scholarly journals Synovial Fluid Volume at the Time of Arthroscopic Rotator Cuff Repair Correlates With Tear Size

Cureus ◽  
2020 ◽  
Author(s):  
Michael Stone ◽  
Grant Jamgochian ◽  
Ocean Thakar ◽  
Manan S Patel ◽  
Joseph A Abboud
Keyword(s):  
Rotator Cuff ◽  
Synovial Fluid ◽  
Rotator Cuff Repair ◽  
Fluid Volume ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Tear Size

scholarly journals Tear size, general health status and smoking influence functional outcome at 5 years following arthroscopic rotator cuff repair

2021 ◽  
pp. 175857322110416
Author(s):  
Olivia Lawson ◽  
Jaimie A Nicholson ◽  
Nicholas D Clement ◽  
Will Rudge ◽  
Deborah J MacDonald ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Rotator Cuff ◽  
Functional Outcome ◽  
General Health ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Tear Size

Introduction There is limited medium-term outcome data regarding the predictors of functional outcome and patient satisfaction after arthroscopic rotator cuff repair. Methods 287 patients that underwent arthroscopic rotator cuff repair under a high-volume single surgeon were contacted at a minimum of 4 years following surgery. Patient demographics, tear size and co-morbidities were pre-operatively recorded. The Oxford shoulder score, EuroQol 5-dimensional score and patient satisfaction were recorded at final follow-up. Results 234 (81.5%) patients completed follow-up at a mean of 5.5 (4–9) years. There were 126 males and 108 females with a mean age of 60 (range 25–83) years. The majority of patients ( n = 211, 90%) were satisfied with their final outcome. Multivariate linear regression analysis ( R2 = 0.64) identified that increasing tear size ( p = 0.04), worsening general health assessed by the EuroQol 5-Dimensional ( p < 0.001), and smoking ( p = 0.049) were associated with a worse Oxford shoulder score. Logistic regression analysis ( R2 = 0.13) identified that worsening general health assessed by the EuroQol 5-Dimensional ( p < 0.001), and smoking ( p = 0.01) were associated with an increased risk of patient dissatisfaction. Conclusion General health status and smoking are independent predictors of functional outcome and patient satisfaction at medium-term follow-up following arthroscopic rotator cuff repair.

scholarly journals Prevalence and Risk Factors of Neuropathic Pain in Patients with a Rotator Cuff Tear

2018 ◽  
Vol 1 (21;1) ◽  
pp. E173-E180 ◽  
Author(s):  
Sangbong Ko
Keyword(s):  
Neuropathic Pain ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Full Thickness ◽  
Cuff Tear ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Tear Size

Background: Until now, few studies had investigated the neuropathic pain component in patients with a rotator cuff tear (RCT). Objectives: The aim of the study was to identify the neuropathic pain component in patients with RCT and to determine the factors correlated with neuropathic pain in patients with RCT. Study Design: Prospective, cohort, prognostic study. Setting: Study patients who required arthroscopic rotator cuff repair were analyzed in a hospital setting. Methods: We prospectively studied 101 patients who were less than 60 years old with fullthickness tears requiring arthroscopic rotator cuff repair and met the inclusion and exclusion criteria. Multiple regression analysis was performed to identify variables that independently affected neuropathic pain in patients with a RCT. We use Douleur neuropathique 4 questionnaire (DN4) to assess neuropathic pain, which was ≥ 4 points of the DN4 questionaire. The visual analog scale (VAS) for the most severe pain within 4 weeks before admission and mean pain level during the last 4 weeks were checked. The atrophy grades of the rotator cuff muscles were classified on magnetic resonance images according to the Goutallier classification. The size and medial retraction of the RCT were measured during arthroscopic repair for RCT. Results: Sixteen (15.8%) of the 101 patients had neuropathic pain according to the cutoff values on the DN4 questionnaire for diagnosing neuropathic pain. The neuropathic pain group had significantly higher prevalence of smoking (P = 0.042), more mean VAS during last 4 weeks (P = 0.008), larger cuff tear (P = 0.003), more medial retraction of cuff (P = 0.016), and severe fatty degeneration of rotator cuff muscles (supraspinatus, P < 0.001; subscapularis, P < 0.001; and infraspinatus, P = 0.003) than the nonneuropathic pain group. The multiple logistic regression analyses showed that more mean VAS during the last 4 weeks and tear size of a rotator cuff were independent of other factors for the neuropathic pain of the patients with a full-thickness RCT. Limitations: Small sample size is the first limitation of this study. Conclusions: The prevalence of neuropathic pain in patients with a full-thickness RCT requiring arthroscopic rotator cuff repair was 15.8 % according to the DN4 questionnaire. The neuropathic pain component was more relevant to the severity of pain and tear size in the patients with a full-thickness RCT. It is important to be aware of the existence of neuropathic pain when treating a patient presenting with pain due to a RCT because accompanying neuropathy with a RCT could have a worse effect on repair of a RCT. IRB approval and clinical trial registration number: CR-15-045 Key words: Shoulder, rotator cuff tear, arthroscopic rotator cuff repair, neuropathic pain

scholarly journals Factors Affecting Prolonged Postoperative Pain and Analgesic Use After Arthroscopic Full-Thickness Rotator Cuff Repair

2021 ◽  
Vol 9 (7) ◽  
pp. 232596712110124
Author(s):  
Abdulhamit Misir ◽  
Erdal Uzun ◽  
Turan Bilge Kizkapan ◽  
Mustafa Ozcamdalli ◽  
Hazim Sekban ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Fatty Degeneration ◽  
Arthroscopic Rotator Cuff Repair ◽  
Narcotic Analgesic ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Tear Size ◽  
Analgesic Use

