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Captured Rotator Cuff: A Poor Prognostic Factor in Rotator Cuff Repair.

Authors: França, Flavio de Oliveira; Freitas, José Márcio Alves; Medeiros, Ricardo Palombini; Queiroga, Romero Ruan Cartaxo de; Nunes, Tiago Prause; Godinho, Glaydson Gomes;

Captured Rotator Cuff: A Poor Prognostic Factor in Rotator Cuff Repair.

Abstract

Resumo Objetivo Descrever uma nova apresentação de ruptura e rerruptura do manguito rotador (MR), a qual denominamos manguito capturado (MC). Objetivamos também avaliá-la clinicamente e por meio de imagens. Métodos Foram avaliados retrospectivamente 16 pacientes com diagnóstico intraoperatório de MC no período de março de 2005 a setembro de 2017; por meio de exames de imagem (radiografia e ressonância magnética [RM]) e escores funcionais (UCLA e Constant & Murley). Nas imagens, analisamos a evolução para artropatia do manguito rotador e presença de rerrupturas. Funcionalmente, comparamos o lado afetado com o contralateral e as lesões extensas com nãoextensas. Resultados Cinco (31,25%) pacientes evoluíram com artropatia do manguito rotador e 10 (62,5%) tiveram rerrupturas. Três (75%) pacientes com lesões não extensas tiveram UCLA e Constant & Murley bons/excelentes. Nos pacientes com lesões extensas, quando avaliado Constant & Murley, 6 (50%) apresentaram resultados bons/excelentes, e no escore UCLA, 7 (58,3%). Comparando o lado acometido (Constant 74,72 pontos; UCLA 20 pontos) com o contralateral (Constant 96,96 pontos; UCLA 25,63 pontos), houve pior resultado funcional com significância estatística. Conclusão O diagnóstico de MC é suspeitado por achados característicos na RM e confirmado na artroscopia. Os ombros acometidos apresentam piores escores funcionais pós-operatórios.

Abstract Objective To describe a new presentation of tears and retears of the rotator cuff, which we denominate captured rotator cuff (CRC). We also aim to evaluate it clinically and through images. Methods We assessed retrospectively 16 patients with intraoperative diagnosis of CRC between March 2005 and September 2017; by means of imaging (radiography and magnetic resonance imaging [MRI]) and functional scores (UCLA and Constant & Murley). In images we analyzed the evolution for rotator cuff arthropathy and presence of retears. Functionally, we compared the affected side with the contralateral side and extensive lesions with nonextensive. Results Five (31.25%) patients presented with rotator cuff arthropathy, and 10 (62.5%) with retears. Three (75%) patients with nonextensive lesions had good/excellent UCLA and Constant & Murley scores. In patients with extensive lesions, when the Constant & Murley score was evaluated, 6 (50%) presented good/excellent results, and in the UCLA score, 7 (58.3%). Comparing the affected side (Constant 74.72 points; UCLA 20 points) with the contralateral side (Constant 96.96 points; UCLA 25.63 points), there were worse functional results with statistical significance. Conclusion The diagnosis of CRC is suspected by characteristic findings on MRI and confirmed in arthroscopy. The affected shoulders present worse functional postoperative scores.

Keywords

Orthopedic surgery, manguito rotador, ruptura, shoulder, ombro, subacromial adhesions, R, rupture, Medicine, aderências subacromiais, rotator cuff, RD701-811

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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