1. Kerlan-Jobe Orthopaedic Clinic score most accurate for assessing rotator cuff pain. According to researchers who studied 23 collegiate or professional athletes one year after arthroscopic repair of type II SLAP lesions, the Kerlan-Jobe Orthopaedic Clinic score is the most accurate for assessing postoperative pain in rotator cuffs. The researchers measured the Kerlan-Jobe score with the American Shoulder and Elbow Surgeons score, and all scores were compared with control values obtained from a healthy athletic cohort.
One year after surgery, 13 athletes were playing pain free, six were playing with pain and four were not playing because of pain. The American Shoulder and Elbow Surgeons score showed 22 athletes who were good-excellent and one with a fair score. The Kerlan-Jobe scores attributed excellent scores to nine athletes, good scores to three, fair scores to four and poor scores to seven.
2. PRP ineffective in rotator cuff treatment. A recent study authored by Scott Rodeo, MD, of the Hospital for Special Surgery, shows that platelet-rich plasma with a fibrin matrix has no benefits for rotator cuff tendon repair, and may have a negative impact on healing. The study placed 79 patients into two groups, one group with patients who received PRFM during repair and the other with patients who did not. Standardized rotator cuff repair techniques and rehabilitation protocol were used for all patients.
Dr. Rodeo found there was no real difference in healing the tendon-to-bone rotator cuff repair in the patients who received PRFM. However, the study did not control for variability in the way platelets were recovered, platelet activation and mechanisms for the way PRFM reacts with the tendon cells. The study was described in an American Orthopaedic Society for Sports Medicine news release.
3. Tears likely to increase without surgery. In about half of patients who are 60 years or younger, full-thickness rotator cuff tear sizes are likely to increase in size if they aren’t surgically managed. A recent study followed 61 patients with rotator cuff tears for two years and in that time span, 49 percent of the tears increased in size. For 25 percent of the shoulders, a new full-thickness rotator cuff was diagnosed at the two-year follow-ups.
There was no correlation between the change in tear size and the age of the patient or the existence of prior trauma. Authors of the study recommended patients who choose non-operative treatment for rotator cuff tears are routinely monitored, especially if they remain symptomatic.
4. Recurrent tears most likely to occur within three months of surgery. A majority of recurrent rotator cuff tears occur in the first three months after surgery and efforts to improve healing during this time could have long-term implications for patient outcomes. In a study, researchers examined 107 consecutive patients who underwent arthroscopically assisted mini-open rotator cuff repair. Ninety-five patients finished the maximum 11-year follow up.
There was a 33 percent failure rate among the participants and 74 percent of those failures occurred atraumatically in the first three months after surgery. An additional 11 percent of the remaining failures occurred between the third and sixth month after repair.
5. Arthroscopic rotator cuff repair effective in older patients. An arthroscopic rotator cuff repair can reduce pain and improve function in patients over the age of 70 with symptomatic full-thickness rotator cuff tears, according to a study published in The Journal of Arthroscopic and Related Surgery.
The study included 44 patients who were examined two years after surgery. All patients experienced improvement in the Shoulder and Elbow Surgeons score, range of motion and the pain score on the visual analogue scale. The patients in the study experienced a low complication rate with this procedure.
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