PMID- 37388869
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230703
IS  - 2666-061X (Electronic)
IS  - 2666-061X (Linking)
VI  - 5
IP  - 3
DP  - 2023 Jun
TI  - Female Sex and Higher Infraspinatus Fatty Infiltration Are Linked to 
      Dissatisfaction at a Minimum Follow-Up of 4 Years after Arthroscopic Repair of 
      Massive Rotator Cuff Tears.
PG  - e731-e737
LID - 10.1016/j.asmr.2023.03.016 [doi]
AB  - PURPOSE: To evaluate patient satisfaction at a minimum of 4 years after 
      arthroscopic rotator cuff repair (ARCR) of massive rotator cuff tears (MRCT), to 
      identify preoperative and intraoperative characteristics associated with 
      satisfaction, and to compare clinical outcomes between satisfied and dissatisfied 
      patients. METHODS: A retrospective review on prospectively collected data was 
      conducted on ARCRs of MRCTs performed at 2 institutions between January 2015 and 
      December 2018. Patients with a minimum 4-year follow-up, preoperative and 
      postoperative data, and primary ARCR of MRCTs were included for analysis. Patient 
      satisfaction was analyzed according to patient demographics, patient-reported 
      outcome measures (American Shoulder and Elbow Surgeons score [ASES], visual 
      analog scale [VAS] for pain, Veteran Rands 12-item health survey [VR-12], and 
      Subjective Shoulder Value [SSV]), range of motion (forward flexion [FF], external 
      rotation [ER], and internal rotation [IR]), tear characteristics (fatty 
      infiltration, tendon involvement, and tear size), and clinical significant 
      measures (minimal clinical important difference [MCID], substantial clinical 
      benefit [SCB], and patient-acceptable symptomatic state [PASS]) for ASES and SSV. 
      Rotator cuff healing was also assessed with ultrasound in 38 patients at final 
      follow-up. RESULTS: A total of 100 patients met the study's criteria. Overall, 
      89% of patients were satisfied with ARCR of a MRCT. Female sex (P = .007) and 
      increased preoperative infraspinatus fatty infiltration (P = .005) were 
      negatively associated with satisfaction. Those in the dissatisfied cohort had 
      significantly lower postoperative ASES (80.7 vs 55.7; P = .002), VR-12 (49 vs 
      37.1; P = .002), and SSV scores (88.1 vs 56; P = .003), higher VAS pain (1.1 vs 
      4.1; P = .002) and lower postoperative range of motion in FF (147 degrees  vs 117 degrees ; P = 
      .04), ER (46 degrees  vs 26 degrees ; P = .003), and IR (L2 vs L4; P = .04). Rotator cuff healing 
      did not have an influence on patient satisfaction (P = .306). Satisfied patients 
      were more likely to return to work than dissatisfied patients (97% vs 55%; P < 
      .001). CONCLUSIONS: Nearly 90% of patients who undergo ARCR for MRCTs are 
      satisfied at a minimum 4-year follow-up. Negative preoperative factors include 
      female sex and increased preoperative infraspinatus fatty infiltration, but no 
      association was observed with rotator cuff healing. Furthermore, dissatisfied 
      patients were less likely to report a clinically important functional 
      improvement. LEVEL OF EVIDENCE: Level IV, prognostic case series.
CI  - (c) 2023 The Authors.
FAU - Ardebol, Javier
AU  - Ardebol J
AD  - Oregon Shoulder Institute, Medford, Oregon, U.S.A.
FAU - Hwang, Simon
AU  - Hwang S
AD  - Oregon Shoulder Institute, Medford, Oregon, U.S.A.
FAU - Pak, Theresa
AU  - Pak T
AD  - Oregon Shoulder Institute, Medford, Oregon, U.S.A.
FAU - Menendez, Mariano E
AU  - Menendez ME
AD  - Oregon Shoulder Institute, Medford, Oregon, U.S.A.
FAU - Gobezie, Reuben
AU  - Gobezie R
AD  - Cleveland Shoulder Institute, Beechwood, Ohio, U.S.A.
FAU - Denard, Patrick J
AU  - Denard PJ
AD  - Oregon Shoulder Institute, Medford, Oregon, U.S.A.
LA  - eng
PT  - Journal Article
DEP - 20230512
PL  - United States
TA  - Arthrosc Sports Med Rehabil
JT  - Arthroscopy, sports medicine, and rehabilitation
JID - 101765256
PMC - PMC10300589
EDAT- 2023/06/30 13:11
MHDA- 2023/06/30 13:12
PMCR- 2023/05/12
CRDT- 2023/06/30 10:09
PHST- 2022/11/14 00:00 [received]
PHST- 2023/03/30 00:00 [accepted]
PHST- 2023/06/30 13:12 [medline]
PHST- 2023/06/30 13:11 [pubmed]
PHST- 2023/06/30 10:09 [entrez]
PHST- 2023/05/12 00:00 [pmc-release]
AID - S2666-061X(23)00058-5 [pii]
AID - 10.1016/j.asmr.2023.03.016 [doi]
PST - epublish
SO  - Arthrosc Sports Med Rehabil. 2023 May 12;5(3):e731-e737. doi: 
      10.1016/j.asmr.2023.03.016. eCollection 2023 Jun.