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Clinical differences between patients with early and late revision surgery for symptomatic failed arthroscopic rotator cuff repair
Purpose Time ranges of revision rotator cuff surgeries after arthroscopic repair are highly variable. However, the cause and clinical relevance of the different timings of revision surgeries have not been analyzed. The purpose of this study was to evaluate the clinical manifestations of patients who...
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| Published in: | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA sports traumatology, arthroscopy : official journal of the ESSKA, 2021-12, Vol.29 (12), p.3921-3928 |
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| container_end_page | 3928 |
| container_issue | 12 |
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| container_title | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA |
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| creator | Lee, Sanghyeon Park, In Kim, Min-Su Shin, Sang-Jin |
| description | Purpose
Time ranges of revision rotator cuff surgeries after arthroscopic repair are highly variable. However, the cause and clinical relevance of the different timings of revision surgeries have not been analyzed. The purpose of this study was to evaluate the clinical manifestations of patients who required revision surgeries at early and late periods after failed arthroscopic rotator cuff repair, and to identify clinical and radiological differences related to the timing of revision surgery.
Methods
Sixty patients who underwent revision surgery due to symptomatic failed rotator cuff repair after arthroscopic repair were included. Patients were divided into two groups: patients who underwent revision surgeries within 1 year postoperatively (21 patients, group I) and patients who underwent revision surgeries more than 1 year postoperatively (39 patients, group II). Clinical and radiological characteristics were compared between the two groups before primary and revision surgery.
Results
VAS for pain (5.9 ± 1.9 in group I, 3.9 ± 1.4 in group II,
P
|
| doi_str_mv | 10.1007/s00167-020-06333-6 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2454104968</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2454104968</sourcerecordid><originalsourceid>FETCH-LOGICAL-c303t-ddbb6fb48ce27b0bea3ec76e058a9d3fd8314a7b578f9ebc18a881e938eb73</originalsourceid><addsrcrecordid>eNp9kU-LFDEQxYMoOK5-AU8BL17arXTSSfoog_9gYUG8hyRdcbP0JG2Sdpmrn9zoCIIHT1UUv_eoqkfISwZvGIC6rgBMqgFGGEByzgf5iByY6I3iQj0mB5jFOIwwyafkWa33AL0V84H8OK4xRW9XusQQsGDyWKnD9oCY6GZbxNQqfYjtjqIt65natNDVNqQFv8cac6J1L1-xnGnIhdbzaWv51HWeBhtXXKgt7a7k6vPWZyU32zrn9xC6w2ZjeU6eBLtWfPGnXpHP7999OX4cbm4_fDq-vRk8B96GZXFOBie0x1E5cGg5eiURJm3nhYdFcyascpPSYUbnmbZaM5y5Rqf4FXl9Md1K_rZjbeYUq8d1tQnzXs0oJsFAzFJ39NU_6H3eS-qrmXGaVX-knFinxgvl-221YDBbiSdbzoaB-ZWJuWRieibmdyZGdhG_iGqHU3_aX-v_qH4CavCS-g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2597942651</pqid></control><display><type>article</type><title>Clinical differences between patients with early and late revision surgery for symptomatic failed arthroscopic rotator cuff repair</title><source>Wiley-Blackwell Read & Publish Collection</source><source>Springer Link</source><source>EBSCOhost SPORTDiscus - Ebooks</source><creator>Lee, Sanghyeon ; Park, In ; Kim, Min-Su ; Shin, Sang-Jin</creator><creatorcontrib>Lee, Sanghyeon ; Park, In ; Kim, Min-Su ; Shin, Sang-Jin</creatorcontrib><description>Purpose
Time ranges of revision rotator cuff surgeries after arthroscopic repair are highly variable. However, the cause and clinical relevance of the different timings of revision surgeries have not been analyzed. The purpose of this study was to evaluate the clinical manifestations of patients who required revision surgeries at early and late periods after failed arthroscopic rotator cuff repair, and to identify clinical and radiological differences related to the timing of revision surgery.
