EFFECTIVENESS ANALYSIS OF ARTHROSCOPICALLY ASSISTED TREATMENT OF ROTATOR CUFF INJURY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

CAO Xinghai ¹ , CHEN Biao ¹ , LI Dazhi ¹ , SUN Bo ² , XIE Songqing ¹ , WU Xiaorong ¹ , FAN Liuping ¹

. 1The First Department of Orthopedics, 2Department of Operation Room, the Second People’s Hospital of Foshan, Foshan Guangdong, 528000, P.R.China. Corresponding author: CAO Xinghai, E-mail: cxh7688@126.com;

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Keywords：

Arthroscope; Rotator cuff injury; Effecitveness

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　　ObjectiveTo explorethe method and effectivenessofarthroscopically assisted treatmentof rotator cuff injury. MethodsBetween November 2009 and March 2011, 27 patients with rotator cuff injury were treated. There were 17 males and 10 females with a mean age of 43.6 years (range, 29-66 years). The disease duration was1 to 36 months (mean, 27months). The location was theleft shoulder in 11 cases and theright shoulder in 16 cases. Of them, 12 cases had a history of trauma and 15 caseshad no obvious predisposing causes. All patients had limitation of shoulder flexionandabduction. Anteroposterior and lateral X-ray films of the shoulder and the out-let X-ray films of the supraspinous muscle were taken. According to the acromion classification of Bigliani, there were 5 cases of type I, 13 cases of type II, and 9 cases of type III. MRI images showed all patients had rupture of the rotator cuff. The examination of shoulder arthroscope showed complete rupture of the supraspinatus muscle in 27 cases and acromion impingement in 23 cases. The patients without impingement underwent tear debridement, and the patients with impingement underwent acromioplasty and resection of subacromial bursa after tear debridement. The 3-4 cm incision was made with arthroscopically assisted positioning, and the metal suture anchorwas placed on the greater tubercle of humerus to repair rotator cuff. ResultsAll incisions healed primarily. All patients were followed up 13-27 months (mean, 19 months). No infection, loosening of internal fixation, and rotator cuffre-tearoccurred. Pain was relieved and the results was satisfactory after operation. The shoulder range of motion (ROM) at last follow-up was significantly improved when compared with preoperative ROM (P lt; 0.05). The visual analogue scale (VAS) score was significantly improved from 8.0 ± 1.8 at preoperation to 1.6 ± 0.7 at 2 weeks after operation and 0.8 ± 0.7 at last follow-up (P lt; 0.05); the University of California Los Angeles (UCLA) score of shoulder was significantly increased from 18.8 ± 6.6 at preoperation to 32.2 ± 3.3at 3months after operation and 33.6 ± 2.1 at last follow-up (P lt; 0.05). Conclusion The effectivenessofarthroscopically assisted treatmentof rotator cuff injury is satisfactory. However, long-termeffectiveness needs furtherfollow-up observation.

Citation： CAO Xinghai,CHEN Biao,LI Dazhi,SUN Bo,XIE Songqing,WU Xiaorong,FAN Liuping. EFFECTIVENESS ANALYSIS OF ARTHROSCOPICALLY ASSISTED TREATMENT OF ROTATOR CUFF INJURY. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(10): 1154-1157. doi: Copy

1.	Potau JM, Bardina X, Ciurana N, et al. Quantitative study of the architecture of the human subacromial space and its relationship with rotator cuff tears. Eur J Anat, 2008, 12 (1): 39-45.
2.	Papadopoulos P, Karataglis D, Boutsiadis A, et al. Functional outcome and structural integrity following mini-open repair of large and massive rotator cuff tears: A 3-5 year follow-up study. J Shoulder Elbow Surg, 2011, 20(1): 131-137.
3.	Ellman H. Arthroscopic subacromial decompression: analysis of one-to three-year results. Arthroscopy, 1987, 3(3): 173-181.
4.	Hijioka A, Suzuki K, Nakamura T, et al. Degenerative change and rotator cuff tears. An anatomical study in 160 shoulders of 80 cadavers. Arch Orthop Trauma Surg, 1993, 112(2): 61-64.
5.	MacDermid JC, Holtby R, Razmjou H, et al. All-arthroscopic versus mini-open repair of small or moderate-sized rotator cuff tears: a protocol for a randomized trial. BMC Musculoskelet Disord, 2006, 7: 25.
6.	张贵祥, 胡运胜, 赵京龙, 等. MRI不同序列对肩袖损伤诊断价值的比较. 中国医学影像技术, 2005, 21(7): 1067-1069.
7.	Teefey SA, Rubin DA, Middleton WD, et al. Detection and quantification of rotator cuff tears. J Bone Joint Surg (Am), 2004, 86-A(4): 708-716.
8.	DeFranco MJ, Cole BJ. Current perspectives on rotator cuff anatomy. Arthroscopy, 2009, 25(3): 305-320.
9.	Zlatkin MB, Hoffman C, Shellock FG. Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi-center study. J Magn Reson Imaging, 2004, 19(5): 623-631.
10.	刘玉杰, 王志刚, 王岩, 等. 肩袖损伤的影像学及关节镜诊疗价值. 中华创伤杂志, 2004, 20(1): 33-35.
11.	陆伟, 崔国庆, 欧阳侃, 等. 关节镜下五种方法修复肩袖撕裂的疗效观察. 中国修复重建外科杂志, 2009, 23(9): 1083-1086.
12.	Shinoda T, Shibata Y, Izaki T, et al. A comparative study of surgical invasion in arthroscopic and open rotator cuff repair. J Shoulder Elbow Surg, 2009, 18(4): 596-599.
13.	刘玉杰, 蔡胥, 王志刚, 等. 关节镜辅助下小切口修复肩袖损伤. 中华手外科杂志, 2005, 21(1): 6-8.
14.	张春刚, 王卫明, 赵德伟, 等. 肩袖部分撕裂的关节镜治疗. 中国骨与关节损伤杂志, 2010, 25(7): 586-588.
15.	Bond JL, Dopirak RM, Higgins J, et al. Arthroscopic replacement of massive, irreparable rotator cuff tears using a GraftJacket allograft: technique and preliminary results. Arthroscopy, 2008, 24(4): 403-409.
16.	Burkhart SS, Johnson TC, Wirth MA, et al. Cyclic loading of transosseous rotator cuff repairs: tension overload as a possible cause of failure. Arthroscopy, 1997, 13(2): 172-176.
17.	Demirham M, Atalar AC, Kilicoglu O. Primary fixation strength of rotator cuff repair techniques: a comparative study. Arthroscopy, 2003, 19(6): 572-576.
18.	Nho SJ, Shindle MK, Sherman SL, et al. Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair. J Bone Joint Surg (Am), 2007, 89 Suppl 3: 127-136.

