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PubMed2006

Wear-simulation analysis of rotating-platform mobile-bearing knees.

The wear and wear debris from rotating-platform mobile-bearing knees and fixed-bearing knees were compared in knee joint-simulator studies. The wear rate of the fixed-bearing knees was found to increase as the kinematics were increased because of an increase in internal-external rotation and an increase in anterorposterior (AP) translation. The wear rate of the rotating-platform mobile-bearing knees was found to be significantly lower than that of the fixed-bearing knees. The rotating-platform mobile-bearing knee was able to decouple the complex kinematics to pure rotation at the inferior tibial articulating surface and linear flexion-extension and AP sliding at the superior femoral articulating interface, substantially reducing cross-shear and wear. No difference was found in the wear debris between the rotating-platform and fixed-bearing knees. This resulted in a substantially reduced functional biological activity or osteolytic potential for the rotating-platform mobile-bearing knees due to the lower wear rates.

Knee Prosthesis↗

PubMed1990

[Rotation angioplasty of chronic coronary artery stenosis].

Coronary artery occlusion of more than six months duration can only rarely be recanalized with conventional techniques. For this reason, rotational angioplasty, which has been successfully applied for occlusion of peripheral arteries, has been employed in modified form for recanalization of chronic coronary artery occlusion. Rotational angioplasty is based on the concept that the slowly revolving, dull and relatively thick head of the flexible rotation catheter will seek the path of least resistance which, even in the case of relatively old arterial occlusions, mostly represents thrombotic material. The elastic, high-torque rotational catheter constructed of several V2A spiral steel wires has an interior lumen for insertion of exchange guidewires up to 0.014" and injection of contrast medium and an olive-shaped head of V2A steel with a diameter of 1.3 to 1.6 mm. A protection catheter made of polyethylene with metal markers and conically-tapered tip provides variable stiffness of the rotating catheter and protection of the endothelium in the proximal vascular segment. The slow rotation of 200 r.p.m. is performed with a small electric motor. Between April 1987 and February 1988, rotation angioplasty was performed in 20 patients, 17 with occlusion of the right coronary artery, two with occlusion of the left anterior descending artery and one with bypass graft occlusion to the left anterior descending artery in whom a conventional guidewire through the chronic occlusion could not be advanced. The duration of occlusion, based on previous angiograms anginal complaints or myocardial infarction, ranged from one month to twelve years, in twelve patients more than six months. In all patients, the indication for revascularization was clearly established.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Arthroscopic acromioplasty for lesions of the rotator cuff.

Arthroscopic acromioplasty was done for a lesion of the rotator cuff in 165 patients: 100 who had stage-II impingement syndrome (no actual tear of the rotator cuff) (group 1), forty who had a partial tear (group 2), and twenty-five who had a full-thickness tear (group 3). The operation consisted of acromioplasty, resection of the coracoacromial ligament and subacromial bursa, and removal of osteophytes, when present, near the inferior aspect of the acromioclavicular joint. In the patients who had a partial or complete tear, minimum debridement of the rotator cuff also was performed. In group 1, eighty-six patients (eighty-nine shoulders) were available for review at a minimum follow-up to two years (average, 31.2 months). The preoperative ratings for pain, activities of daily living, work, and sports improved markedly in eighty-one patients postoperatively. The most common findings at operation were proliferative subacromial bursitis and an acromial protuberance. Two complications were recorded. Seven patients had a subsequent open operation on the shoulder. In group 2, the average follow-up was 28.9 months (range, twenty-four to forty-eight months). Of the forty patients, thirty-three had a major improvement in the ratings for pain, activities of daily living, work, and sports. One complication, transient palsy of the lateral femoral cutaneous nerve, was noted. Two patients who had an unsatisfactory result had a second operation: one, open acromioplasty and the other, repair of the rotator cuff. In group 3, the average follow-up was 30.8 months (range, twenty-four to fifty-five months). There were fourteen satisfactory and eleven unsatisfactory results. Of the twenty-five patients, seven later had open repair of the rotator cuff, and six had a satisfactory result from that procedure. No complications were recorded. It was concluded that arthroscopic acromioplasty is effective in the treatment of isolated stage-II impingement and partial tears of the rotator cuff. Arthroscopic treatment of complete tears produced over-all results that were inferior to those of traditional open repair. Arthroscopic subacromial decompression cannot be supported as treatment for complete tears of the rotator cuff.

