An assessment of the functional outcomes of patients undergoing early exercise physiotherapy following arthroscopic rotator cuff repair using the double-row suture bridge technique

Nixon K. Dias; Rakesh Sera

doi:10.18203/issn.2455-4510.IntJResOrthop20205562

Authors

Nixon K. Dias Department of Arthroscopy, Hosmat Hospital, Bangalore, Karnataka, India
Rakesh Sera Department of Arthroscopy, Hosmat Hospital, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20205562

Keywords:

Arthroscopic cuff, Early physiotherapy, Suture-bridge technique

Abstract

Background: The methods of repairing rotator cuff tear are single-row technique, traditional double-row technique and suture-bridge technique. Studies have shown that the arthroscopic suture-bridge technique improved the pressurized contact area between the tendon and footprint. Controversy exists regarding the influence of early versus delayed motion on stiffness and healing rate after cuff repair. Early motion rehabilitation increases range of motion after cuff repair, although risk of re-tear is higher compared to immobilization. This study evaluated the functional outcomes in patients who underwent arthroscopic rotator cuff repair using the suture-bridge technique followed by an early exercise physiotherapy regime.
Methods: The study was a prospective and retrospective analysis of patients treated arthroscopically for rotator cuff tears in Hosmat hospital, Bangalore. 30 patients who had only a supraspinatus/infraspinatus tear were included in the study. The functional outcome was assessed by two scoring systems, UCLA and ASES scores. Post operatively, patients were immobilized for 3 weeks only. They were followed up at 3 weeks, 6 weeks, 12 weeks and at 6 months.
Results: Our study had 20 patients reporting a good outcome, whereas 9 patients had a fair outcome. Only 1 patient reported a poor outcome. The mean ASES scores improved from 20.43 to 77.87 whereas the UCLA score improved from 10.03 to 27.93. None had re-tears.
Conclusions: The arthroscopic suture-bridge technique resulted in acceptable patient satisfaction and functional outcome as 67% of our patients had a “good” outcome. Early ROM exercise accelerated recovery from postoperative stiffness for patients after arthroscopic rotator cuff repair.

Metrics

Metrics Loading ...

Author Biography

Nixon K. Dias, Department of Arthroscopy, Hosmat Hospital, Bangalore, Karnataka, India

FELLOW

DEPARTMENT OF ARTHROSCOPY

References

Ren YM, Zhang HB, Duan YH, Sun YB, Yang T, Tian MQ. Comparison of arthroscopic suture-bridge technique and double-row technique for treating rotator cuff tears: A PRISMA meta-analysis. Medicine (Baltimore). 2019;98(20):e15640.

Fealy S, Kingham TP, Altchek DW. Mini-open rotator cuff repair using a two-row fixation technique: outcomes analysis in patients with small, moderate, and large rotator cuff tears. Arthroscopy. 2002;18:665-70.

Lo IKY, Burkhart SS. Double-row arthroscopic rotator cuff repair: re-establishing the footprint of the rotator cuff. Arthroscopy. 2003;19:1035-42.

Park MC, Elattrache NS, Ahmad CS, Tibone JE. Transosseous-equivalent” rotator cuff repair technique. Arthroscopy. 2006;22:1360:1-5.

Haque A, Pal Singh H. Does structural integrity following rotator cuff repair affect functional outcomes and pain scores? A meta-analysis. Shoulder Elbow. 2018;10(3):163-9.

Cho NS, Lee BG, Rhee YG. Arthroscopic rotator cuff repair using a suture bridge technique: is the repair integrity actually maintained? Am J Sports Med. 2011;39(10):2108-16.

Vo A, Zhou H, Dumont G, Fogerty S, Rosso C, Li X. Physical therapy and rehabilitation after rotator cuff repair: a review of current concepts. Int J Phys Med Rehabil. 2013;1(142):2.

Kelly BT, Roskin LA, Kirkendall DT, Speer KP. Shoulder muscle activation during aquatic and dry land exercises in nonimpaired subjects. J Orthop Sports Phys Ther. 2000;30(4):204-10.

Osti L, Papalia R, Del Buono A, Denaro V, Maffulli N. Comparison of arthroscopic rotator cuff repair in healthy patients over and under 65 years of age. Knee Surg Sport Trauma. 2010;18:1700-6.

Verma NN, Bhatia S, Baker Iii CL, Cole BJ, Boniquit N, Nicholson GP. Outcomes of arthroscopic rotator cuff repair in patients aged 70 years or older. Arthroscopy. 2010;26:1273-80.

Naimark M, Robbins CB, Gagnier JJ, Landfair G, Carpenter J, Bedi A, Miller B. Impact of smoking on patient outcomes after arthroscopic rotator cuff repair. BMJ Open Sport & Exercise Medicine. 2018;4(1):e000416.

Liu SH, Baker CL. Arthroscopically assisted rotator cuff repair: Correlation of functional results with integrity of the cuff. Arthroscopy. 1994;10:54-60.

Kim DH, Elattrache NS, Tibone JE, Jun BJ, DeLaMora SN, Kvitne RS, Lee TQ. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J sports med. 2006;34(3):407-14.

Liu SH, Baker CL. Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994;10(1):54-60.

Koo SS, Burkhart SS. Rehabilitation following arthroscopic rotator cuff repair. Clin Sports Med. 2010;29(2):203-11.

Chan K, MacDermid JC, Hoppe DJ, Ayeni OR, Bhandari M, Foote CJ et al. Delayed versus early motion after arthroscopic rotator cuff repair: a meta-analysis. J Shoulder Elbow Surg. 2014;23(11):1631-9.

Chang KV, Hung CY, Han DS, Chen WS, Wang TG, Chien KL. Early Versus Delayed Passive Range of Motion Exercise for Arthroscopic Rotator Cuff Repair: A Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2015;43(5):1265-73.