Methods
Sixty patients who underwent revision surgery due to symptomatic failed rotator cuff repair after arthroscopic repair were included. Patients were divided into two groups: patients who underwent revision surgeries within 1 year postoperatively (21 patients, group I) and patients who underwent revision surgeries more than 1 year postoperatively (39 patients, group II). Clinical and radiological characteristics were compared between the two groups before primary and revision surgery.
Results
VAS for pain (5.9 ± 1.9 in group I, 3.9 ± 1.4 in group II,
P
< 0.001) and Constant score (50.7 ± 9.9 in group I, 60.4 ± 8.9 in group II,
P
< 0.001) at the time of revision surgery were significantly different between the two groups. In group II, isometric muscle strength of forward flexion (74.1 ± 21.1 to 63.9 ± 15.1,
P
= 0.020) and external rotation (73.0 ± 23.5 to 61.2 ± 15.0,
P
= 0.032) were significantly deteriorated after primary surgery, even with significant improvement of pain and shoulder function (VAS: 5.7 ± 1.9 to 3.9 ± 1.4,
P
< 0.001; Constant score: 50.3 ± 11.0 to 60.4 ± 8.9,
P
< 0.001). On postoperative MRI, re-tear at the tendon–bone interface on the greater tuberosity occurred significantly more in group I (81.0%) than group II (51.3%,
P
= 0.024). Incidence of full-thickness tear of the subscapularis tendon was significantly different between the two groups (42.9% in group I, 12.8% in group II,
P
= 0.012).
Conclusion
Patients who had early revision surgeries had significantly worse clinical outcomes after primary surgery than patients who had late revision surgeries. Healing failure at the tendon–bone interface on the greater tuberosity and re-tear combined with full-thickness tear of subscapularis tendon were related to early revision. Conversely, patients of the late revision group had muscle weakness that considerably impacted daily activities, even with improved pain and shoulder function.
Level of evidence
III.</description><identifier>ISSN: 0942-2056</identifier><identifier>EISSN: 1433-7347</identifier><identifier>DOI: 10.1007/s00167-020-06333-6</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Bone healing ; Bone surgery ; Magnetic resonance imaging ; Medicine ; Medicine & Public Health ; Muscle contraction ; Muscle strength ; Orthopedics ; Pain ; Patients ; Revisions ; Rotator cuff ; Shoulder ; Sports Medicine ; Surgery ; Tearing ; Thickness</subject><ispartof>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021-12, Vol.29 (12), p.3921-3928</ispartof><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020</rights><rights>European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c303t-ddbb6fb48ce27b0bea3ec76e058a9d3fd8314a7b578f9ebc18a881e938eb73</cites><orcidid>0000-0002-0812-4628</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Lee, Sanghyeon</creatorcontrib><creatorcontrib>Park, In</creatorcontrib><creatorcontrib>Kim, Min-Su</creatorcontrib><creatorcontrib>Shin, Sang-Jin</creatorcontrib><title>Clinical differences between patients with early and late revision surgery for symptomatic failed arthroscopic rotator cuff repair</title><title>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</title><addtitle>Knee Surg Sports Traumatol Arthrosc</addtitle><description>Purpose
Time ranges of revision rotator cuff surgeries after arthroscopic repair are highly variable. However, the cause and clinical relevance of the different timings of revision surgeries have not been analyzed. The purpose of this study was to evaluate the clinical manifestations of patients who required revision surgeries at early and late periods after failed arthroscopic rotator cuff repair, and to identify clinical and radiological differences related to the timing of revision surgery.
Methods
Sixty patients who underwent revision surgery due to symptomatic failed rotator cuff repair after arthroscopic repair were included. Patients were divided into two groups: patients who underwent revision surgeries within 1 year postoperatively (21 patients, group I) and patients who underwent revision surgeries more than 1 year postoperatively (39 patients, group II). Clinical and radiological characteristics were compared between the two groups before primary and revision surgery.
