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Factors associated with healing failure after early repair of acute, trauma-related rotator cuff tears
Helsingborg Hosp, Sweden; Lund Univ, Sweden.
Helsingborg Hosp, Sweden; Lund Univ, Sweden.
Linköpings universitet, Institutionen för biomedicinska och kliniska vetenskaper, Avdelningen för kirurgi, ortopedi och onkologi. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Centrum för kirurgi, ortopedi och cancervård, Ortopedkliniken i Linköping.ORCID-id: 0000-0001-7873-3093
Lund Univ, Sweden.
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2023 (engelsk)Inngår i: Journal of shoulder and elbow surgery, ISSN 1058-2746, E-ISSN 1532-6500, Vol. 32, nr 10, s. 2074-2081Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Background: Healing failure after rotator cuff repair is a challenging problem. Acute, trauma-related tears are considered a separate entity and are often treated surgically. The aim of this study was to identify factors associated with healing failure in previously asymp-tomatic patients with trauma-related rotator cuff tears treated with early arthroscopic repair. Methods: This study included 62 consecutively recruited patients (23% women; median age, 61 years; age range, 42-75 years) with acute symptoms in a previously asymptomatic shoulder and a magnetic resonance imaging-verified full-thickness rotator cuff tear after shoulder trauma. All patients were offered, and underwent, early arthroscopic repair, during which a biopsy specimen was har-vested from the supraspinatus tendon and analyzed for signs of degeneration. Of the patients, 57 (92%) completed 1-year follow-up and underwent assessment of repair integrity on magnetic resonance images according to the Sugaya classification. Risk factors for heal-ing failure were investigated using a causal-relation diagram where age, body mass index, tendon degeneration (Bonar score), diabetes mellitus, fatty infiltration (FI), sex, smoking, tear location regarding integrity of the rotator cable, and tear size (number of ruptured tendons and tendon retraction) were included and analyzed. Results: Healing failure at 1 year was identified in 37% of patients (n = 21). A high degree of FI of the supraspinatus muscle (P = .01), a tear location including disruption of rotator cable integrity (P = .01), and old age (P = .03) were associated with healing failure. Tendon degeneration as determined by histopathology was not associated with healing failure at 1-year follow-up (P = .63). Conclusion: Older age, increased FI of the supraspinatus muscle, and a tear including disruption of the rotator cable increased the risk of healing failure after early arthroscopic repair in patients with trauma-related full-thickness rotator cuff tears. Level of evidence: Level I; Prospective Cohort Design; Prognosis Study

sted, utgiver, år, opplag, sider
MOSBY-ELSEVIER , 2023. Vol. 32, nr 10, s. 2074-2081
Emneord [en]
Rotator cuff tear; tendon healing; subacute repair; risk factors; healing failure; tendon degeneration; rotator cable
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Identifikatorer
URN: urn:nbn:se:liu:diva-198838DOI: 10.1016/j.jse.2023.03.027ISI: 001080456800001PubMedID: 37178969OAI: oai:DiVA.org:liu-198838DiVA, id: diva2:1808756
Merknad

Funding Agencies|Stig och Ragna Gorthon Research Foundation; Thelma Zoegas Foundation, Helsingborg, Sweden; Region Ostergotland Research Council, Linkoping, Sweden

Tilgjengelig fra: 2023-11-01 Laget: 2023-11-01 Sist oppdatert: 2024-04-15

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