Download PDF
CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2022; 57(01): 136-143
DOI: 10.1055/s-0040-1716763
Artigos Originais
Ombro e Cotovelo

Resultado clínico do reparo parcial nas roturas irreparáveis do manguito rotador[*]

Article in several languages: português | English
Eduardo Angeli Malavolta
1   Grupo de Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Luca Martinez 
1   Grupo de Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Mauro Emilio Conforto Gracitelli 
1   Grupo de Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Jorge Henrique Assunção 
1   Grupo de Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Fernando Brandão Andrade-Silva 
1   Grupo de Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
,
Arnaldo Amado Ferreira Neto 
1   Grupo de Ombro e Cotovelo, Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
› Author Affiliations
› Further Information
   Permissions and Reprints

Resumo

Objetivo Avaliar o resultado funcional de pacientes submetidos ao reparo parcial por via artroscópica de roturas extensas do manguito rotador.

Métodos Série de casos retrospectiva, avaliando pacientes com roturas extensas do manguito rotador submetidos ao reparo parcial por via artroscópica. O desfecho primário foi a escala American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES, na sigla em inglês) aos 24 meses. Foram desfechos secundários a escala Modified-University of California at Los Angeles Shoulder Rating Scale (UCLA, na sigla em inglês), e seus subdomínios satisfação, flexão anterior ativa e força de flexão anterior ativa.

Resultados Avaliamos 33 pacientes. A escala da ASES evoluiu de 39,7 ± 19,6 para 77,6 ± 17,4 (p < 0,001). A escala da UCLA evoluiu de 13,3 ± 5,5 para 27,9 ± 5,6 (p < 0,001). A taxa de satisfação foi de 97%. O número de pacientes com flexão anterior ativa > 150° passou de 12 (36,4%) para 25 (75,8%) (p = 0,002). O número de pacientes com força de flexão anterior ativa normal ou boa passou de 9 (27,3%) para 22 (66,7%) (p = 0,015).

Conclusão O reparo parcial nas roturas irreparáveis do manguito rotador leva a melhora significativa de acordo com as escalas da ASES e UCLA.

Palavras-chave

manguito rotador - artroscopia - ombro - avaliação de resultado de intervenções terapêuticas

Suporte Financeiro

Não houve apoio financeiro de fontes públicas, comerciais, ou sem fins lucrativos.


* Trabalho desenvolvido no Instituto de Ortopedia e Traumatologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.




