Effect of unilateral rotator cuff repair on the contralateral shoulder in patients with bilateral rotator cuff tears_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Chen , YANG Pu , ZHANG Hui , LIU Weijie , ZHANG Yi , YU Tengbo , ZHAO Xia ,  QI Chao

Department of Sports Medicine, the Affiliated Hospital of Qingdao University, Qingdao Shandong, 266103, P.R.China;

Corresponding author：

QI Chao, Email: qichao2002@163.com

Keywords：

Bilateral rotator cuff tears; arthroscopy; rotator cuff repair; conservative treatment

DOI：

10.7507/1002-1892.202006045

Video：

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Objective To investigate the effect of unilateral rotator cuff repair on the contralateral shoulder in patients with bilateral rotator cuff tears.Methods A clinical data of 46 patients with bilateral rotator cuff tears met the criteria between May 2016 and May 2019 was retrospectively analyzed. Of 46 patients, 23 patients underwent bilateral conservative treatment (conservation group), 23 patients underwent unilateral arthroscopic rotator cuff repair, and conservative treatment on the contralateral side (operation group). There was no significant difference in gender, age, disease duration, degree of rotator cuff tear, and comorbidities between 2 groups (P>0.05). Before operation and at 6 and 12 months after operation, the degree of the rotator cuff tear was measured by MRI, and the shoulder function was evaluated by the visual analogue scale (VAS) score, University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and range of motion (ROM) (forward flexion, external rotation, external rotation at 90° of abduction, and internal rotation). The evaluation results of the non-surgical side of shoulders in the operation group were compared with one side of shoulders in the conservation group.Results All incisions healed by first intention without any complication after operation. All patients were followed up 12 months. MRI reexamination showed that the degree of rotator cuff tear of the contralateral shoulder in the operation group increased significantly after operation (P<0.05). There was no significant difference between the operation group and the conservation group before operation (P>0.05), but the rotator cuff tear of the contralateral shoulder in the operation group was more serious than that of the conservation group at 6 and 12 months after operation (P<0.05). At 6 and 12 months after operation, the VAS score, UCLA score, and ASES score significantly improved when compared with the preoperative scores in 2 groups (P<0.05). There was no significant difference in the VAS score, UCLA score, and ASES score between 2 groups before operation (P>0.05). The function scores in the conservation group were better than those in the operation group at 6 and 12 months after operation (P<0.05). There were significant differences in the ROM of shoulder between pre- and post-operation in 2 groups (P<0.05). And there was no significant difference between 2 groups at pre- and post-operation (P>0.05).Conclusion For patients with bilateral rotator cuff tears, the unilateral rotator cuff repair can aggravate the rotator cuff tear of contralateral shoulder.

Citation： WANG Chen, YANG Pu, ZHANG Hui, LIU Weijie, ZHANG Yi, YU Tengbo, ZHAO Xia, QI Chao. Effect of unilateral rotator cuff repair on the contralateral shoulder in patients with bilateral rotator cuff tears. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(11): 1399-1404. doi: 10.7507/1002-1892.202006045 Copy