1. Potau JM, Bardina X, Ciurana N, et al. Quantitative study of the architecture of the human subacromial space and its relationship with rotator cuff tears. Eur J Anat, 2008, 12 (1): 39-45.
2. Papadopoulos P, Karataglis D, Boutsiadis A, et al. Functional outcome and structural integrity following mini-open repair of large and massive rotator cuff tears: A 3-5 year follow-up study. J Shoulder Elbow Surg, 2011, 20(1): 131-137.
3. Ellman H. Arthroscopic subacromial decompression: analysis of one-to three-year results. Arthroscopy, 1987, 3(3): 173-181.
4. Hijioka A, Suzuki K, Nakamura T, et al. Degenerative change and rotator cuff tears. An anatomical study in 160 shoulders of 80 cadavers. Arch Orthop Trauma Surg, 1993, 112(2): 61-64.
5. MacDermid JC, Holtby R, Razmjou H, et al. All-arthroscopic versus mini-open repair of small or moderate-sized rotator cuff tears: a protocol for a randomized trial. BMC Musculoskelet Disord, 2006, 7: 25.
6. 张贵祥, 胡运胜, 赵京龙, 等. MRI不同序列对肩袖损伤诊断价值的比较. 中国医学影像技术, 2005, 21(7): 1067-1069.
7. Teefey SA, Rubin DA, Middleton WD, et al. Detection and quantification of rotator cuff tears. J Bone Joint Surg (Am), 2004, 86-A(4): 708-716.
8. DeFranco MJ, Cole BJ. Current perspectives on rotator cuff anatomy. Arthroscopy, 2009, 25(3): 305-320.
9. Zlatkin MB, Hoffman C, Shellock FG. Assessment of the rotator cuff and glenoid labrum using an extremity MR system: MR results compared to surgical findings from a multi-center study. J Magn Reson Imaging, 2004, 19(5): 623-631.
10. 刘玉杰, 王志刚, 王岩, 等. 肩袖损伤的影像学及关节镜诊疗价值. 中华创伤杂志, 2004, 20(1): 33-35.
11. 陆伟, 崔国庆, 欧阳侃, 等. 关节镜下五种方法修复肩袖撕裂的疗效观察. 中国修复重建外科杂志, 2009, 23(9): 1083-1086.
12. Shinoda T, Shibata Y, Izaki T, et al. A comparative study of surgical invasion in arthroscopic and open rotator cuff repair. J Shoulder Elbow Surg, 2009, 18(4): 596-599.
13. 刘玉杰, 蔡胥, 王志刚, 等. 关节镜辅助下小切口修复肩袖损伤. 中华手外科杂志, 2005, 21(1): 6-8.
14. 张春刚, 王卫明, 赵德伟, 等. 肩袖部分撕裂的关节镜治疗. 中国骨与关节损伤杂志, 2010, 25(7): 586-588.
15. Bond JL, Dopirak RM, Higgins J, et al. Arthroscopic replacement of massive, irreparable rotator cuff tears using a GraftJacket allograft: technique and preliminary results. Arthroscopy, 2008, 24(4): 403-409.
16. Burkhart SS, Johnson TC, Wirth MA, et al. Cyclic loading of transosseous rotator cuff repairs: tension overload as a possible cause of failure. Arthroscopy, 1997, 13(2): 172-176.
17. Demirham M, Atalar AC, Kilicoglu O. Primary fixation strength of rotator cuff repair techniques: a comparative study. Arthroscopy, 2003, 19(6): 572-576.
18. Nho SJ, Shindle MK, Sherman SL, et al. Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair. J Bone Joint Surg (Am), 2007, 89 Suppl 3: 127-136.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS ANALYSIS OF ARTHROSCOPICALLY ASSISTED TREATMENT OF ROTATOR CUFF INJURY

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