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Footprint Preservation Enhances Functional and Structural Outcome After Rotator Cuff Repair

Footprint Preservation Enhances Functional and Structural Outcome After Rotator Cuff Repair

Marco Adriani, MD, ITALY Marcello Motta, MD, ITALY Alberto Guizzi, ITALY Francesco DeFilippo, MD, ITALY Maristella Francesca Saccomanno, MD, PhD, ITALY Giuseppe Milano, Prof., ITALY

University of Brescia, Brescia, ITALY


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

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Summary: Recent biomechanical studies showed that anatomic rotator cuff repair preserving remnant tendon tissue can enhance tendon-to-bone healing in animal models, Footprint preservation associated with nanofractures of the greater tuberosity enhances functional and structural outcome after rotator cuff repair.


Aim

to evaluate the clinical efficacy of biologic enhancement of tendon bone-healing through footprint preservation associated with nanofractures of the greater tuberosity in rotator cuff repair.

Background

Recent biomechanical studies showed that anatomic rotator cuff repair preserving remnant tendon tissue can enhance tendon-to-bone healing in animal models.

Methods

A retrospective study was conducted. Patients who underwent an arthroscopic rotator cuff repair by preserving the native humeral insertion associated with nanofractures of the greater tuberosity were included. Exclusion criteria were: partial thickness tears, irreparable tears, capsulo-labral pathologies, calcific tendonitis, gleno-humeral osteoarthritis and/or previous surgery. Primary outcome was the ASES score. Secondary outcomes were: Quick-DASH, WORC and evaluation of tendon integrity through a magnetic resonance imaging (MRI) performed six months after surgery. A paired t-test was used to compare pre and postoperative outcomes. Multivariate analysis was performed to determine which predictors were independently associated with the outcome. Significance was set at p < 0.05.

Results

The study included 15 males and 14 females. Mean age (+ SD) of patients was 61.69 + 8.89 years. Mean follow-up was 46.68 + 3.92. Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001). Subgroup analysis for tear size showed significant differences in the QuickDASH score (0.03). Particularly, a significant difference in the QuickDASH score could be detected between medium and big tears (p=0.008) as well as medium and massive lesions (p=0.04). No differences could be detected between big and massive tears (p= 0.35). Postoperative imaging showed healed tendons in 21 out of 29 (71.4%) MRI.

Conclusions

Footprint preservation associated with nanofractures of the greater tuberosity enhances functional and structural outcome after rotator cuff repair.


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