- Post-Procedure: Rotator Interval Capsule Closure (Treacy, Field, and Savoie)
- Post-Procedure: Arthroscopic Side-to-Side Repair of Delamination Tears and Localized Partial-Thickness Articular-Side Cuff Tears
- Post-Procedure: Arthroscopic Repair of Complete Rotator Cuff Tears
- Post-Procedure: Repair of Large or Massive Contracted Tears Using the Interval Slide Technique (Tauro et al)
- Post-Procedure: Subscapularis Tendon Repair
Post-Procedure: Rotator Interval Capsule Closure (Treacy, Field, and Savoie)
POST-PROCEDURE CARE
- Immobilize in a sling for 3 to 6 weeks.
- Avoid overhead motion or external rotation beyond neutral for 6 weeks.
- Begin overhead motion at 6 weeks postoperatively.
- Begin resisted isotonic strengthening at 10 weeks.
- If the tear was small, an accelerated rehabilitation program may be used.
- Progressive activities are incorporated as strength allows, and unrestricted activities usually are resumed 6 to 12 months after surgery.
COMPLICATIONS
- Infection
- Postoperative stiffness
- Failure of repair
- Complex regional pain syndrome
- Deep vein thrombosis.
ANALYSIS OF RESULTS
Arthroscopic repair has results and complication rates that are similar to those of open and mini-open techniques for partial to small full-thickness rotator cuff tears, but with lower gains in strength and motion and higher rates of recurrence for very large and massive tears.
OUTCOMES AND EVIDENCE
- Brislin, Field, and Savoie: 11% complication rate for primary arthroscopic rotator cuff repair, including shoulder stiffness, failure of healing, infections, complex regional pain syndrome, and deep venous thrombosis
- Cole et al: significant improvements in all outcome measures; 22% recurrence of tear, which correlated with patient age and extension of the tear to the supraspinatus
- Kang et al: arthroscopic versus mini-open treatment of chronic small and medium rotator cuff tears; found that early functional outcomes were nearly equivalent, but the arthroscopic group had statistically significant improvement in pain scores at 3 months
- Deutsch: 98% satisfaction with arthroscopic repair of partial-thickness (>50% thickness) tears
- Verma et al: no statistical difference in outcome of arthroscopic repair versus mini-open repair
- Lafosse et al: failure rate of 11% with arthroscopic rotator cuff repair, lower with double-row than single-row fixation.
- Franceschi et al: comparable clinical results between single-row and double-row fixation techniques at 2-year follow-up
- Huijsmans et al: 91% excellent or good outcome after arthroscopic rotator cuff repair with double-row fixation
- Charousset et al: better tendon healing rates with double-row fixation, but no difference in clinical results.
- Ma et al: cadaver study showed higher ultimate tensile load of double-row fixation compared to three different types of single-row fixation.
- Andrews et al: 85% good and excellent results with arthroscopic debridement alone in young athletes
- Budoff et al: 89% good to excellent results after arthroscopic debridement alone for partial-thickness rotator cuff tears at 5 years follow-up; this decreased to 81% after five years.
- Esch: 76% with partial tears had satisfactory results with arthroscopic debridement and subacromial decompression.
- Cordasco et al: no difference in outcome of arthroscopic acromioplasty and debridement in patients with partial-thickness rotator cuff tears compared to those without tear.
- Weber: partial-thickness tears treated with arthroscopic debridement and acromioplasty versus arthroscopic acromioplasty and mini-open repair; the debridement and acromioplasty group had 14 good and no excellent results; the repair group had 28 good and 3 excellent results.
Procedure: Rotator Interval Capsule Closure (Treacy, Field, and Savoie)
Post-Procedure: Arthroscopic Side-to-Side Repair of Delamination Tears and Localized Partial-Thickness Articular-Side Cuff Tears
POST-PROCEDURE CARE
- Immobilize in a sling for 3 to 6 weeks.
- Avoid overhead motion or external rotation beyond neutral for 6 weeks.
- Begin overhead motion at 6 weeks postoperatively.
- Begin resisted isotonic strengthening at 10 weeks.
