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Movement Patterns of the Shoulder Post Synthetic Interpositional PTFE Patch Repair for Large Rotator Cuff Tears

Toohey, Thomas P.; Hackett, Lisa M., AMS; Lam, Patrick H., MD (USYD), PhD (UNSW); Murrell, George A.C., MBBS (Adel), MD (UNSW), DPhil (Oxon)

Techniques in Shoulder & Elbow Surgery: June 2019 - Volume 20 - Issue 2 - p 39–46
doi: 10.1097/BTE.0000000000000169
Research Article
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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.

Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, Australia

Ethics approval for this study was obtained from the South-Eastern Sydney Human Research Ethics Committee (HREC ref no 12/310). (Study Title: “Outcome of shoulder replacement and patches for treatment of massive/irreparable rotator cuff tear.” HREC Ref no 12/310). On August 7, 2018 ethics approval for 12/310 was extended to June 14, 2019. Informed patient consent was obtained from each participant of this study.

The authors declare no conflict of interest.

Reprints: George A.C. Murrell, MBBS (Adel), MD (UNSW), DPhil (Oxon), Orthopaedic Research Institute, Level 2, 4-10 South Street, Kogarah, Sydney, NSW 2217, Australia (e-mail: murrell.g@ori.org.au).

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