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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2006 April;57(2):21-6
Lesions to the cuff of the rotator muscles: arthrotomic or arthroscopic treatment?
Valente A., Quaglia F., Ravera R.
Clinica Ortopedica Dipartimento di Scienze Cliniche e Biologiche Università degli Studi di Torino Ospedale S. Luigi Gonzaga, Orbassano (TO)
Aim. The purpose of this study is to study and compare the results of arthrotomic and arthroscopic treatment in repair of the rotator cuff.
Methods. At the Orthopedic Clinic of the S. Luigi Hospital of Orbassano, between 1998 and 2005, 98 patients underwent surgical repair of the rotator cuff. Forty-eight repairs were done arthrotomically and 49 arthroscopically using the standard technique. The patients included in the study presented degenerative lesions in rotator cuff tendons. Fifteen percent had undergone intra-articular cortisone therapy in the years prior to surgery. One patient with concomitant lesion of the brachial plexus was excluded from the study. The average follow-up period was 5 years. The patients were assessed on the basis of the UCLA files, the Hospital for Special Surgery (HSS) score system for the shoulder and the Simple Shoulder Test (SST).
Results. Almost all patients, treated with both techniques, reported a reduction in pain and an increase in functionality of the extremity compared to the preoperative period. Ninety-six percent of patients treated with arthroscopy and 58% of those treated with arthrotomy were immediately satisfied by the operation. Dissatisfaction of patients was due to the persistence of pain and the diminution of strength in the postoperative period.
Conclusion. Our study confirms the data reported in the literature: the arthroscopic technique gave results comparable to the open technique as regards pain and function (P> 0.05), but proved better in terms of postoperative patient satisfaction (P= 0.001).