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Scientific Articles   |    
A Comparison of Outcomes After Arthroscopic Repair of Partial Versus Small or Medium-Sized Full-Thickness Rotator Cuff Tears
Karin S. Peters, MD1; Sebastian McCallum2; Lisa Briggs, AMS3; George A.C. Murrell, MBBS, DPhil, MD4
1 Kliniek Klein Rosendael, Rosendaalselaan 30, 6891 DG Rozendaal, The Netherlands. Email address: kpeters@medinova.com
2 2/50 Carr Street, Coogee, NSW 2034, Australia
3 17 Kensington Street, Kogarah, NSW 2217, Australia
4 Department of Orthopaedic Surgery, Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Level 2, 4-10 South Street, Kogarah, Sydney, NSW 2217, Australia
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Kliniek Klein Rosendael, Rosendaalselaan 30, 6891 DG Rozendaal, The Netherlands. Email address: kpeters@medinova.com
2/50 Carr Street, Coogee, NSW 2034, Australia
17 Kensington Street, Kogarah, NSW 2217, Australia
Department of Orthopaedic Surgery, Orthopaedic Research Institute, St. George Hospital Campus, University of New South Wales, Level 2, 4-10 South Street, Kogarah, Sydney, NSW 2217, Australia
Investigation performed at the Orthopaedic Research Institute, St. George Hospital, University of New South Wales, Sydney, New South Wales, Australia

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Jun 20;94(12):1078-1085. doi: 10.2106/JBJS.J.00519
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Abstract

Background: 

Little is known about the outcomes after repair of partial-thickness rotator cuff tears. The aim of this study was to assess the outcome after repair of partial-thickness rotator cuff tears compared with full-thickness tears. Our hypothesis was that repair of partial-thickness tears leads to more shoulder stiffness but fewer retears compared with repair of full-thickness tears.

Methods: 

A group of 105 consecutive patients who had a full-thickness tear measuring <3 cm2 was compared with a group of sixty-four patients who had a partial-thickness tear. All tears were repaired with use of a knotless single-row arthroscopic repair. The American Shoulder and Elbow Surgeons (ASES) score and standardized patient and examiner-determined outcomes were obtained preoperatively and at six, twelve, and twenty-four weeks and at two years after surgery. Rotator cuff integrity was determined by ultrasound examination at six months and two years after surgery.

Results: 

Examiner-determined postoperative stiffness at six weeks was common in both groups (50% of those with a partial-thickness tear and 47% of those with a full-thickness tear) but was decreased compared with preoperative findings in both groups to 21% and 19%, respectively, at three months and to 15% and 14% at six months. The ultrasound-determined retear rate was small (5% in the partial-thickness group and 10% in the full-thickness group) at six months, but increased to 10% and 20%, respectively, at twenty-four months. The ASES score, patient-determined overall shoulder function, and all pain scores were superior to preoperative scores at six months (p < 0.001) and at twenty-four months (p < 0.001) in both groups.

Conclusions: 

Arthroscopic repair of partial-thickness and small and medium-sized full-thickness rotator cuff tears was associated with excellent medium-term clinical outcomes with low retear rates. The data did not support our hypothesis: the differences in retear rate and postoperative shoulder stiffness rate found between the two groups did not reach significance.

Level of Evidence: 

Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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