Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association · 2018
Higher Critical Shoulder Angle and Acromion Index Are Associated With Increased Retear Risk After Isolated Supraspinatus Tendon Repair at Short-Term Follow Up.
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Scheiderer Bastian, Imhoff Florian B, Johnson Jeremiah D, Aglio James, Cote Mark P, Beitzel Knut, Imhoff Andreas B, Arciero Robert A, Mazzocca Augustus D, Morikawa Daichi
Аннотация
PURPOSE: To evaluate the effect of critical shoulder angle (CSA), acromion index (AI), and glenoid inclination (GI) on the postoperative healing rate after arthroscopic supraspinatus tendon repair.
METHODS: Patients after arthroscopic repair of a symptomatic, unilateral, single-tendon, full-thickness supraspinatus tear in whom nonoperative management had failed were retrospectively reviewed. Magnetic resonance imaging (MRI) studies were obtained 6 months postoperatively and were evaluated by 2 independent observers. Repair integrity was classified as either intact or torn. Preoperative true anteroposterior radiographs were used to measure CSA, AI, and GI.
RESULTS: Fifty-seven patients were evaluated 6 months postoperatively. The mean patient age at surgery was 54.7 ± 7.7 years. On MRI studies, 41 patients (71.9%) had an intact repair and 16 patients (28.1%) had a full-thickness retear. There were no significant differences between the intact and retear group in regard to patient age (P = .648), initial tear size (P = .205), or fatty degeneration (P = .508). The mean CSA for the retear group (37° ± 4°) was significantly higher than that in the intact group (35° ± 3°; P = .014). If the CSA was >38°, the odds ratio of having a retear was 3.78 (95% confidence interval 1.05 to 13.58; P = .042). Average AI for the retear group (0.73 ± 0.09) was significantly higher than that in the intact group (0.69 ± 0.06; P = .049). The mean GI was 17° ± 6° for the intact group and 16° ± 6° for the retear group (P = .739).
CONCLUSIONS: At short-term follow-up, higher CSA and AI significantly increased the retear risk after arthroscopic supraspinatus tendon repair. CSA >38° increased the retear risk almost 4-fold. Overall GI was elevated but did not correlate with failure rate.
LEVEL OF EVIDENCE: III, case control study.
METHODS: Patients after arthroscopic repair of a symptomatic, unilateral, single-tendon, full-thickness supraspinatus tear in whom nonoperative management had failed were retrospectively reviewed. Magnetic resonance imaging (MRI) studies were obtained 6 months postoperatively and were evaluated by 2 independent observers. Repair integrity was classified as either intact or torn. Preoperative true anteroposterior radiographs were used to measure CSA, AI, and GI.
RESULTS: Fifty-seven patients were evaluated 6 months postoperatively. The mean patient age at surgery was 54.7 ± 7.7 years. On MRI studies, 41 patients (71.9%) had an intact repair and 16 patients (28.1%) had a full-thickness retear. There were no significant differences between the intact and retear group in regard to patient age (P = .648), initial tear size (P = .205), or fatty degeneration (P = .508). The mean CSA for the retear group (37° ± 4°) was significantly higher than that in the intact group (35° ± 3°; P = .014). If the CSA was >38°, the odds ratio of having a retear was 3.78 (95% confidence interval 1.05 to 13.58; P = .042). Average AI for the retear group (0.73 ± 0.09) was significantly higher than that in the intact group (0.69 ± 0.06; P = .049). The mean GI was 17° ± 6° for the intact group and 16° ± 6° for the retear group (P = .739).
CONCLUSIONS: At short-term follow-up, higher CSA and AI significantly increased the retear risk after arthroscopic supraspinatus tendon repair. CSA >38° increased the retear risk almost 4-fold. Overall GI was elevated but did not correlate with failure rate.
LEVEL OF EVIDENCE: III, case control study.