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Lücke, Christoph; Schnetzke, Marc; Engelke, Jennifer; Storg, Janis; Loew, Markus; Lichtenberg, Sven

Correction of the CSA does not decrease the re-tear rate after SSP repair : Results of a retrospective comparative study

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  • Media type: E-Article
  • Title: Correction of the CSA does not decrease the re-tear rate after SSP repair : Results of a retrospective comparative study : Results of a retrospective comparative study
  • Contributor: Lücke, Christoph; Schnetzke, Marc; Engelke, Jennifer; Storg, Janis; Loew, Markus; Lichtenberg, Sven
  • Published: Springer Science and Business Media LLC, 2021
  • Published in: Obere Extremität, 16 (2021) 2, Seite 114-119
  • Language: English
  • DOI: 10.1007/s11678-021-00641-0
  • ISSN: 1862-6599; 1862-6602
  • Keywords: Orthopedics and Sports Medicine ; Surgery
  • Origination:
  • Footnote:
  • Description: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>The re-tear rate after supraspinatus tendon (SSP) repair is high despite optimization of surgical techniques. The critical shoulder angle (CSA) &gt; 35° has been identified as a risk for re-tear. Surgical reduction of the CSA performing additional lateral acromioplasty (ALAP) is intended to reduce the risk.</jats:p> </jats:sec><jats:sec> <jats:title>Objective</jats:title> <jats:p>We aimed to evaluate the effect of ALAP on the re-tear rate in patients with a CSA &gt; 35° after SSP repair.</jats:p> </jats:sec><jats:sec> <jats:title>Patients and methods</jats:title> <jats:p>The study included 49 shoulders fulfilling predefined inclusion criteria. The patients were assigned to two groups; group I (25 SSP) was additionally treated with an ALAP. In group II (24 SSP) standard acromioplasty was performed during reconstruction. Magnetic resonance imaging and a clinical examination (Constant Score; CS) were performed 12 months after surgery.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>After 15 months group I showed a re-tear rate of 20%, a decreased CSA (mean 38.0° preoperatively vs. 34.5° postoperatively) and an increase in CS (mean 53.9 vs. 84.6). After 16 months group II showed a re-tear rate of 16.7%, no difference between pre- and postoperative CSA (37.8° vs. 37.6°), and an increase in CS (48.9 vs. 84.5). There was no difference between the groups in terms of re-tears and postoperative CS (<jats:italic>p</jats:italic> = 0.4557), but there was a significant difference in postoperative CSA (<jats:italic>p</jats:italic> &lt; 0.0001). We did not find a decrease in the failure rate after ALAP. Unlike other studies, patients with a postoperative CSA &gt; 35° did not have a worse clinical outcome and no increased rate of re-tears compared with patients with a mechanically reduced CSA.</jats:p> </jats:sec><jats:sec> <jats:title>Conclusion</jats:title> <jats:p>Additive lateral acromioplasty does not decrease the re-tear rate after arthroscopic SSP repair. However, ALAP significantly decreases the CSA to normal values.</jats:p> </jats:sec>