- If the tear was small, an accelerated rehabilitation program may be used.
- Progressive activities are incorporated as strength allows, and unrestricted activities usually are resumed 6 to 12 months after surgery.
COMPLICATIONS
- Infection
- Postoperative stiffness
- Failure of repair
- Complex regional pain syndrome
- Deep vein thrombosis.
ANALYSIS OF RESULTS
Arthroscopic repair has results and complication rates that are similar to those of open and mini-open techniques for partial to small full-thickness rotator cuff tears, but with lower gains in strength and motion and higher rates of recurrence for very large and massive tears.
OUTCOMES AND EVIDENCE
- Brislin, Field, and Savoie: 11% complication rate for primary arthroscopic rotator cuff repair, including shoulder stiffness, failure of healing, infections, complex regional pain syndrome, and deep venous thrombosis
- Cole et al: significant improvements in all outcome measures; 22% recurrence of tear, which correlated with patient age and extension of the tear to the supraspinatus
- Kang et al: arthroscopic versus mini-open treatment of chronic small and medium rotator cuff tears; found that early functional outcomes were nearly equivalent, but the arthroscopic group had statistically significant improvement in pain scores at 3 months
- Deutsch: 98% satisfaction with arthroscopic repair of partial-thickness (>50% thickness) tears
- Verma et al: no statistical difference in outcome of arthroscopic repair versus mini-open repair
- Lafosse et al: failure rate of 11% with arthroscopic rotator cuff repair, lower with double-row than single-row fixation.
- Franceschi et al: comparable clinical results between single-row and double-row fixation techniques at 2-year follow-up
- Huijsmans et al: 91% excellent or good outcome after arthroscopic rotator cuff repair with double-row fixation
- Charousset et al: better tendon healing rates with double-row fixation, but no difference in clinical results.
- Ma et al: cadaver study showed higher ultimate tensile load of double-row fixation compared to three different types of single-row fixation.
- Andrews et al: 85% good and excellent results with arthroscopic debridement alone in young athletes
- Budoff et al: 89% good to excellent results after arthroscopic debridement alone for partial-thickness rotator cuff tears at 5 years follow-up; this decreased to 81% after five years.
- Esch: 76% with partial tears had satisfactory results with arthroscopic debridement and subacromial decompression.
- Cordasco et al: no difference in outcome of arthroscopic acromioplasty and debridement in patients with partial-thickness rotator cuff tears compared to those without tear.
- Weber: partial-thickness tears treated with arthroscopic debridement and acromioplasty versus arthroscopic acromioplasty and mini-open repair; the debridement and acromioplasty group had 14 good and no excellent results; the repair group had 28 good and 3 excellent results.
Procedure: Arthroscopic Side-to-Side Repair of Delamination Tears and Localized Partial-Thickness Articular-Side Cuff Tears
Post-Procedure: Arthroscopic Repair of Complete Rotator Cuff Tears
POST-PROCEDURE CARE
- Immobilize in a sling for 3 to 6 weeks.
- Avoid overhead motion or external rotation beyond neutral for 6 weeks.
- Begin overhead motion at 6 weeks postoperatively.
- Begin resisted isotonic strengthening at 10 weeks.
- If the tear was small, an accelerated rehabilitation program may be used.
- Progressive activities are incorporated as strength allows, and unrestricted activities usually are resumed 6 to 12 months after surgery.
COMPLICATIONS
- Infection
- Postoperative stiffness
- Failure of repair
- Complex regional pain syndrome
- Deep vein thrombosis.
ANALYSIS OF RESULTS
Arthroscopic repair has results and complication rates that are similar to those of open and mini-open techniques for partial to small full-thickness rotator cuff tears, but with lower gains in strength and motion and higher rates of recurrence for very large and massive tears.