Acromioclavicular Joint↗

PubMed1988

[Rupture of the rotator cuff. Quantification of indirect signs in standard radiology and the Leclercq maneuver].

The roentgenograms and the "Leclercq's manoeuvre" of 105 patients who had a shoulder arthrography were reviewed. We differentiated two groups: One with a rotator cuff tear. The other without a rotator cuff tear. The space between the acromion and the head of the humerus was measured on rotation zero degree and external rotational roentgenograms. When the acromio-humeral space was less than 8 mm, it was always correlated with a rotator cuff tear (specificity = 1). If at least tow of the following signs were present, there was in most cases a rotator cuff tear (specificity = 0.96): Sclerosed acromion. Spur of the acromion. Cystic changes around the greater tuberosity. Rounded tuberosities. Inferior gleno-humeral spur. The "Leclercq's manoeuvre" was considered positive either when there was an acromio-humeral space narrowing compared with the other side, or when there was an upward subluxation of the head of the humerus. When positive there was always a rotator cuff tear (sensibility = 0.7; specificity = 1).

Arthrography↗

PubMed1982

An in vitro biomechanical evaluation of anterior-posterior motion of the knee. Tibial displacement, rotation, and torque.

We tested the anterior-posterior motion of nine normal cadaver knees in zero to 90 degrees of flexion using a specially designed apparatus. This apparatus applied a dynamic anterior-posterior force to each knee and measured the resulting tibial displacement, rotation, and torque. In the intact knee, an anterior force produced an internal tibial torque and internal tibial rotation, while a posterior force produced an external torque and external rotation. Anterior-posterior displacement increased by 30 per cent when the tibia was allowed to rotate freely about its neutral rotation position. Isolated section of the anterior cruciate ligament produced more than double the amount of anterior displacement without affecting posterior displacement. Isolated section of the posterior cruciate ligament produced almost triple the amount of posterior displacement without affecting anterior displacement. After cutting either the anterior or the posterior cruciate ligament, the resulting internal or external secondary tibial rotation disappeared. It appears, therefore, that the anterior and posterior cruciate ligaments are the primary restraints to motion in the anterior and posterior directions as well as the causes of internal and external tibial rotation during anterior and posterior motion.

Aged↗

PubMed1982

Orientation disparity and plasticity of cortical cells in kittens following surgical rotation of the eye.

We have studied the effect of surgically induced monocular rotation of the eye on cells in visual area 17 of normal kittens (N = 420 cells) and of kittens monocularly deprived (N = 296 cells) at early (1-1.5 months) or late (3 months) ages. The receptive fields of cortical neurons in monocularly deprived kittens of the early operated group were abnormal in shape, a condition which is reflected by the high proportions of cells missing orientation (46.9%) and direction (47.7%) specificity when driven through the rotated eye. In addition, many cells (46%) were visually inactive in these kittens. The proportions of the above cell groups were less pronounced in the operated kittens with binocular vision and in all late operated kittens, indicating a specific effect of the rotation itself. In the early operated kittens with binocular vision, the rotation resulted in 35.9% binocular cells in the hemisphere contralateral and 40.0% in the hemisphere ipsilateral to the rotated eye. The results for the monocularly deprived early operated kittens were 42.8% and 21.5% respectively. Thus, the rotation was effective in limiting the influence of the deprivation to only the contralateral hemisphere. The distribution of the cells in accordance with their receptive field orientations following correction for the surgical rotation shows a considerable disturbance to orientation specificity, as reflected by the wide range of angular disparities found for the binocular cells. While for three kittens (28 cells) a tendency toward the zero line was found, for four kittens (28 cells) we could not prove, it indicating that a compensation for the interocular difference surgically induced is not seen.

Adaptation, Physiological↗

PubMedDate not supplied

The posterolateral drawer test and external rotational recurvatum test for posterolateral rotatory instability of the knee.

Posterolateral drawer tests and external rotational recurvatum tests are used to detect posterolateral rotatory instability. A specific manner of performance of these tests is necessary to properly interpret the nature of acute and chronic knee conditions. The posterolateral drawer test is performed at 80 degrees of knee flexion and is maximum in 15 degrees of external rotation. Since the posterior cruciate ligament is intact in posterolateral rotatory instability, the posterior drawer will be negative on maximum internal tibial rotation. Fibrous scar tissue may conceal an otherwise positive posterolateral drawer sign in the chronic condition. The external rotational recurvatum test examines the knee in extension. Tightness and spasm of the biceps femoris and semimembranosus may obscure a positive external rotational recurvatum test in the acute or chronic condition. The external rotational recurvatum test will be negative when the anteromedial and intermediate bundles of the anterior cruciate ligament are intact owing to their contact with the intercondylar shelf in extension. The posterolateral drawer and the external rotational recurvatum can be subtle tests and require careful observation for accurate evaluation of both the acute or chronic condition of the knee joint.

