Correlation of Clinical and Structural Outcomes After Arthroscopic Rotator Cuff Repair With a Suture Bridge Technique

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2013 ISAKOS ABSTRACTS

edge, and inferior surface. Cut-off values for each region, determined by Receiver Operating Characteristic (ROC) analysis, were used to define whether acromial shape differed between shoulders with and without RCT. Subsequently, changes in acromial morphology were compared in subjects with and without RCT by using the Pearson chi-squared test (significance, P<0.05). Associations between the size of the tear in the rotator cuff tendon and the change in acromial morphology were evaluated by using Pearson correlation analysis. Results: Cut-off values were 2 mm for the anterior edge, 3 mm for the lateral edge, 4 mm for the medial edge, and 4 mm for the inferior surface. Acromial morphology at the anterior and lateral edges differed significantly (P<0.01) between shoulders with and without RCT. Tear size was not correlated with change in acromial morphology (P¼0.37e0.73). Conclusion: Morphologic change at the anterior (>2 mm) and lateral (>3 mm) edges of the acromion is associated with the presence of a full-thickness RCT in symptomatic patients, suggesting that acromial morphology can be diagnostic for RCT. The size of the tear in the rotator cuff tendon was not correlated with the severity of the change in acromial morphology. Paper #102: Correlation of Clinical and Structural Outcomes After Arthroscopic Rotator Cuff Repair With a Suture Bridge Technique SUNGWOOK CHOI, MD, PHD, KOREA PRESENTING AUTHOR KWANG WOO NAM, MD, KOREA MYUNG KU KIM, MD, KOREA SANG RIM KIM, KOREA HYUN SEONG KANG, MD, KOREA CHEN TAI TEONG, MD, KOREA $ Jeju National University Hospital, Jeju, Korea

SUMMARY Arthroscopic suture bridge rotator cuff repairs have higher healing rate, improvement in pain relief and the ability to perform activities. ABSTRACT DATA Background: According to biomechanical comparative studies, the suture bridge repair technique has been proven to produce better results than the other techniques. However, it is unclear whether clinical outcomes correlate with structural outcomes after suture bridge repair. Purpose: To evaluate the clinical outcomes and the maintenance of repair integrity after arthroscopic rotator cuff repair using a suture bridge technique for patients with over the medium sized rotator cuff tears. Method: Seventy three patients (35 males, 38 females) underwent arthroscopic rotator cuff repair with suture bridge repair technique from May 2008 to September 2010. Clinical and functional evaluations were made according to the Constant score, the UCLA score, as well as a full physical examination of the shoulder. All patients were judged to reveal healed tendon on magnetic resonance imaging (MRI) at least 12 months after postoperatively. Results: The average age at the time of surgery of the 73 patients was 61.4 years (range, 46 to 77 years). The average

duration of postoperative time in which a follow-up MRI was performed was 20.8 months (range, 12 to 41 months). The average clinical outcome scores and strength were all improved significantly at the time of the last follow-up (P<0.001). The overall rate of retears (type IV, V) was 17 cases (23.3%) The larger the intraoperative tear size, the higher the rate of retear (P <0.002). When the preoperative fatty degeneration grade was higher, the incidence of retear was also increased (P <0.001). The incidence of retear tended to increase with age older than 60 years (P <0.045). Although heavy worker group showed more retear, this difference did not reach statistical significance. (P <0.186). Conclusions: Arthroscopic suture bridge rotator cuff repairs have higher healing rate, improvement in pain relief and the ability to perform activities. Tendon healing is affected by various factors. The retear site tended to be more frequently in the musculotendinous junction area. Interestingly, almost all patients were satisfied with the results of the surgery, although repair integrity is not maintained. Keywords: shoulder; rotator cuff repair; suture bridge technique; retear; outcome Paper #103: Anatomic Study of Extensor Carpi Radialis Brevis in Relation to Etiology of Lateral Epicondylitis AKIMOTO NIMURA, MD, PHD, JAPAN PRESENTING AUTHOR TOMOYUKI MOCHIZUKI, MD, PHD, JAPAN HIROYUKI SUGAYA, MD, JAPAN TAKESHI MUNETA, MD, PHD, JAPAN KEIICHI AKITA, MD, PHD, JAPAN $ Tokyo Medical and Dental University, Tokyo, Japan

SUMMARY In relation to the etiology of the lateral epicondylitis, ECRB tendon originated with the simple tendinous portion compared to other extensors and the only thin capsule was underlying under the anterior side of the ECRB origin. This portion seems to be fragile to repetitive stress or micro trauma, and could be the lesion for the etiology of the lateral epicondylitis. ABSTRACT DATA The pathogenesis of the lateral epicondylitis remains controversial. So far, the enthesopathy of the origin of extensor carpi radialis brevis (ECRB) is mainly suspected to be the etiology of the lateral epicondylitis. Pathological findings of the lesion have been described as angiofibroblasic tendinosis. To understand why such changes specifically occurred in the ECRB origin, anatomic knowledge about it becomes important. Anatomic knowledge about the ECRB origin has been explained that it simply starts from the lateral ridge of the humerus same as other extensors. Characteristics of each tendons were not actually well-known, because ECRB and other extensors could not be clearly divided to form the common tendon around their origins. Objectives of this study are to analyze anatomic features of the ECRB origin compared to other extensors, and to identify relationships between the ECRB origin and other