Results
VAS for pain (5.9 ± 1.9 in group I, 3.9 ± 1.4 in group II,
P
< 0.001) and Constant score (50.7 ± 9.9 in group I, 60.4 ± 8.9 in group II,
P
< 0.001) at the time of revision surgery were significantly different between the two groups. In group II, isometric muscle strength of forward flexion (74.1 ± 21.1 to 63.9 ± 15.1,
P
= 0.020) and external rotation (73.0 ± 23.5 to 61.2 ± 15.0,
P
= 0.032) were significantly deteriorated after primary surgery, even with significant improvement of pain and shoulder function (VAS: 5.7 ± 1.9 to 3.9 ± 1.4,
P
< 0.001; Constant score: 50.3 ± 11.0 to 60.4 ± 8.9,
P
< 0.001). On postoperative MRI, re-tear at the tendon–bone interface on the greater tuberosity occurred significantly more in group I (81.0%) than group II (51.3%,
P
= 0.024). Incidence of full-thickness tear of the subscapularis tendon was significantly different between the two groups (42.9% in group I, 12.8% in group II,
P
= 0.012).
Conclusion
Patients who had early revision surgeries had significantly worse clinical outcomes after primary surgery than patients who had late revision surgeries. Healing failure at the tendon–bone interface on the greater tuberosity and re-tear combined with full-thickness tear of subscapularis tendon were related to early revision. Conversely, patients of the late revision group had muscle weakness that considerably impacted daily activities, even with improved pain and shoulder function.
Level of evidence
III.</description><subject>Bone healing</subject><subject>Bone surgery</subject><subject>Magnetic resonance imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Muscle contraction</subject><subject>Muscle strength</subject><subject>Orthopedics</subject><subject>Pain</subject><subject>Patients</subject><subject>Revisions</subject><subject>Rotator cuff</subject><subject>Shoulder</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Tearing</subject><subject>Thickness</subject><issn>0942-2056</issn><issn>1433-7347</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU-LFDEQxYMoOK5-AU8BL17arXTSSfoog_9gYUG8hyRdcbP0JG2Sdpmrn9zoCIIHT1UUv_eoqkfISwZvGIC6rgBMqgFGGEByzgf5iByY6I3iQj0mB5jFOIwwyafkWa33AL0V84H8OK4xRW9XusQQsGDyWKnD9oCY6GZbxNQqfYjtjqIt65natNDVNqQFv8cac6J1L1-xnGnIhdbzaWv51HWeBhtXXKgt7a7k6vPWZyU32zrn9xC6w2ZjeU6eBLtWfPGnXpHP7999OX4cbm4_fDq-vRk8B96GZXFOBie0x1E5cGg5eiURJm3nhYdFcyascpPSYUbnmbZaM5y5Rqf4FXl9Md1K_rZjbeYUq8d1tQnzXs0oJsFAzFJ39NU_6H3eS-qrmXGaVX-knFinxgvl-221YDBbiSdbzoaB-ZWJuWRieibmdyZGdhG_iGqHU3_aX-v_qH4CavCS-g</recordid><startdate>20211201</startdate><enddate>20211201</enddate><creator>Lee, Sanghyeon</creator><creator>Park, In</creator><creator>Kim, Min-Su</creator><creator>Shin, Sang-Jin</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0812-4628</orcidid></search><sort><creationdate>20211201</creationdate><title>Clinical differences between patients with early and late revision surgery for symptomatic failed arthroscopic rotator cuff repair</title><author>Lee, Sanghyeon ; Park, In ; Kim, Min-Su ; Shin, Sang-Jin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c303t-ddbb6fb48ce27b0bea3ec76e058a9d3fd8314a7b578f9ebc18a881e938eb73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bone healing</topic><topic>Bone surgery</topic><topic>Magnetic resonance imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Muscle contraction</topic><topic>Muscle strength</topic><topic>Orthopedics</topic><topic>Pain</topic><topic>Patients</topic><topic>Revisions</topic><topic>Rotator cuff</topic><topic>Shoulder</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Tearing</topic><topic>Thickness</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Sanghyeon</creatorcontrib><creatorcontrib>Park, In</creatorcontrib><creatorcontrib>Kim, Min-Su</creatorcontrib><creatorcontrib>Shin, Sang-Jin</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Sanghyeon</au><au>Park, In</au><au>Kim, Min-Su</au><au>Shin, Sang-Jin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical differences between patients with early and late revision surgery for symptomatic failed arthroscopic rotator cuff repair</atitle><jtitle>Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA</jtitle><stitle>Knee Surg Sports Traumatol Arthrosc</stitle><date>2021-12-01</date><risdate>2021</risdate><volume>29</volume><issue>12</issue><spage>3921</spage><epage>3928</epage><pages>3921-3928</pages><issn>0942-2056</issn><eissn>1433-7347</eissn><abstract>Purpose