Humans↗

PubMed1994

The educational effect of clinical rotations in nonindustrialized countries.

BACKGROUND: Rotations by American medical students in foreign countries have been common in US medical schools for nearly half a century. Although anecdotal literature makes claims for the significant educational value of these foreign rotations, neither the nature and educational consequences of these experiences, nor the students' impressions, have been thoroughly documented. METHODS: To document the educational impact of clinical rotations in developing countries, all 30 students at the University of Buffalo who participated in such rotations during a period of 7 years were given a questionnaire to complete. Completed questionnaires (n = 28) were analyzed using content analysis. RESULTS: Students reported increased skill and confidence in the use of knowledge, personal history, and physical as the primary means of diagnosis; students also reported that the rotations contributed to outcomes such as enhanced sensitivity to cost issues, heightened awareness of the importance of public health and preventive medicine, greater appreciation for the role of the family and culture in health and disease, and decreased reliance on technology. CONCLUSIONS: Students who completed clinical rotations in Third World countries reported gaining knowledge and skills in areas which, while important in all medical fields, are of particular concern to the family physician. While no causative relationship can be adduced from this study, the fact that 70% of the students who completed these rotations entered primary care careers suggests at least a reinforcing effect.

Clinical Clerkship↗

PubMed1997

Ecosystem health as a clinical rotation for senior students in Canadian veterinary schools.

We describe 4 years of an experimental rotation in ecosystem health offered to senior veterinary students in Canada. Faculty from the 4 Canadian veterinary colleges collaborated in offering the rotation once annually at 1 of the colleges. The 1st rotation was held in Guelph in 1993, followed in successive years by rotations at Saskatoon, Saint-Hyacinthe, and Charlottetown. The rotation is a predominantly field-based experience that allows students to work with veterinary and other role models who are actively engaged in clinical research related to ecosystem health. Five specific field studies that worked particularly well during the rotations are presented. These studies involved investigating mortality in wildlife due to botulism, designing an environmental surveillance system around herds of beef cattle, using belugas to evaluate the health of the St. Lawrence River, dealing with competition for water use by aquaculture and agriculture, and exploring the role of veterinarians during major coastal oil spills. The experience has resulted in our developing the subject matter, field examples, teaching approach, and confidence necessary to make ecosystem health the focus of a productive clinical rotation for senior year veterinary students.

Agriculture↗

PubMed1998

Increased substance P in subacromial bursa and shoulder pain in rotator cuff diseases.

The subacromial bursa is recognized as a site associated with the shoulder pain caused by rotator cuff disease in the middle-aged and elderly. Substance P is contained in primary afferent nerves, and its quantity increases during chronic pain. The amount of substance P in the subacromial bursa of patients with rotator cuff disease was examined. Radioimmunoassay and immunohistochemistry were employed to quantify and localize substance P. The preoperative pain level was measured with a visual analogue scale with 0 as no pain, 5 as moderate, and 10 as severe. Thirty-seven patients that had undergone operation were divided into two groups: one composed of 19 patients with subacromial bursitis and a partial-thickness tear of the rotator cuff (nonperforated cuff) and the other composed of 18 patients with a full-thickness tear (perforated cuff). Subacromial bursae obtained from seven fresh cadavers with no shoulder pain before death were used as controls. The visual analogue scale showed significantly greater pain in the group with the nonperforated rotator cuff than in the group with the perforated cuff. Consistent with these results, the amount of substance P in the subacromial bursa was significantly greater in the former group than in the latter. Nerve fibers immunoreactive to substance P were localized around the vessels, with a larger number of fibers in the group with the nonperforated rotator cuff. Therefore, an increased amount of substance P in the subacromial bursa appears to correlate with the pain caused by rotator cuff disease.

Adult↗

PubMed1994

The coracoacromial arch: MR evaluation and correlation with rotator cuff pathology.

