolta EA, Assunção JH, Ramos FF, Ferreira TC, Gracitelli MEC, Bordalo-Rodrigues M, Ferreira Neto AA (2016) Serial structural MRI evaluation of arthroscopy rotator cuff repair: does Sugaya’s classification correlate with the postoperative clinical outcomes? Arch Orthop Trauma Surg 136:791–797CrossRefGoogle Scholar