1.	Yamaguchi K, Ditsios K, Middleton WD, et al. The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg (Am), 2006, 88(8): 1699-1704.
2.	Longo UG, Franceschi F, Berton A, et al. Conservative treatment and rotator cuff tear progression. Med Sport Sci, 2012, 57: 90-99.
3.	Ranebo MC, Björnsson Hallgren HC, Adolfsson LE. Patients with a long-standing cuff tear in one shoulder have high rates of contralateral cuff tears: a study of patients with arthroscopically verified cuff tears 22 years ago. J Shoulder Elbow Surg, 2018, 27(3): e68-e74.
4.	Kim HJ, Kee YM, Kim JY, et al. Safe time frame of staged bilateral arthroscopic rotator cuff repair. J Shoulder Elbow Surg, 2019, 28(9): 1707-1715.
5.	Lee WH, Do HK, Lee JH, et al. Clinical outcomes of conservative treatment and arthroscopic repair of rotator cuff tears: A retrospective observational study. Ann Rehabil Med, 2016, 40(2): 252-262.
6.	Lee HJ, Jeong JY, Kim CK, et al. Surgical treatment of lesions of the long head of the biceps brachii tendon with rotator cuff tear: a prospective randomized clinical trial comparing the clinical results of tenotomy and tenodesis. J Shoulder Elbow Surg, 2016, 25(7): 1107-1114.
7.	Shim SB, Jeong JY, Yum TH, et al. A Comparative study to evaluate the risk factors for medium-sized rotator cuff tear in patients younger than 50 years of age. Arthroscopy, 2018, 34(11): 2971-2979.
8.	Rossi LA, Atala N, Bertona A, et al. Return to sports after in situ arthroscopic repair of partial rotator cuff tears. Arthroscopy, 2019, 35(1): 32-37.
9.	Bureau NJ, Deslauriers M, Lepage-Saucier M, et al. Rotator cuff tear morphologic parameters at magnetic resonance imaging: relationship with muscle atrophy and fatty infiltration and patient-reported function and health-related quality of life. J Comput Assist Tomogr, 2018, 42(5): 784-791.
10.	Gialanella B, Comini L, Gaiani M, et al. Conservative treatment of rotator cuff tear in older patients: a role for the cycloergometer? A randomized study. Eur J Phys Rehabil Med, 2018, 54(6): 900-910.
11.	Liem D, Buschmann VE, Schmidt C, et al. The prevalence of rotator cuff tears: is the contralateral shoulder at risk? Am J Sports Med, 2014, 42(4): 826-830.
12.	Chung SW, Kim JY, Yoon JP, et al. Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med, 2015, 43(3): 588-596.
13.	Rossi LA, Atala NA, Bertona A, et al. Long-term outcomes after in situ arthroscopic repair of partial rotator cuff tears. Arthroscopy, 2019, 35(3): 698-702.
14.	Cheon SJ, Lee HY, Jeon WK. Arthroscopic treatment for intratendinous rotator cuff tear results in satisfactory clinical outcomes and structural integrity. Knee Surg Sports Traumatol Arthrosc, 2018, 26(12): 3797-3803.
15.	Baumgarten KM, Chang PS, Dannenbring TM, et al. Does arthroscopic rotator cuff repair improve patients’ activity levels? J Shoulder Elbow Surg, 2018, 27(12): 2167-2174.
16.	Yoo JC, Lim TK, Kim DH, et al. Comparison between the patients with surgery and without surgery after recommendation of surgical repair for symptomatic rotator cuff tear. J Orthop Sci, 2018, 23(1): 64-69.
17.	Rhee SM, Kim DH, Kim SH, et al. The clinical outcomes and their associated factors in staged bilateral arthroscopic rotator cuff repair. Arthroscopy, 2018, 34(10): 2799-2807.
18.	Abate M, Di Carlo L, Salini V, et al. Risk factors associated to bilateral rotator cuff tears. Orthop Traumatol Surg Res, 2017, 103(6): 841-845.
19.	Kim YS, Kim SE, Bae SH, et al. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI. Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2073-2080.
20.	Chalmers PN, Granger E, Nelson R, et al. Factors affecting cost, outcomes, and tendon healing after arthroscopic rotator cuff repair. Arthroscopy, 2018, 34(5): 1393-1400.
21.	Carbone S, Gumina S, Arceri V, et al. The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes. J Shoulder Elbow Surg, 2012, 21(1): 56-60.
22.	Pak CH, Moon YL, Sim SW, et al. Bilateral arthroscopic rotator cuff repair using a single-stage procedure. Orthopedics, 2015, 38(5): e423-427.