The relative prevalence of various acromial shapes, appearance of the coracoacromial ligament and enthesophytes along the inferior aspect of the acromioclavicular joint in patients with and without rotator cuff tears were evaluated. Of 76 patients with clinical instability and impingement, 31 had a normal rotator cuff and 45 demonstrated a partial or full tear of the supraspinatus tendon at surgery. Results were compared with those from magnetic resonance (MR) scans of 57 asymptomatic volunteers. Of the 45 patients with a supraspinatus tear, 38% (17) had a flat acromial undersurface (type I), 40% (18) had a concave acromial undersurface (type II), 18% (8) had an anteriorly hooked acromion (type III), and 4% (2) had an inferiorly convex acromion (type IV). Among the 31 patients with a normal rotator cuff at surgery and the 57 asymptomatic volunteers, the respective prevalences of the type I acromion were 39% (12) and 44% (25), of type II 48% (15) and 35% (20), type III 3% (1) and 12% (7), and type IV 10% (3) and 9% (5). Shoulders with surgically proven rotator cuff tears showed a tendential association with a type III acromion (8/45) and statistically significant associations with a thickened coracoacromial ligament (17/45) and acromioclavicular enthesophytes (18/45). For the association between inferiorly directed acromioclavicular joint enthesophytes and rotator cuff tears, age appears to be a confounding factor. The type IV acromion, newly classified by this study, does not have a recognizable association with rotator cuff tears.(ABSTRACT TRUNCATED AT 250 WORDS)

Acromioclavicular Joint↗

PubMed2007

[Biomechanical evaluation of glenohumeral stability through muscle force vector analysis. Effect of a decreased glenoid inclination in shoulders with global rotator cuff tears].

OBJECTIVES: The aim of the study was to quantify the decrease in glenohumeral stability following a global rotator cuff tear and to evaluate the effect of a decreased glenoid inclination angle through analysis of muscle force vectors in a computer model. MATERIAL AND METHODS: The lines of action of eight shoulder muscles were integrated into a standard geometric model. Muscle force magnitudes were estimated based on physiological cross-sectional area and normalized electromyographic activity. The magnitude and elevation angle of the resultant force vector was calculated at 0, 30, 60, and 90 degrees of abduction. A rotator cuff tear was simulated by reduction of the corresponding muscle force vectors. RESULTS: At 0 and 30 degrees of glenohumeral abduction a global rotator cuff tear showed a resultant force vector pointing outside the glenoid. In the computer model, decreasing the inclination angle of the glenoid by 30 degrees increased the stability in rotator cuff-deficient shoulders. CONCLUSIONS: The results of this study provide a biomechanical rationale for clinical complications of global rotator cuff tear such as superior humeral head translation. The decreased glenoid inclination simulated in the computer model may represent a biomechanical basis for the development of new operative techniques to treat global rotator cuff tears.

Biomechanical Phenomena↗

PubMed2004

Multivariate analysis of biochemical markers in synovial fluid from the shoulder joint for diagnosis of rotator cuff tears.

Multivariate discriminant analysis allowed definition of cytokine, matrix metalloproteinases (MMP), and tissue inhibitors of metalloproteinases (TIMP) levels in synovial fluid (SF) of patients with rotator cuff tears and other shoulder lesions. We analyzed SF aspirated from the glenohumeral joints of 17 patients with rotator cuff tears; SF from nine patients with other shoulder lesions was used to characterize a non-rotator-cuff-tear (NRCT) group. Discriminant analysis demonstrated statistically significant differences in (1) the determination of whether rotator cuff tear patients are separable from the NRCT group using the influential functions, the most influential of which were interleukin 1-beta, MMP-2, and MMP-13, and (2) the assessment of whether full-thickness rotator cuff tears are distinguishable from partial tears using identical influential functions. The most influential function in the latter analysis was MMP-13. Both interleukin 1-beta and MMP-13 might be biochemical markers of impending rotator cuff tears.

Adolescent↗

PubMed2004

2D SPLASH: a new method to determine the fatty infiltration of the rotator cuff muscles.

