Factors associated with healing failure after early repair of acute, trauma-related rotator cuff tears

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Factors associated with healing failure after early repair of acute, trauma-related rotator cuff tears

Aagaard, Knut E. (author): Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Lund OsteoArthritis Division - Joint injury research group,Forskargrupper vid Lunds universitet,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Lund University Research Groups,Helsingborg Hospital,Helsingborg Hosp, Sweden; Lund Univ, Sweden

Lunsjö, Karl (author): Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Helsingborg Hospital,Helsingborg Hosp, Sweden; Lund Univ, Sweden

Adolfsson, Lars (author): Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping

Frobell, Richard (author): Lund University,Lunds universitet,Ortopedi, Lund,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund OsteoArthritis Division - Joint injury research group,Forskargrupper vid Lunds universitet,Orthopaedics (Lund),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups,Lund Univ, Sweden

Björnsson Hallgren, Hanna (author): Linköpings universitet,Linköping University,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Ortopedkliniken i Linköping

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MOSBY-ELSEVIER, 2023
2023
English 8 s.
In: Journal of Shoulder and Elbow Surgery. - : MOSBY-ELSEVIER. - 1058-2746 .- 1532-6500. ; 32:10, s. 2074-2081

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Journal article (peer-reviewed)

Abstract Subject headings

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 asymptomatic 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 harvested 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 healing 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.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)

Keyword

healing failure
Level I
Prognosis Study
Prospective Cohort Design
risk factors
rotator cable
Rotator cuff tear
subacute repair
tendon degeneration
tendon healing
Rotator cuff tear; tendon healing; subacute repair; risk factors; healing failure; tendon degeneration; rotator cable

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art (subject category)
ref (subject category)

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By the author/editor: Aagaard, Knut E.; Lunsjö, Karl; Adolfsson, Lars; Frobell, Richard; Björnsson Hallgr ...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Surgery

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By the university: Lund University; Linköping University

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