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ORIGINAL ARTICLE
Year : 2019  |  Volume : 54  |  Issue : 2  |  Page : 116-125

Arthroscopic repair of combined anterior and superior cuff tear


Department of Orthopedic Surgery, Alexandria University, Alexandria, Egypt

Correspondence Address:
MD Mohamed A El Sheikh
Department of Orthopedics and Traumatology, El-Hadara University Hospital, Alexandria School of Medicine, Alexandria University, Alexandria
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/eoj.eoj_22_19

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Purpose The aim of this study is to evaluate the results of arthroscopic repair of combined anterior and superior cuff tear. Patients and methods One-stage arthroscopic repair of concomitant supraspinatus and subscapularis tendon tear was performed in 25 patients. All patients were evaluated at a minimum 1-year follow-up with a visual analog scale score for pain; subjective shoulder value, which was used for subjective evaluation of the affected shoulder as a percentage of the normal one; range of motion; the American Shoulder and Elbow Surgeons score; and University of California at Los Angeles scores for clinical assessment. Belly-Press test and lift-off test, in particular back-to-hand distance, were used to evaluate subscapularis function. Empty can test was used to evaluate the supraspinatus strength. Results The mean age at the time of surgery was 53.9±11.3 years. The rate of dominant arm involvement was 60% of the patients. At the final follow-up, the mean visual analog scale score improved significantly to 0.38±0.01 points postoperatively (P<0.01). The mean subjective shoulder value improved from 36.5±6.98 preoperatively to 89.9±7.52 at the end of follow-up, and this was significant (P<0.001).The mean American Shoulder and Elbow Surgeons score improved significantly to 90.8±8.45 at the mean 1-year follow-up (P<0.001). The mean University of California at Los Angeles score improved significantly to 30.4±3.85 at the end of follow-up (P<0.001). Patients gained a significant reduction of belly-press angle from 36.5±12.5 to 13.9±3.25 (P<0.0026). Back-to-hand distance significantly improved from 2.95±0.68 to 6.0±1.33 cm (P<0.0033). The mean active forward flexion and the mean active internal rotation significantly improved postoperatively, whereas the mean active external rotation was nonsignificantly reduced. Of the 25 shoulders, 23 (92%) were considered by the patients to be much better or better as a result of the operation. Conclusion The arthroscopic tackling of concomitant shoulder anterior and superior rotator cuff tears showed satisfactory results and fastened the return to normal activity at 1-year follow-up, as well as postoperative stiffness was avoided. Level of evidence: Level III, case–control study.


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