Key result
Glenohumeral joint movement at maximal active abduction following PTFE patch repair (59±5 degrees) was significantly less than in asymptomatic shoulders (95±3 degrees; P<0.01).
Why the study?
Synthetic polytetrafluoroethylene patch repair for large rotator cuff tears provides good strength and range of motion, but information evaluating shoulder movement patterns postoperatively is limited.
Does polytetrafluoroethylene patch repair restore normal shoulder kinematics compared to other surgical methods and normal shoulders in patients with large rotator cuff tears?
Observational (n=35)
Does polytetrafluoroethylene patch repair restore normal shoulder kinematics compared to other surgical methods and normal shoulders in patients with large rotator cuff tears?
Absolute Event Rate: 59% vs 95%
p-value: p=<0.01
Abnormal shoulder motion post rotator cuff repair is due to decreased glenohumeral joint movement rather than compensatory increased scapulothoracic motion.
Reduced glenohumeral motion after PTFE patch repair may limit kinematic expectations; leaves open whether alternative techniques better restore normal shoulder kinematics.
The use of a synthetic polytetrafluoroethylene patch to repair large rotator cuff tears has resulted in good postoperative outcomes with respect to strength and range of motion. However, there is little information evaluating the movement patterns of the shoulder after patch repair. Following a reliability study of radiography to assess shoulder joint angles, radiographic assessment of shoulder kinematics was performed at 68±52 weeks (mean±SEM) postoperatively. This study compared the outcomes of polytetrafluoroethylene patch repair (n=15), suture-anchor repair (n=8), reverse total shoulder arthroplasty (n=7), and normal shoulders (n=5). The inter-rater and intrarater reliability of radiography was excellent (r=0.98, 0.96). Glenohumeral joint movement at maximal active abduction following patch repair (59±5 degrees), suture-anchor repair (57±8 degrees) and reverse total shoulder arthroplasty (52±7 degrees) was less than asymptomatic shoulders (95±3 degrees; P<0.01). Scapulothoracic motion remained similar between all cohorts. The present study demonstrated that the abnormal relationship between glenohumeral and scapulothoracic motion post rotator cuff repair is due to a decrease in glenohumeral joint movement, rather than a compensatory increase in scapulothoracic motion.
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Toohey et al. (2019) conducted an observational in Large rotator cuff tears (n=35). Polytetrafluoroethylene patch repair vs. Suture-anchor repair, reverse total shoulder arthroplasty, and normal shoulders was evaluated on Glenohumeral joint movement at maximal active abduction (p=<0.01). Glenohumeral joint movement at maximal active abduction following PTFE patch repair (59±5 degrees) was significantly less than in asymptomatic shoulders (95±3 degrees; P<0.01).
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