El resultado favorable visto a largo plazo de la artroscopia reparadora de golpe de hélice.
Most patients have good or excellent shoulder strength, pain and function and are highly satisfied 4 to 10 years after arthroscopic rotator cuff repair, regardless of whether absorbable or non-absorbable sutures are used, according to a retrospective study.
Rotator cuff injury is a common shoulder disorder seen in orthopaedic clinics. Improvements to surgical techniques for rotator cuff repair are continually being made in order to achieve an optimal outcome for these patients.
Eugene M Wolf, MD, at the California Pacific Medical Centre, San Francisco, United States, and colleagues evaluated the 4- to 10-year clinical results of patients who underwent arthroscopic repair of full-thickness rotator cuff tears. "This is the largest series of arthroscopic rotator cuff repairs with the longest period of follow-up data reported to date," note the authors.
The investigators reviewed medical records and conducted telephone interviews of 60 men and 35 women who had their rotator cuff tears repaired by the same surgeon. Shoulder scores were measured using the modified University of California, Los Angeles (UCLA), rating system.
Overall, 94% of patients had good or excellent postoperative shoulder scores. Moreover, excellent forward flexion of the shoulder was noted.
Favourable scores were reported for strength, pain, and function. The UCLA strength score was 4.6 out of 5, the mean pain score was 8.8 out of 10, and the mean function score was 9.3 out of 10. Furthermore, 96% of patients were satisfied with the results of their surgery and felt that the procedure was successful.
The study also found that suture type did not significantly affect outcome. Similar shoulder scores were seen with both absorbable and non-absorbable sutures.
The authors conclude that "arthroscopic rotator cuff repair can achieve a high level of good and excellent results with minimal morbidity and minimal violation of the surrounding soft tissue envelope."
Arthroscopy 2004 Jan;20:1:5-12.
ABSTRACT ARTÍCULO
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.