OUTCOMES AND EVIDENCE
- Brislin, Field, and Savoie: 11% complication rate for primary arthroscopic rotator cuff repair, including shoulder stiffness, failure of healing, infections, complex regional pain syndrome, and deep venous thrombosis
- Cole et al: significant improvements in all outcome measures; 22% recurrence of tear, which correlated with patient age and extension of the tear to the supraspinatus
- Kang et al: arthroscopic versus mini-open treatment of chronic small and medium rotator cuff tears; found that early functional outcomes were nearly equivalent, but the arthroscopic group had statistically significant improvement in pain scores at 3 months
- Deutsch: 98% satisfaction with arthroscopic repair of partial-thickness (>50% thickness) tears
- Verma et al: no statistical difference in outcome of arthroscopic repair versus mini-open repair
- Lafosse et al: failure rate of 11% with arthroscopic rotator cuff repair, lower with double-row than single-row fixation.
- Franceschi et al: comparable clinical results between single-row and double-row fixation techniques at 2-year follow-up
- Huijsmans et al: 91% excellent or good outcome after arthroscopic rotator cuff repair with double-row fixation
- Charousset et al: better tendon healing rates with double-row fixation, but no difference in clinical results.
- Ma et al: cadaver study showed higher ultimate tensile load of double-row fixation compared to three different types of single-row fixation.
- Andrews et al: 85% good and excellent results with arthroscopic debridement alone in young athletes
- Budoff et al: 89% good to excellent results after arthroscopic debridement alone for partial-thickness rotator cuff tears at 5 years follow-up; this decreased to 81% after five years.
- Esch: 76% with partial tears had satisfactory results with arthroscopic debridement and subacromial decompression.
- Cordasco et al: no difference in outcome of arthroscopic acromioplasty and debridement in patients with partial-thickness rotator cuff tears compared to those without tear.
- Weber: partial-thickness tears treated with arthroscopic debridement and acromioplasty versus arthroscopic acromioplasty and mini-open repair; the debridement and acromioplasty group had 14 good and no excellent results; the repair group had 28 good and 3 excellent results.
Procedure: Arthroscopic Repair of Complete Rotator Cuff Tears
Post-Procedure: Repair of Large or Massive Contracted Tears Using the Interval Slide Technique (Tauro et al)
POST-PROCEDURE CARE
- Immobilize in a sling for 3 to 6 weeks.
- Avoid overhead motion or external rotation beyond neutral for 6 weeks.
- Begin overhead motion at 6 weeks postoperatively.
- Begin resisted isotonic strengthening at 10 weeks.
- If the tear was small, an accelerated rehabilitation program may be used.
- Progressive activities are incorporated as strength allows, and unrestricted activities usually are resumed 6 to 12 months after surgery.
COMPLICATIONS
- Infection
- Postoperative stiffness
- Failure of repair
- Complex regional pain syndrome
- Deep vein thrombosis.
ANALYSIS OF RESULTS
Arthroscopic repair has results and complication rates that are similar to those of open and mini-open techniques for partial to small full-thickness rotator cuff tears, but with lower gains in strength and motion and higher rates of recurrence for very large and massive tears.
OUTCOMES AND EVIDENCE
- Brislin, Field, and Savoie: 11% complication rate for primary arthroscopic rotator cuff repair, including shoulder stiffness, failure of healing, infections, complex regional pain syndrome, and deep venous thrombosis
- Cole et al: significant improvements in all outcome measures; 22% recurrence of tear, which correlated with patient age and extension of the tear to the supraspinatus
- Kang et al: arthroscopic versus mini-open treatment of chronic small and medium rotator cuff tears; found that early functional outcomes were nearly equivalent, but the arthroscopic group had statistically significant improvement in pain scores at 3 months
- Deutsch: 98% satisfaction with arthroscopic repair of partial-thickness (>50% thickness) tears
- Verma et al: no statistical difference in outcome of arthroscopic repair versus mini-open repair
- Lafosse et al: failure rate of 11% with arthroscopic rotator cuff repair, lower with double-row than single-row fixation.
- Franceschi et al: comparable clinical results between single-row and double-row fixation techniques at 2-year follow-up
- Huijsmans et al: 91% excellent or good outcome after arthroscopic rotator cuff repair with double-row fixation
- Charousset et al: better tendon healing rates with double-row fixation, but no difference in clinical results.