Background: Postoperative pain and analgesic use after arthroscopic rotator cuff repair remain important issues that affect rehabilitation and overall outcomes. Purpose: To evaluate the pre- and intraoperative factors that may cause prolonged duration of postoperative pain and analgesic use. Study Design: Case-control study; Level of evidence, 3. Methods: We included 443 patients who underwent arthroscopic rotator cuff repair and subacromial decompression. Visual analog scale (VAS) scores for pain were obtained preoperatively and at 30 and 90 days postoperatively. Patients were divided into a group who had prolonged postoperative pain (duration ≥1 and <3 months; n = 86 patients) and a group with nonprolonged pain (duration <1 month; n = 357 patients). The following factors were compared between groups: age, sex, body mass index, repair technique, tear size, retraction amount, repair tension, tendon degeneration, preoperative pseudoparesis, symptom duration, application of microfracture to the rotator cuff footprint for marrow stimulation, smoking, degree of fatty degeneration, preoperative narcotic analgesic use, diabetes, acromioclavicular joint degeneration, and preoperative Douleur Neuropathique 4 (DN4) and American Shoulder and Elbow Society (ASES) scores. Results: Significant differences were seen between the prolonged and nonprolonged groups regarding the median duration of pain (54 vs 27 days, respectively; P < .001) and analgesic use (42 vs 28 days, respectively; P < .001). Significant differences were noted between the groups for symptom duration ( P = .007), smoking status ( P = .001), degree of fatty degeneration ( P = .009), preoperative narcotic analgesic use ( P < .001), preoperative DN4 and ASES scores, 30-day VAS score ( P < .001), duration of opioid and nonopioid analgesic use ( P < .001), tear size ( P = .026), and retraction stage ( P = .032). Tear size ( P = .009), retraction amount ( P = .005), preoperative narcotic analgesic use ( P < .001), degree of fatty degeneration ( P < .001), and preoperative DN4 score ( P = .024) were factors independently associated with prolonged postoperative pain and analgesic use. Conclusion: Patients with larger size tears, retracted tendons, preoperative use of narcotic analgesics, higher tensioned tendon after repair, and Goutallier grade 3 or 4 fatty degeneration faced an increased risk of prolonged postoperative pain and analgesic use after arthroscopic rotator cuff repair. These factors might be mitigated by psychosocial support; gentle, controlled, and individualized postoperative rehabilitation approaches; detailed preoperative evaluation; and closer follow-up of patients who are treated operatively.

scholarly journals The WORC Index and Predicting Treatment Failure in Patients Undergoing Primary Arthroscopic Rotator Cuff Repair

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711985951
Author(s):  
Matthew J. Herring ◽  
Melissa White ◽  
Jonathan P. Braman
Keyword(s):  
Rotator Cuff ◽  
Treatment Failure ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Tendon Tear ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair ◽  
Tear Size ◽  
Risk Of Treatment

Background: Rotator cuff tears are common injuries that are reliably treated with arthroscopic repair, producing good to excellent results. The Western Ontario Rotator Cuff (WORC) index is a validated disease-specific instrument used to assess patient outcomes; however, no study to date has correlated WORC index with treatment failure. Purpose: To evaluate the WORC index as a predictor for successful treatment in arthroscopic rotator cuff repair. An additional purpose was to identify patient and tear characteristics associated with risk of treatment failure. Study Design: Case-control study; Level of evidence, 3. Methods: This study reviewed a total of 500 patients who underwent arthroscopic rotator cuff repair with a minimum of 2-year follow-up. Patient charts were reviewed for treatment failures, defined as persistent or recurrent shoulder pain or weakness, leading to further workup and identification of a failure to heal or recurrent tear by magnetic resonance imaging. Patient demographic and comorbidity data were gathered and correlated with risk of failure. All patients completed WORC questionnaires, and scores were correlated with risk of treatment failure. Results: There were 28 (5.6%) treatment failures at a median 28 weeks (SD, 42 weeks) postoperatively. Patients claiming workers’ compensation were 3.21 times more likely (odds ratio; P = .018) to fail treatment. Posterior interval tears (those including infraspinatus) were 3.14 times more likely ( P = .01) to fail than anterior interval tears. Tear size was associated with treatment failure; the odds of failure was 3.24 for a 2-tendon tear and 5.83 for a 3-tendon tear ( P = .03). Tears involving the nondominant arm were associated with an increased risk of failure by a factor of 3.04 (95% CI, 1.01-9.11; P = .047). A WORC score ≥80 was associated with a 95% probability of treatment success at 1 year. Conclusion: After arthroscopic rotator cuff repair, patients with WORC scores ≥80 at 1 year have a 95% probability of successful treatment and likely do not benefit from continued follow-up visits. Furthermore, several risk factors were identified that may influence outcomes after rotator cuff repair, including workers’ compensation, location of tear, tear size, and hand dominance.

Incidence of Propionibacterium acnes in arthroscopic rotator cuff repair

2020 ◽  
Vol 25 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Yukihiro Kajita ◽  
Yusuke Iwahori ◽  
Yohei Harada ◽  
Masataka Deie
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Propionibacterium Acnes ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair

Do elderly patients gain as much benefit from arthroscopic rotator cuff repair as their younger peers?

2019 ◽  
Vol 28 (6) ◽  
pp. 1056-1065 ◽  
Author(s):  
Caroline Witney-Lagen ◽  
Georgios Mazis ◽  
Juan Bruguera ◽  
Ehud Atoun ◽  
Giuseppe Sforza ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Elderly Patients ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff ◽  
Cuff Repair
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