Alberto Guevara-Alvarez M.D. , Edwin A. Valencia-Ramon M.D. , Hugo Bothorel M.Eng. , Philippe Collin M.D. , Jeanni Zbinden M.D. , Alberto Guizzi M.D. , Alexandre Lädermann M.D.
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A multivariate logistic regression of the of patient acceptable symptom state for American Shoulder and Elbow Surgeons (ASES) score was performed to evaluate whether the origin of tear led to a different relative risk (RR) independently from tear and surgical characteristics.</p></div><div><h3>Results</h3><p>A total of 616 consecutive shoulders (304 traumatic and 312 degenerative) were finally included. Traumatic ruptures presented a greater distribution of male (72% vs 51%, <em>P</em> < .001) and younger patients (53 vs 57 years, <em>P</em> < .001), as well as earlier onset of symptoms (3 vs 15 months, <em>P</em> < .001), reduced range of motion in preoperative assessment for forward elevation (130° vs 150°, <em>P</em> < .001), and slightly greater preoperative ASES (46.5 ± 19.7 vs 50.0 ± 18.0, <em>P</em> = .022) and Constant (47.0 ± 20.2 vs 52.0 ± 18.9, <em>P</em> = .001) scores. Degenerative tears presented a lower proportion of grade 3 tendon coronal retraction (11% vs 18%, <em>P</em> = .031). Postoperative tendon integrity at 6 months was comparable for both groups, predominantly Sugaya types 1 and 2 (91% traumatic; 92% degenerative, <em>P</em> = .371). Both groups exhibited favorable outcomes in range of motion and postoperative functional scores at last follow-up. The multivariate regression confirmed that the tear origin was not significantly associated with patient acceptable symptom state achievement (<em>P</em> = .201) but rather with greater preoperative ASES score (RR, 1.01), men (RR, 1.16) and workers’ compensation (RR, 0.65) (<em>P</em> < .05).</p></div><div><h3>Conclusions</h3><p>Traumatic cases were frequent, involved younger patients, more frequently affected the anterior rotator cuff, and were associated with more severe tendon retraction. Traumatic and degenerative RCRs lead to comparable clinical and radiologic results.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective comparative study.</p></div>","PeriodicalId":34631,"journal":{"name":"Arthroscopy Sports Medicine and Rehabilitation","volume":"6 2","pages":"Article 100867"},"PeriodicalIF":0.0000,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666061X23002183/pdfft?md5=d8ed767671865c7928b411902f345957&pid=1-s2.0-S2666061X23002183-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Traumatic and Atraumatic Rotator Cuff Tears Have the Same Rates of Healing\",\"authors\":\"Alberto Guevara-Alvarez M.D. , Edwin A. Valencia-Ramon M.D. , Hugo Bothorel M.Eng. , Philippe Collin M.D. , Jeanni Zbinden M.D. , Alberto Guizzi M.D. , Alexandre Lädermann M.D.\",\"doi\":\"10.1016/j.asmr.2023.100867\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>To examine whether traumatic rotator cuff repairs (RCRs) differ in postoperative rotator cuff tendon integrity and functional outcomes from degenerative RCRs.</p></div><div><h3>Methods</h3><p>RCRs performed by a single surgeon were retrospectively identified. The inclusion criteria were repairable Goutallier grades 0 to 2 full-thickness rotator cuff tears. Demographic and clinical data as well as radiological results were compared. A multivariate logistic regression of the of patient acceptable symptom state for American Shoulder and Elbow Surgeons (ASES) score was performed to evaluate whether the origin of tear led to a different relative risk (RR) independently from tear and surgical characteristics.