Clinical and Radiographic Outcomes After Arthroscopic Lamina-Specific Double-Row Repair of Large Delaminated Rotator Cuff Tears in Active Patients

Daisuke Mori; Kazuha Kizaki; Noboru Funakoshi; Fumiharu Yamashita; Yasuyuki Mizuno; Takaaki Shirai; Masahiko Kobayashi

doi:10.1177/2325967119838249

Clinical and Radiographic Outcomes After Arthroscopic Lamina-Specific Double-Row Repair of Large Delaminated Rotator Cuff Tears in Active Patients

Orthop J Sports Med. 2019 Apr 22;7(4):2325967119838249. doi: 10.1177/2325967119838249. eCollection 2019 Apr.

Authors

Daisuke Mori¹, Kazuha Kizaki¹, Noboru Funakoshi¹, Fumiharu Yamashita¹, Yasuyuki Mizuno¹, Takaaki Shirai¹, Masahiko Kobayashi¹

Affiliation

¹ Department of Orthopaedic Surgery, Kyoto Shimogamo Hospital, Kyoto, Japan.

Abstract

Background: The presence of delamination and a larger rotator cuff tear (RCT) size have been associated with poorer outcomes in rotator cuff repair. Therefore, we developed a new surgical procedure, arthroscopic lamina-specific double-row fixation (ALSDR), for the repair of large delaminated RCTs.

Purpose: To investigate the clinical outcomes, magnetic resonance imaging findings, and satisfaction with several variables after ALSDR for large delaminated RCTs.

Study design: Case series; Level of evidence, 4.

Methods: A total of 30 active patients (mean age, 59.1 years) undergoing ALSDR were assessed by a numeric rating scale (NRS; 0-10) for pain, surgery, work, and exercise as well as American Shoulder and Elbow Surgeons (ASES), Constant, and Simple Shoulder Test (SST) scores at a mean of 65.9 months postoperatively. Rotator cuff integrity was determined by magnetic resonance imaging. The Spearman correlation coefficient (ρ) was used to determine the correlation between clinical and NRS scores.

Results: Five patients (16.7%) had a retear. Each of the postoperative functional and NRS scores except the NRS work score was significantly better in the healed shoulders than in the shoulders with a retear (P < .001). The NRS pain score showed a significant negative correlation with ASES, Constant, and SST scores (ρ = -0.775, -0.668, and -0.742, respectively; P < .001 for all). The NRS surgery score had a positive correlation with Constant and SST scores (ρ = 0.393 [P = .032] and ρ = 0.456 [P = .011], respectively). The NRS work score had a positive correlation with ASES, Constant, and SST scores (ρ = 0.382 [P = .037], ρ = 0.386 [P = .035], and ρ = 0.414 [P = .023], respectively). The NRS exercise score had a positive correlation with ASES, Constant, and SST scores (ρ = 0.567 [P = .001], ρ = 0.511 [P = .004], and ρ = 0.639 [P < .001], respectively).

Conclusion: Our results showed that there was a significant correlation between clinical and NRS scores. The results indicate that ALSDR can provide a high degree of functionality and can be a useful alternative treatment for active patients with large delaminated RCTs.

Keywords: correlation; delamination; large rotator cuff tear; structural and clinical outcomes.