The objective of this paper is to quantify the fatty degeneration (infiltration) of rotator cuff muscles with a new spectroscopic FLASH (SPLASH) sequence. Before planned surgery (reconstruction or muscle transfer), 20 patients (13 men, 7 women; 35-75 years) with different stages of rotator cuff disease underwent an MR examination in a 1.5-T unit. The protocol consists of imaging sequences and a newly implemented SPLASH, which allows an exact quantification of the fat/water ratio with a high spatial resolution in an arbitrarily shaped region of interest (ROI). The percentages of fat in the rotator cuff muscles were determined. To determine statistically significant differences between the different stages of rotator cuff tear, a Kruskal-Wallis H test was used. Fatty infiltration of the supraspinatus muscle was correlated with cross-sectional area (CSA) measures (Bravais-Pearson). We found significant differences between different stages of rotator cuff disease, the fatty infiltration and the volume loss (determined by the occupation ratio) of the supraspinatus muscle. With the increasing extent of rotator cuff disease, fatty infiltration increases significantly, as does the volume loss of the supraspinatus muscle. Comparing fatty infiltration and the occupation ratio individually, there was only a moderate inverse correlation between fatty infiltration and the occupation ratio, with considerable variation of data. Fatty infiltration of the infraspinatus muscle occurred when the infraspinatus tendon was involved to a lesser extent. The SPLASH sequence allows exact quantification of fatty infiltration in an arbitrarily shaped ROI. The extent of atrophy and fatty infiltration correlates with the size of the tear. Atrophy and fatty infiltration correlate only moderately and should be evaluated separately.

Adipose Tissue↗

PubMed1997

Diagnosis of rotator cuff lesions: comparison of US and MRI on 38 joint specimens.

An experimental study was performed on cadaveric joint specimens of the shoulder to determine the accuracy of US and MRI in diagnosis of abnormalities of the rotator cuff. The value of different morphological criteria was evaluated for discrimination of degeneration as well as partial and complete disruption. A total of 38 surgically exposed specimens of the shoulder joint were examined by US, MRI and pathological methods visualising the tendons of the rotator cuff in same axial and longitudinal orientations. The three imaging modalities were reviewed separately by experienced examiners, respectively, who were blind to other results. Evaluation criteria consisted of signs of shape (thinning, thickening, discontinuity and absence of rotator cuff) and structure (changes in echogenicity in US, increased signal intensity in MRI, tissue changes in pathology). Findings in US and MRI were finally compared with pathology to assess sensitivity and specificity. Pathology demonstrated 4 full-thickness tears, 6 partial-thickness tears, 16 cases with degeneration and 12 normal rotator cuffs. Ultrasound showed pathological signs in all abnormal cuffs, and one MRI report was false negative. Specificity was 67 % in US (4 of 12 cases were false positive) and 100 % in MRI (no abnormal findings in healthy tendons). Discrimination of different pathological disorders of the rotator cuff was reduced in both methods. Using US only 10 of 16 cases of degeneration, 2 of 6 partial tears and 3 of 4 complete tears were correctly defined. Using MRI 13 of 16 degenerations, 3 of 6 partial tears and 3 of 4 complete tears were detected. The MRI technique failed to visualise intratendinous calcifications in all 3 cases. We conclude that MRI and US are both sensitive in detection of abnormalities of the rotator cuff. Ultrasound should be the primary diagnostic method in screening of shoulder pain because it is economic and fast. The MRI technique should be used secondary because it provides more information about extent of tendons and has lower risk of artefacts.

Adult↗

PubMed2004

Arthroscopic rotator cuff repair: 4- to 10-year results.

PURPOSE: The purpose of this article is to report the 4- to 10-year results of arthroscopic repair of full- thickness rotator cuff tears. TYPE OF STUDY: This is a retrospective study evaluating a series of arthroscopic rotator cuff repairs performed by a single surgeon from February 1990 to February 1996. METHODS: Retrospective chart reviews and telephone interviews were performed to evaluate the results of arthroscopic repair of rotator cuff tears. Results were evaluated using a modified University of California, Los Angeles (UCLA), shoulder scoring system. RESULTS: One-hundred five arthroscopic rotator cuff repairs were performed in 104 patients between February 1990 and February 1996. Of these, 95 patients (96 shoulders) were available for follow-up evaluation at the time of this review. The mean UCLA score of all shoulders involved was 32. Fifty-one patients showed excellent results; 39, good; 2, fair; and 4, poor according to the modified UCLA scoring system. In no case was any loss of motion noted as a result of the surgical intervention. CONCLUSIONS: This retrospective study is the largest series of arthroscopic rotator cuff repairs with the longest period of follow-up thus far reported. Of the patients available for follow-up evaluation, 94% of patients qualified as a good to excellent result according to the UCLA shoulder scoring system. This study shows that patients treated with this arthroscopic rotator cuff repair technique have maintained excellent clinical outcomes 4 to 10 years after surgery. LEVEL OF EVIDENCE: Level IV.