Publication History

Received: 05 March 2020

Accepted: 06 July 2020

Article published online:
29 October 2020

© 2020. Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • Referências

  • 1 Yamamoto A, Takagishi K, Osawa T. et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 2010; 19 (01) 116-120
    CrossrefPubMedGoogle Scholar
  • 2 Malavolta EA, Gracitelli MEC, Assunção JH, Pinto GMR, da Silveira AZF, Ferreira AA. Shoulder disorders in an outpatient clinic: an epidemiological study. Acta Ortop Bras 2017; 25 (03) 78-80
    CrossrefPubMedGoogle Scholar
  • 3 Malavolta EA, Assunção JH, Beraldo RA, Pinto GMR, Gracitelli MEC, Ferreira Neto AA. Rotator cuff repair in the Brazilian Unified Health System: Brazilian trends from 2003 to 2015. Rev Bras Ortop 2017; 52 (04) 501-505
    Google Scholar
  • 4 Kooistra B, Gurnani N, Weening A, van den Bekerom M, van Deurzen D. Low level of evidence for all treatment modalities for irreparable posterosuperior rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 2019; 27 (12) 4038-4048
    CrossrefPubMedGoogle Scholar
  • 5 Burkhart SS. Reconciling the paradox of rotator cuff repair versus debridement: a unified biomechanical rationale for the treatment of rotator cuff tears. Arthroscopy 1994; 10 (01) 4-19
    CrossrefPubMedGoogle Scholar
  • 6 Burkhart SS, Nottage WM, Ogilvie-Harris DJ, Kohn HS, Pachelli A. Partial repair of irreparable rotator cuff tears. Arthroscopy 1994; 10 (04) 363-370
    CrossrefPubMedGoogle Scholar
  • 7 Malahias MA, Kostretzis L, Chronopoulos E, Brilakis E, Avramidis G, Antonogiannakis E. Arthroscopic partial repair for massive rotator cuff tears: does it work? A systematic review. Sports Med Open 2019; 5 (01) 13
    CrossrefPubMedGoogle Scholar
  • 8 Maillot C, Martellotto A, Demezon H, Harly E, Le Huec J-C. Multiple Treatment Comparisons for Large and Massive Rotator Cuff Tears: A Network Meta-analysis. Clin J Sport Med 2019; ••• DOI: 10.1097/JSM.0000000000000786.
    CrossrefPubMedGoogle Scholar
  • 9 Knaut LA, Moser ADL, Melo SdeA, Richards RR. Translation and cultural adaptation to the portuguese language of the American Shoulder and Elbow Surgeons Standardized Shoulder assessment form (ASES) for evaluation of shoulder function. Rev Bras Reumatol 2010; 50 (02) 176-189
    CrossrefPubMedGoogle Scholar
  • 10 Oku EC, Andrade AP, Stadiniky SP, Carrera EF. Tradução e adaptação cultural do Modified-University of California at Los Angeles Shoulder Rating Scale para a língua portuguesa. Rev Bras Reumatol 2006; 46 (04) 246-252
    CrossrefGoogle Scholar
  • 11 Fuchs B, Weishaupt D, Zanetti M, Hodler J, Gerber C. Fatty degeneration of the muscles of the rotator cuff: assessment by computed tomography versus magnetic resonance imaging. J Shoulder Elbow Surg 1999; 8 (06) 599-605
    CrossrefPubMedGoogle Scholar
  • 12 Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG. Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal?. J Bone Joint Surg Am 2005; 87 (06) 1229-1240
    PubMedGoogle Scholar
  • 13 Cvetanovich GL, Gowd AK, Liu JN. et al. Establishing clinically significant outcome after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 2019; 28 (05) 939-948
    CrossrefPubMedGoogle Scholar
  • 14 Cuff DJ, Pupello DR, Santoni BG. Partial rotator cuff repair and biceps tenotomy for the treatment of patients with massive cuff tears and retained overhead elevation: midterm outcomes with a minimum 5 years of follow-up. J Shoulder Elbow Surg 2016; 25 (11) 1803-1809
    CrossrefPubMedGoogle Scholar
  • 15 Holtby R, Razmjou H. Relationship between clinical and surgical findings and reparability of large and massive rotator cuff tears: a longitudinal study. BMC Musculoskelet Disord 2014; 15: 180
    CrossrefPubMedGoogle Scholar
  • 16 Franceschi F, Papalia R, Vasta S, Leonardi F, Maffulli N, Denaro V. Surgical management of irreparable rotator cuff tears. Knee Surg Sports Traumatol Arthrosc 2015; 23 (02) 494-501
    CrossrefPubMedGoogle Scholar
  • 17 Iagulli ND, Field LD, Hobgood ER, Ramsey JR, Savoie III FH. Comparison of partial versus complete arthroscopic repair of massive rotator cuff tears. Am J Sports Med 2012; 40 (05) 1022-1026
    CrossrefPubMedGoogle Scholar
  • 18 Berth A, Neumann W, Awiszus F, Pap G. Massive rotator cuff tears: functional outcome after debridement or arthroscopic partial repair. J Orthop Traumatol 2010; 11 (01) 13-20
    CrossrefPubMedGoogle Scholar
  • 19 Godenèche A, Freychet B, Lanzetti RM, Clechet J, Carrillon Y, Saffarini M. Should massive rotator cuff tears be reconstructed even when only partially repairable?. Knee Surg Sports Traumatol Arthrosc 2017; 25 (07) 2164-2173
    CrossrefPubMedGoogle Scholar
  • 20 Kim SJ, Lee IS, Kim SH, Lee WY, Chun YM. Arthroscopic partial repair of irreparable large to massive rotator cuff tears. Arthroscopy 2012; 28 (06) 761-768
    CrossrefPubMedGoogle Scholar
  • 21 Mori D, Funakoshi N, Yamashita F. Arthroscopic surgery of irreparable large or massive rotator cuff tears with low-grade fatty degeneration of the infraspinatus: patch autograft procedure versus partial repair procedure. Arthroscopy 2013; 29 (12) 1911-1921
    CrossrefPubMedGoogle Scholar
  • 22 Mihata T, Lee TQ, Watanabe C. et al. Clinical results of arthroscopic superior capsule reconstruction for irreparable rotator cuff tears. Arthroscopy 2013; 29 (03) 459-470
    CrossrefPubMedGoogle Scholar
  • 23 Burkhart SS, Hartzler RU. Superior Capsular Reconstruction Reverses Profound Pseudoparalysis in Patients With Irreparable Rotator Cuff Tears and Minimal or No Glenohumeral Arthritis. Arthroscopy 2019; 35 (01) 22-28
    CrossrefPubMedGoogle Scholar
  • 24 Pennington WT, Bartz BA, Pauli JM, Walker CE, Schmidt W. Arthroscopic Superior Capsular Reconstruction With Acellular Dermal Allograft for the Treatment of Massive Irreparable Rotator Cuff Tears: Short-Term Clinical Outcomes and the Radiographic Parameter of Superior Capsular Distance. Arthroscopy 2018; 34 (06) 1764-1773
    CrossrefPubMedGoogle Scholar
  • 25 Denard PJ, Brady PC, Adams CR, Tokish JM, Burkhart SS. Preliminary Results of Arthroscopic Superior Capsule Reconstruction with Dermal Allograft. Arthroscopy 2018; 34 (01) 93-99
    CrossrefPubMedGoogle Scholar
  • 26 Hirahara AM, Andersen WJ, Panero AJ. Superior Capsular Reconstruction: Clinical Outcomes After Minimum 2-Year Follow-Up. Am J Orthop 2017; 46 (06) 266-278
    PubMedGoogle Scholar
  • 27 Petrillo S, Longo UG, Papalia R, Denaro V. Reverse shoulder arthroplasty for massive irreparable rotator cuff tears and cuff tear arthropathy: a systematic review. Musculoskelet Surg 2017; 101 (02) 105-112
    CrossrefPubMedGoogle Scholar
  • 28 Heuberer PR, Kölblinger R, Buchleitner S. et al. Arthroscopic management of massive rotator cuff tears: an evaluation of debridement, complete, and partial repair with and without force couple restoration. Knee Surg Sports Traumatol Arthrosc 2016; 24 (12) 3828-3837
    CrossrefPubMedGoogle Scholar
  • 29 Miyazaki AN, Fregoneze M, Santos PD. et al. Avaliação funcional do reparo artroscópico da lesão do manguito rotador em pacientes com pseudoparalisia. Rev Bras Ortop 2014; 49 (02) 178-182
    CrossrefPubMedGoogle Scholar
  • 30 Miyazaki AN, Santos PD, da Silva LA, do Val Sella G, Checchia SL, Yonamine AM. Are the good functional results from arthroscopic repair of massive rotator cuff injuries maintained over the long term?. Rev Bras Ortop 2015; 51 (01) 40-44
    CrossrefPubMedGoogle Scholar