- Ma et al: cadaver study showed higher ultimate tensile load of double-row fixation compared to three different types of single-row fixation.
- Andrews et al: 85% good and excellent results with arthroscopic debridement alone in young athletes
- Budoff et al: 89% good to excellent results after arthroscopic debridement alone for partial-thickness rotator cuff tears at 5 years follow-up; this decreased to 81% after five years.
- Esch: 76% with partial tears had satisfactory results with arthroscopic debridement and subacromial decompression.
- Cordasco et al: no difference in outcome of arthroscopic acromioplasty and debridement in patients with partial-thickness rotator cuff tears compared to those without tear.
- Weber: partial-thickness tears treated with arthroscopic debridement and acromioplasty versus arthroscopic acromioplasty and mini-open repair; the debridement and acromioplasty group had 14 good and no excellent results; the repair group had 28 good and 3 excellent results.
Procedure: Repair of Large or Massive Contracted Tears Using the Interval Slide Technique (Tauro et al)
Post-Procedure: Subscapularis Tendon Repair
POST-PROCEDURE CARE
- Immobilize in a sling for 3 to 6 weeks.
- Avoid overhead motion or external rotation beyond neutral for 6 weeks.
- Begin overhead motion at 6 weeks postoperatively.
- Begin resisted isotonic strengthening at 10 weeks.
- If the tear was small, an accelerated rehabilitation program may be used.
- Progressive activities are incorporated as strength allows, and unrestricted activities usually are resumed 6 to 12 months after surgery.
COMPLICATIONS
- Infection
- Postoperative stiffness
- Failure of repair
- Complex regional pain syndrome
- Deep vein thrombosis.
ANALYSIS OF RESULTS
Arthroscopic repair has results and complication rates that are similar to those of open and mini-open techniques for partial to small full-thickness rotator cuff tears, but with lower gains in strength and motion and higher rates of recurrence for very large and massive tears.
OUTCOMES AND EVIDENCE
- Brislin, Field, and Savoie: 11% complication rate for primary arthroscopic rotator cuff repair, including shoulder stiffness, failure of healing, infections, complex regional pain syndrome, and deep venous thrombosis
- Cole et al: significant improvements in all outcome measures; 22% recurrence of tear, which correlated with patient age and extension of the tear to the supraspinatus
- Kang et al: arthroscopic versus mini-open treatment of chronic small and medium rotator cuff tears; found that early functional outcomes were nearly equivalent, but the arthroscopic group had statistically significant improvement in pain scores at 3 months
- Deutsch: 98% satisfaction with arthroscopic repair of partial-thickness (>50% thickness) tears
- Verma et al: no statistical difference in outcome of arthroscopic repair versus mini-open repair
- Lafosse et al: failure rate of 11% with arthroscopic rotator cuff repair, lower with double-row than single-row fixation.
- Franceschi et al: comparable clinical results between single-row and double-row fixation techniques at 2-year follow-up
- Huijsmans et al: 91% excellent or good outcome after arthroscopic rotator cuff repair with double-row fixation
- Charousset et al: better tendon healing rates with double-row fixation, but no difference in clinical results.
- Ma et al: cadaver study showed higher ultimate tensile load of double-row fixation compared to three different types of single-row fixation.
- Andrews et al: 85% good and excellent results with arthroscopic debridement alone in young athletes
- Budoff et al: 89% good to excellent results after arthroscopic debridement alone for partial-thickness rotator cuff tears at 5 years follow-up; this decreased to 81% after five years.
- Esch: 76% with partial tears had satisfactory results with arthroscopic debridement and subacromial decompression.
- Cordasco et al: no difference in outcome of arthroscopic acromioplasty and debridement in patients with partial-thickness rotator cuff tears compared to those without tear.
- Weber: partial-thickness tears treated with arthroscopic debridement and acromioplasty versus arthroscopic acromioplasty and mini-open repair; the debridement and acromioplasty group had 14 good and no excellent results; the repair group had 28 good and 3 excellent results.
Procedure: Subscapularis Tendon Repair
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