PMID- 33959668
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220422
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Electronic)
IS  - 2325-9671 (Linking)
VI  - 9
IP  - 4
DP  - 2021 Apr
TI  - Revision Rotator Cuff Repair Versus Primary Repair for Large to Massive Tears 
      Involving the Posterosuperior Cuff: Comparison of Clinical and Radiological 
      Outcomes.
PG  - 2325967121998791
LID - 10.1177/2325967121998791 [doi]
LID - 2325967121998791
AB  - BACKGROUND: The retear rate after revision rotator cuff repair (rRCR) ranges from 
      50% to 90%. Patients who undergo primary RCR (pRCR) for large to massive rotator 
      cuff tear (mRCT) also have unpredictable outcomes. PURPOSE: To compare the 
      clinical outcomes after rRCR for a posterosuperior rotator cuff tear of any size 
      with those after pRCR for mRCT and to identify the risk factors for poor outcomes 
      and retear after rRCR. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: 
      Among patients with posterosuperior cuff tear treated between 2010 and 2017, the 
      clinical outcomes of 46 patients who underwent rRCR were compared with 106 
      patients who underwent pRCR for mRCT. Between-group differences in 
      patient-reported outcomes (visual analog scale [VAS] for pain, VAS for 
      satisfaction and American Shoulder and Elbow Surgeons [ASES] and Constant scores) 
      at final follow-up were evaluated and compared with previously published minimal 
      clinically important difference (MCID) values. Radiological outcomes were 
      evaluated using magnetic resonance imaging or ultrasonography at a minimum 1-year 
      follow-up. Multivariate linear regression analysis was performed to identify the 
      risk factors for poor ASES score, and multivariate logistic regression analysis 
      was used to assess the risk factors for retear after rRCR. RESULTS: The mean 
      follow-up was 26.4 months (range, 24-81 months). Although final VAS for pain, VAS 
      for satisfaction, and ASES scores in the rRCR group were significantly worse than 
      those in the pRCR group, the Constant score was similar between the groups. These 
      differences in outcomes did not exceed the MCID threshold. The retear rate in the 
      rRCR group was 50% compared with 39% for the pRCR group (P = .194). In the rRCR 
      group, risk factors for worse ASES score were retear (P = .043; r = -11.3), lower 
      body mass index (P = .032; r = 1.9), and lower preoperative VAS for pain (P = 
      .038; r = 2.3), and risk factors for retear were preoperative high-grade fatty 
      degeneration (Goutallier grades 3 and 4) of the supraspinatus muscle (P = .026; 
      odds ratio, 5.2) and serum hyperlipidemia (P = .035; odds ratio, 11.8). 
      CONCLUSION: Both study groups had similar clinical and radiological outcomes. 
      Patients with symptomatic failed rotator cuff repairs having high-grade fatty 
      degeneration of the supraspinatus muscle and/or serum hyperlipidemia had a 
      greater likelihood of retear after rRCR.
CI  - (c) The Author(s) 2021.
FAU - Meshram, Prashant
AU  - Meshram P
AD  - Shoulder Division, Department of Orthopedics, Johns Hopkins University, 
      Baltimore, Maryland, USA. RINGGOLD: 1466
FAU - Liu, Bei
AU  - Liu B
AD  - Department of Orthopaedic Surgery, Seoul National University College of Medicine, 
      Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. 
      RINGGOLD: 65462
FAU - Kim, Sang Woo
AU  - Kim SW
AD  - Department of Orthopaedic Surgery, Seoul National University College of Medicine, 
      Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. 
      RINGGOLD: 65462
FAU - Heo, Kang
AU  - Heo K
AD  - Department of Orthopaedic Surgery, Seoul National University College of Medicine, 
      Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. 
      RINGGOLD: 65462
FAU - Oh, Joo Han
AU  - Oh JH
AD  - Department of Orthopaedic Surgery, Seoul National University College of Medicine, 
      Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea. 
      RINGGOLD: 65462
LA  - eng
PT  - Journal Article
DEP - 20210420
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
PMC - PMC8060764
OTO - NOTNLM
OT  - clinical outcomes
OT  - primary
OT  - revision
OT  - rotator cuff repair
EDAT- 2021/05/08 06:00
MHDA- 2021/05/08 06:01
PMCR- 2021/04/20
CRDT- 2021/05/07 07:16
PHST- 2020/11/03 00:00 [received]
PHST- 2020/12/14 00:00 [accepted]
PHST- 2021/05/07 07:16 [entrez]
PHST- 2021/05/08 06:00 [pubmed]
PHST- 2021/05/08 06:01 [medline]
PHST- 2021/04/20 00:00 [pmc-release]
AID - 10.1177_2325967121998791 [pii]
AID - 10.1177/2325967121998791 [doi]
PST - epublish
SO  - Orthop J Sports Med. 2021 Apr 20;9(4):2325967121998791. doi: 
      10.1177/2325967121998791. eCollection 2021 Apr.