Libération arthroscopique combinée à une fixation en simple rang ou double rang d’une rupture traumatique du supra-épineux associée à capsulite rétractile réfractaire au traitement conservateur - étude prospective randomisée - 06/05/21

Arthroscopic release combined with single-row fixation or double-row suture bridge fixation in patients with traumatic supraspinatus tear and adhesive capsulitis non-responsive to conservative management: A prospective randomized trial

Doi : 10.1016/j.rcot.2021.01.016

Cheng Li ^a, Heng Zhang ^b, Xiaobo Bo ^c, Guochun Zha ^a, Yong Pang ^a, Xin Zheng ^a, Xiangyang Chen ^a, Kaijin Guo ^a,⁎
^a The Affiliated Hospital of Xuzhou Medical University, Department of Orthopedics, 221006, Xuzhou, Jiangsu Province, China
^b Zaozhuang Mining Group Central Hospital, Department of Orthopedics, 277800 Zaozhuang, Shandong Province, China
^c Zaozhuang Mining Group Central Hospital, Department of Medical imaging, 277800 Zaozhuang, Shandong Province, China

^⁎Auteur correspondnt.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 06 May 2021
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Abstract

Background

There are few previous studies on traumatic supraspinatus tear with adhesive capsulitis. This study used arthroscopic release with single-row fixation or double-row suture bridge fixation to treat adhesive capsulitis of the shoulder with rotator cuff tears. Further, the clinical efficacy of arthroscopic release with single-row fixation and double-row suture bridge fixation was compared.

Hypotheses

Arthroscopic release combined with single-row fixation or double-row suture bridge fixation showed good clinical outcomes in patients with traumatic supraspinatus tear with adhesive capsulitis.

Methods

A single-center prospective randomized trial was performed from June 2013 to June 2017. Of the 68 patients with traumatic supraspinatus tear and adhesive capsulitis who underwent arthroscopic release, 34 (22 with tear measuring ≤3cm and 12 with tear measuring >3cm) were included in the single-row fixation group and 34 (20 with tear measuring ≤3cm and 14 with tear measuring >3cm) were included in the double-row suture bridge fixation group. The visual analogue scale (VAS) score, University of California Los Angeles (UCLA) and American Shoulder and Elbow Surgeons (ASES) shoulder scores, range of motion, time to achieve satisfactory scores, and rotator cuff re-tear rate were compared between the groups.

Results

The range of motion, VAS score, UCLA and ASES shoulder scores significantly improved after surgery in both groups. There was a significant difference in the UCLA and ASES shoulder scores, time to achieve satisfactory scores, and rotator cuff re-tear rates in patients with tears measuring >3cm between the groups.

Conclusions

Arthroscopic release combined with single-row fixation or double-row suture bridge fixation showed good clinical outcomes in patients with traumatic supraspinatus tear with adhesive capsulitis. Therefore, the capsule of the shoulder should be thoroughly released to achieve such outcomes. For patients with rotator cuff tears measuring >3cm, double-row suture bridge fixation was superior to single-row fixation and the rotator cuff re-tear rate was low.

Level of evidence

I; prospective, randomized trial, treatment study.

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Keywords : Arthroscopy, Release, Suture bridge, Supraspinatus tear, Adhesive capsulitis

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.