1. Yamaguchi K, Ditsios K, Middleton WD, et al. The demographic and morphological features of rotator cuff disease: a comparison of asymptomatic and symptomatic shoulders. J Bone Joint Surg (Am), 2006, 88(8): 1699-1704.
2. Longo UG, Franceschi F, Berton A, et al. Conservative treatment and rotator cuff tear progression. Med Sport Sci, 2012, 57: 90-99.
3. Ranebo MC, Björnsson Hallgren HC, Adolfsson LE. Patients with a long-standing cuff tear in one shoulder have high rates of contralateral cuff tears: a study of patients with arthroscopically verified cuff tears 22 years ago. J Shoulder Elbow Surg, 2018, 27(3): e68-e74.
4. Kim HJ, Kee YM, Kim JY, et al. Safe time frame of staged bilateral arthroscopic rotator cuff repair. J Shoulder Elbow Surg, 2019, 28(9): 1707-1715.
5. Lee WH, Do HK, Lee JH, et al. Clinical outcomes of conservative treatment and arthroscopic repair of rotator cuff tears: A retrospective observational study. Ann Rehabil Med, 2016, 40(2): 252-262.
6. Lee HJ, Jeong JY, Kim CK, et al. Surgical treatment of lesions of the long head of the biceps brachii tendon with rotator cuff tear: a prospective randomized clinical trial comparing the clinical results of tenotomy and tenodesis. J Shoulder Elbow Surg, 2016, 25(7): 1107-1114.
7. Shim SB, Jeong JY, Yum TH, et al. A Comparative study to evaluate the risk factors for medium-sized rotator cuff tear in patients younger than 50 years of age. Arthroscopy, 2018, 34(11): 2971-2979.
8. Rossi LA, Atala N, Bertona A, et al. Return to sports after in situ arthroscopic repair of partial rotator cuff tears. Arthroscopy, 2019, 35(1): 32-37.
9. Bureau NJ, Deslauriers M, Lepage-Saucier M, et al. Rotator cuff tear morphologic parameters at magnetic resonance imaging: relationship with muscle atrophy and fatty infiltration and patient-reported function and health-related quality of life. J Comput Assist Tomogr, 2018, 42(5): 784-791.
10. Gialanella B, Comini L, Gaiani M, et al. Conservative treatment of rotator cuff tear in older patients: a role for the cycloergometer? A randomized study. Eur J Phys Rehabil Med, 2018, 54(6): 900-910.
11. Liem D, Buschmann VE, Schmidt C, et al. The prevalence of rotator cuff tears: is the contralateral shoulder at risk? Am J Sports Med, 2014, 42(4): 826-830.
12. Chung SW, Kim JY, Yoon JP, et al. Arthroscopic repair of partial-thickness and small full-thickness rotator cuff tears: tendon quality as a prognostic factor for repair integrity. Am J Sports Med, 2015, 43(3): 588-596.
13. Rossi LA, Atala NA, Bertona A, et al. Long-term outcomes after in situ arthroscopic repair of partial rotator cuff tears. Arthroscopy, 2019, 35(3): 698-702.
14. Cheon SJ, Lee HY, Jeon WK. Arthroscopic treatment for intratendinous rotator cuff tear results in satisfactory clinical outcomes and structural integrity. Knee Surg Sports Traumatol Arthrosc, 2018, 26(12): 3797-3803.
15. Baumgarten KM, Chang PS, Dannenbring TM, et al. Does arthroscopic rotator cuff repair improve patients’ activity levels? J Shoulder Elbow Surg, 2018, 27(12): 2167-2174.
16. Yoo JC, Lim TK, Kim DH, et al. Comparison between the patients with surgery and without surgery after recommendation of surgical repair for symptomatic rotator cuff tear. J Orthop Sci, 2018, 23(1): 64-69.
17. Rhee SM, Kim DH, Kim SH, et al. The clinical outcomes and their associated factors in staged bilateral arthroscopic rotator cuff repair. Arthroscopy, 2018, 34(10): 2799-2807.
18. Abate M, Di Carlo L, Salini V, et al. Risk factors associated to bilateral rotator cuff tears. Orthop Traumatol Surg Res, 2017, 103(6): 841-845.
19. Kim YS, Kim SE, Bae SH, et al. Tear progression of symptomatic full-thickness and partial-thickness rotator cuff tears as measured by repeated MRI. Knee Surg Sports Traumatol Arthrosc, 2017, 25(7): 2073-2080.
20. Chalmers PN, Granger E, Nelson R, et al. Factors affecting cost, outcomes, and tendon healing after arthroscopic rotator cuff repair. Arthroscopy, 2018, 34(5): 1393-1400.
21. Carbone S, Gumina S, Arceri V, et al. The impact of preoperative smoking habit on rotator cuff tear: cigarette smoking influences rotator cuff tear sizes. J Shoulder Elbow Surg, 2012, 21(1): 56-60.
22. Pak CH, Moon YL, Sim SW, et al. Bilateral arthroscopic rotator cuff repair using a single-stage procedure. Orthopedics, 2015, 38(5): e423-427.

Chinese Journal of Reparative and Reconstructive Surgery

Effect of unilateral rotator cuff repair on the contralateral shoulder in patients with bilateral rotator cuff tears

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