</p></div><div><h3>Results</h3><p>A total of 616 consecutive shoulders (304 traumatic and 312 degenerative) were finally included. Traumatic ruptures presented a greater distribution of male (72% vs 51%, <em>P</em> < .001) and younger patients (53 vs 57 years, <em>P</em> < .001), as well as earlier onset of symptoms (3 vs 15 months, <em>P</em> < .001), reduced range of motion in preoperative assessment for forward elevation (130° vs 150°, <em>P</em> < .001), and slightly greater preoperative ASES (46.5 ± 19.7 vs 50.0 ± 18.0, <em>P</em> = .022) and Constant (47.0 ± 20.2 vs 52.0 ± 18.9, <em>P</em> = .001) scores. Degenerative tears presented a lower proportion of grade 3 tendon coronal retraction (11% vs 18%, <em>P</em> = .031). Postoperative tendon integrity at 6 months was comparable for both groups, predominantly Sugaya types 1 and 2 (91% traumatic; 92% degenerative, <em>P</em> = .371). Both groups exhibited favorable outcomes in range of motion and postoperative functional scores at last follow-up. The multivariate regression confirmed that the tear origin was not significantly associated with patient acceptable symptom state achievement (<em>P</em> = .201) but rather with greater preoperative ASES score (RR, 1.01), men (RR, 1.16) and workers’ compensation (RR, 0.65) (<em>P</em> < .05).</p></div><div><h3>Conclusions</h3><p>Traumatic cases were frequent, involved younger patients, more frequently affected the anterior rotator cuff, and were associated with more severe tendon retraction. Traumatic and degenerative RCRs lead to comparable clinical and radiologic results.</p></div><div><h3>Level of Evidence</h3><p>Level III, retrospective comparative study.</p></div>\",\"PeriodicalId\":34631,\"journal\":{\"name\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"volume\":\"6 2\",\"pages\":\"Article 100867\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.sciencedirect.com/science/article/pii/S2666061X23002183/pdfft?md5=d8ed767671865c7928b411902f345957&pid=1-s2.0-S2666061X23002183-main.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy Sports Medicine and Rehabilitation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666061X23002183\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy Sports Medicine and Rehabilitation","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666061X23002183","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
Traumatic and Atraumatic Rotator Cuff Tears Have the Same Rates of Healing
Background
To examine whether traumatic rotator cuff repairs (RCRs) differ in postoperative rotator cuff tendon integrity and functional outcomes from degenerative RCRs.
Methods
RCRs performed by a single surgeon were retrospectively identified. The inclusion criteria were repairable Goutallier grades 0 to 2 full-thickness rotator cuff tears. Demographic and clinical data as well as radiological results were compared. A multivariate logistic regression of the of patient acceptable symptom state for American Shoulder and Elbow Surgeons (ASES) score was performed to evaluate whether the origin of tear led to a different relative risk (RR) independently from tear and surgical characteristics.
Results
A total of 616 consecutive shoulders (304 traumatic and 312 degenerative) were finally included. Traumatic ruptures presented a greater distribution of male (72% vs 51%, P < .001) and younger patients (53 vs 57 years, P < .001), as well as earlier onset of symptoms (3 vs 15 months, P < .001), reduced range of motion in preoperative assessment for forward elevation (130° vs 150°, P < .001), and slightly greater preoperative ASES (46.5 ± 19.7 vs 50.0 ± 18.0, P = .022) and Constant (47.0 ± 20.2 vs 52.0 ± 18.9, P = .001) scores. Degenerative tears presented a lower proportion of grade 3 tendon coronal retraction (11% vs 18%, P = .031). Postoperative tendon integrity at 6 months was comparable for both groups, predominantly Sugaya types 1 and 2 (91% traumatic; 92% degenerative, P = .371). Both groups exhibited favorable outcomes in range of motion and postoperative functional scores at last follow-up. The multivariate regression confirmed that the tear origin was not significantly associated with patient acceptable symptom state achievement (P = .201) but rather with greater preoperative ASES score (RR, 1.01), men (RR, 1.16) and workers’ compensation (RR, 0.65) (P < .05).
Conclusions
Traumatic cases were frequent, involved younger patients, more frequently affected the anterior rotator cuff, and were associated with more severe tendon retraction. Traumatic and degenerative RCRs lead to comparable clinical and radiologic results.
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