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Indian J Orthop. 2019 May-Jun;53(3):384-391. doi: 10.4103/ortho.IJOrtho_440_18.

Clinical and Structural Outcomes after Arthroscopic Repair of Medium- to Massive-Sized Delaminated and Nondelaminated Rotator Cuff Tears.

Author information

1
Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
2
Department of Radiodiagnosis, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India.
3
Department of Orthopaedics, Shoulder Unit, Lairesse Kliniek, Amsterdam, The Netherlands.

Abstract

Introduction:

Current evidence is controversial about the outcomes after the repair of the delaminated versus nondelaminated rotator cuff tears. The objective of this study was to evaluate the factors affecting delamination of the cuff and clinical and structural outcomes after en masse arthroscopic repair of delaminated versus nondelaminated cuff of varying sizes.

Materials and Methods:

A total of 233 patients with full-thickness posterosuperior cuff tears were divided in two groups: Group 1: Delaminated tears (n = 131) and Group 2: Nondelaminated tears (n = 102) of medium, large, and massive sizes. Both groups were evaluated by clinical scores (Constant-Murley [CM], American shoulder and elbow score [ASES]) and ultrasonography (USG), at a minimum followup of 2 years.

Results:

The mean followup was 45.47 months. There was a weak but statistically significant linear correlation (P = 0.02) between the increasing size of tear and delamination, whereas increasing age and duration of symptoms did not correlate with increasing tendency of delamination. Final followup USG analysis revealed that there was no significant difference (P = 0.55) between healing rates of Group 1 and Group 2. Further taking various tear sizes into account, USG revealed no significant difference between the healing rates of two groups. The mean overall final postoperative CM and ASES scores of two groups did not show any significant difference (CM; P = 0.36, ASES; P = 0.4). However, the clinical outcome was significantly better in the completely healed group as compared to partially healed or retear group.

Conclusions:

A weak linear correlation between delamination and increasing size of the tear was noted. Although overall structural and clinical outcome is no different between two groups, the clinical outcomes of completely healed tear are better than partially healed ones.

Level of Evidence:

Level III, Retrospective comparative.

KEYWORDS:

Clinical outcome; cuff healing; delamination; partially healed defect; rotator cuff tear; size of tear

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