Impact of comorbidities on clinical and radiological outcomes after arthroscopic transosseous equivalent double-row rotator cuff repair

Abstract

Aims: Several comorbidities have been reported to adversely affect outcomes following rotator cuff repair. This study aimed to evaluate the effect of comorbidities on postoperative tendon healing and functional outcomes in patients undergoing arthroscopic transosseous equivalent (TOE) double-row rotator cuff repair. Methods: In this retrospective cohort study, 44 shoulders in 44 patients who underwent arthroscopic TOE double-row repair between April 2006 and November 2011 were analyzed. All procedures were performed by a single surgeon using an identical surgical technique. Comorbidity burden was quantified using the Charlson Comorbidity Index (CCI). Patients were classified into two groups based on CCI scores (CCI=0 and CCI≥1). Additionally, an exploratory subgroup analysis using ordinal CCI categories (0, 1, and ≥2) was performed. Functional outcomes were assessed at final follow-up using the Rotator Cuff-Quality of Life (RC-QoL) Scale, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, and University of California-Los Angeles (UCLA) score. Tendon integrity was evaluated with magnetic resonance imaging (MRI) at a mean of 21 months postoperatively. Results: No statistically significant differences were observed between the two groups in any functional outcome measure at final follow-up (all p>0.05). Similarly, postoperative MRI revealed no significant differences in tendon healing rates between the groups according to Sugaya’s classification. Conclusion: The presence of comorbidities, as quantified by the CCI, did not adversely affect tendon healing or functional outcomes following arthroscopic TOE double-row rotator cuff repair. The enhanced tendon footprint and compression achieved by this technique may mitigate the potential negative impact of systemic comorbidities on tendon-bone healing.

Keywords

• Rotator cuff tear
• arthroscopic repair
• transosseous equivalent
• double-row technique
• Charlson Comorbidity Index

Eşlik eden komorbiditelerin artroskopik transosseöz eşdeğer çift sıra rotator manşet tamiri sonrası klinik ve radyolojik sonuçlara etkisi

Abstract

Amaç: Rotator manşet tamiri sonrası klinik sonuçları olumsuz etkileyebileceği bildirilen çeşitli komorbiditeler bulunmaktadır. Bu çalışmanın amacı, artroskopik transosseöz eşdeğer (TOE) çift sıra rotator manşet tamiri uygulanan hastalarda komorbiditelerin postoperatif tendon iyileşmesi ve fonksiyonel sonuçlar üzerindeki etkisini değerlendirmektir. Yöntemler: Nisan 2006–Kasım 2011 tarihleri arasında artroskopik TOE çift sıra tamir uygulanan 44 hasta retrospektif olarak incelendi. Tüm ameliyatlar aynı cerrah tarafından standart teknikle gerçekleştirildi. Komorbidite yükü Charlson Komorbidite İndeksi (CCI) ile değerlendirildi ve hastalar CCI = 0 olan Grup 1 (n = 20) ve CCI ≥ 1 olan Grup 2 (n = 24) şeklinde sınıflandırıldı. Fonksiyonel sonuçlar son takipte RC-QoL, ASES, Constant–Murley ve UCLA skorları ile değerlendirildi. Tendon iyileşmesi, ameliyat sonrası ortalama 21. ayda çekilen manyetik rezonans görüntülemede (MRG) değerlendirildi. Bulgular: Son takipte fonksiyonel skorlar açısından iki grup arasında istatistiksel olarak anlamlı fark bulunmadı (tüm p > 0.05). Benzer şekilde, postoperatif MRG değerlendirmesinde Sugaya sınıflandırmasına göre tendon iyileşme oranları gruplar arasında anlamlı şekilde farklı değildi. Sonuç: Komorbidite varlığı, artroskopik transosseöz eşdeğer çift sıra rotator manşet tamiri sonrası tendon iyileşmesini veya fonksiyonel sonuçları olumsuz etkilememiştir. TOE çift sıra tekniğinin sağladığı geniş tendon ayak izi ve artmış kompresyon, sistemik komorbiditelerin potansiyel olumsuz etkilerini dengeleyebilir.

Keywords

• Rotator manşet yırtığı
• Artroskopik tamir
• Transosseöz eşdeğer
• Çift sıra teknik
• Charlson komorbidite indeksi

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