Adult↗

PubMed2006

Stiffness and rotator cuff tears: incidence, arthroscopic findings, and treatment results.

PURPOSE: Although stiffness of the shoulder has been evaluated after rotator cuff repair, it has not been studied in patients with cuff tears that occurred before repair. The primary purpose of this study was to determine whether preoperative stiffness persists after cuff repair. We also evaluated the incidence and possible causes of stiffness in patients who underwent arthroscopic rotator cuff repair. METHODS: This was a retrospective evaluation of 72 arthroscopic patients who underwent rotator cuff repair. Preoperative range-of-motion (ROM) deficits in abduction, forward flexion, external rotation, and internal rotation were recorded and were added together to determine the total ROM deficit (TROMD). Patients were then divided into 3 groups on the basis of TROMD. Group 1 comprised 42 patients with 0 degrees to 20 degrees TROMD. Group 2 consisted of 24 patients with 25 degrees to 70 degrees TROMD, and group 3 included 6 patients with a TROMD greater than 70 degrees. Preoperative medical history, intraoperative condition of the capsule and bursa, and cuff tear size were recorded. RESULTS: Capsular and bursal abnormalities were more common in stiffer patients, but arthroscopic evidence of adhesive capsulitis was found only in group 3 (3 of 6 patients). Postoperatively, average TROMD deficit decreased from 10 degrees to 4 degrees in group 1, from 36 degrees to 12 degrees in group 2, and from 89 degrees to 31 degrees in group 3. No reoperations or postoperative manipulations were reported in group 1 or 2. In group 3, 3 patients (the only 3 with adhesive capsulitis) showed no or minimal improvement in postoperative ROM. These 3 patients required a secondary arthroscopic capsular release. After all 3 repairs had completely healed, the TROMD averaged 35 degrees in this subgroup. CONCLUSIONS: Preoperative stiffness is common in patients who undergo rotator cuff repair. Mild and moderate stiffness generally resolve after surgery followed by routine therapy. Patients with a TROMD of 70 degrees or more may have adhesive capsulitis as well as a cuff tear and may not do well with cuff repair alone. LEVEL OF EVIDENCE: Level IV, case series.

Adult↗

PubMed2007

Arthroscopic rotator cuff repair with and without subacromial decompression: a prospective randomized study.

PURPOSE: Our purpose was to evaluate the role of subacromial decompression in the arthroscopic repair of full-thickness rotator cuff tears in a prospective randomized clinical study. METHODS: Arthroscopic cuff repair was performed in 80 patients with a full-thickness rotator cuff tear. They were divided into 2 groups comprising 40 patients each. In group 1 arthroscopic rotator cuff repair was performed with subacromial decompression. In group 2 the repair was performed without decompression. Rotator cuff tears were repaired via metal suture anchors for tendon-to-bone repair, side-to-side repair, or a combination of the 2 techniques. Results were evaluated by use of the Constant score normalized for age and gender, as well as the Disabilities of the Arm, Shoulder and Hand (DASH) and Work-DASH self-administered questionnaires. On analyzing the results at 2 years' follow-up, we considered the following independent variables: age; gender; dominance; location, shape, area, retraction, and reducibility of cuff tear; fatty degeneration; involvement of subscapularis tendon; treatment of biceps tendon; rotator cuff repair technique; and type of acromion. A univariate and multivariate statistical analysis was performed to determine which variables were independently associated with the outcome. RESULTS: Comparison between the groups did not show significant differences for each variable considered. The overall results for the Constant score were 103.6 points in group 1 and 96.1 points in group 2; those for the DASH score were 18.2 points and 23.1 points, respectively; and those for the Work-DASH score were 23.7 points and 26.2 points, respectively. Univariate and multivariate analysis showed that the following variables significantly and independently influenced the outcome: age; shape, retraction, and reducibility of cuff tear; fatty degeneration; involvement of subscapularis; and repair technique. Subacromial decompression did not influence the outcome significantly for each scoring system considered. CONCLUSIONS: At short-term follow-up, subacromial decompression did not seem to significantly affect the outcome of arthroscopic rotator cuff repair. Longer follow-up studies will be necessary to confirm the clinical relevance of these observations. LEVEL OF EVIDENCE: Level I, randomized controlled trial with no significant difference but narrow confidence intervals.

Aged↗