Factors associated with the development of early- to mid-term cuff-tear arthropathy following arthroscopic rotator cuff repair
Journal of Shoulder and Elbow Surgery, cilt.30, sa.7, ss.1572-1580, 2021 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 30 Sayı: 7
- Basım Tarihi: 2021
- Doi Numarası: 10.1016/j.jse.2020.09.016
- Dergi Adı: Journal of Shoulder and Elbow Surgery
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
- Sayfa Sayıları: ss.1572-1580
- Anahtar Kelimeler: Rotator cuff, tear, integrity, massive, arthropathy, pseudoparalysis, outcome, marker
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Background: Few studies have specifically evaluated the development of cuff-tear arthropathy (CTA) after a rotator cuff repair in the postoperative early to mid-term. This study aimed to identify the factors associated with the development of CTA, to evaluate the effect of arthropathy on functional outcomes, and to evaluate the incidence of CTA 3-10 years after an arthroscopic rotator cuff repair. Methods: A total of 312 patients who underwent an arthroscopic repair of a large or massive full-thickness rotator cuff tear with a minimum follow-up of 3 years were retrospectively divided into 2 groups for analysis: those with postrepair CTA (arthritic glenohumeral changes due to rotator cuff insufficiency) and those without. CTA was assessed using the Seebauer and modified Hamada-Fukuda classification systems. Pre-, intra-, and postoperative patient characteristics; characteristics of the rotator cuff tear; clinical and radiological parameters; and pre- and postoperative functional scores were compared. Results: The rate of development of CTA was 11.5% (36 of 312 patients, 13 centric and 23 eccentric arthropathy). CTA was more frequently associated with the poor integrity of the supraspinatus tendon after repair (P <.001) and massive tears (P =.006). Postoperative pseudoparalysis (P <.001), symptomatic retear (P <.001), tear size (P =.026), critical shoulder angle (P =.001), preoperative acromiohumeral interval (P =.046), and the humeral head superior migration (P =.001) were found to be associated with the development of CTA. However, only postoperative pseudoparalysis was found to be an independent risk factor (P <.001, odds ratio: 2.965). Patients with postrepair CTA had significantly worse functional outcome scores. Conclusion: The postoperative development of pseudoparalysis may be a marker of CTA in the future and that closer follow-up may be necessary.