Time ranges of revision rotator cuff surgeries after arthroscopic repair are highly variable. However, the cause and clinical relevance of the different timings of revision surgeries have not been analyzed. The purpose of this study was to evaluate the clinical manifestations of patients who required revision surgeries at early and late periods after failed arthroscopic rotator cuff repair, and to identify clinical and radiological differences related to the timing of revision surgery.
Methods
Sixty patients who underwent revision surgery due to symptomatic failed rotator cuff repair after arthroscopic repair were included. Patients were divided into two groups: patients who underwent revision surgeries within 1 year postoperatively (21 patients, group I) and patients who underwent revision surgeries more than 1 year postoperatively (39 patients, group II). Clinical and radiological characteristics were compared between the two groups before primary and revision surgery.
Results
VAS for pain (5.9 ± 1.9 in group I, 3.9 ± 1.4 in group II,
P
< 0.001) and Constant score (50.7 ± 9.9 in group I, 60.4 ± 8.9 in group II,
P
< 0.001) at the time of revision surgery were significantly different between the two groups. In group II, isometric muscle strength of forward flexion (74.1 ± 21.1 to 63.9 ± 15.1,
P
= 0.020) and external rotation (73.0 ± 23.5 to 61.2 ± 15.0,
P
= 0.032) were significantly deteriorated after primary surgery, even with significant improvement of pain and shoulder function (VAS: 5.7 ± 1.9 to 3.9 ± 1.4,
P
< 0.001; Constant score: 50.3 ± 11.0 to 60.4 ± 8.9,
P
< 0.001). On postoperative MRI, re-tear at the tendon–bone interface on the greater tuberosity occurred significantly more in group I (81.0%) than group II (51.3%,
P
= 0.024). Incidence of full-thickness tear of the subscapularis tendon was significantly different between the two groups (42.9% in group I, 12.8% in group II,
P
= 0.012).
Conclusion
Patients who had early revision surgeries had significantly worse clinical outcomes after primary surgery than patients who had late revision surgeries. Healing failure at the tendon–bone interface on the greater tuberosity and re-tear combined with full-thickness tear of subscapularis tendon were related to early revision. Conversely, patients of the late revision group had muscle weakness that considerably impacted daily activities, even with improved pain and shoulder function.
Level of evidence
III.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><doi>10.1007/s00167-020-06333-6</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-0812-4628</orcidid></addata></record> |
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| identifier | ISSN: 0942-2056 |
| ispartof | Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2021-12, Vol.29 (12), p.3921-3928 |
| issn | 0942-2056 1433-7347 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2454104968 |
| source | Wiley-Blackwell Read & Publish Collection; Springer Link; EBSCOhost SPORTDiscus - Ebooks |
| subjects | Bone healing Bone surgery Magnetic resonance imaging Medicine Medicine & Public Health Muscle contraction Muscle strength Orthopedics Pain Patients Revisions Rotator cuff Shoulder Sports Medicine Surgery Tearing Thickness |
| title | Clinical differences between patients with early and late revision surgery for symptomatic failed arthroscopic rotator cuff repair |
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