ORLANDO — Microfracture of the greater tuberosity increased the healing of large rotator cuff tears, but researchers found no significant change in functional outcomes, according to a presentation here at the Arthroscopy Association of North America Annual Meeting.
“The purpose of this study was to compare the clinical and imaging of arthroscopic rotator cuff repair with and without microfractures of the greater tuberosity,” Giuseppe Milano, MD, said. “The hypothesis was that microfractures would provide better results than those provided by simple cortical abrasion in arthroscopic rotator cuff repair.”
Milano and researchers performed a prospective randomized controlled study of 80 patients with full-thickness rotator cuff tears who underwent single row repair. Forty patients in group 1 underwent debridement of the greater tuberosity and 40 patients in group 2 underwent microfractures of the greater tuberosity. The study excluded patients with partial-thickness and irreparable cuff tears, subscapularis tears, labral pathology, os acromiale, degenerative arthritis of glenohumeral joint, symptomatic arthritis of acromioclavicular joint, rotator cuff arthropathy, previous surgery to the same shoulder and workers’ compensation claims. Primary outcome measures were DASH scores, Constant scores, structural integrity on MRI and logistic regression and multivariate linear analyses. Mean follow-up was 28 months.
The researchers found no significant difference in DASH or Constant scores between groups. On MRI, tendon healing was 52.6% in group 1 and 65.7% in group 2, which Milano said was statistically significant. Multivariate analysis showed age, gender, timing of symptoms, tendon retraction and fatty degeneration influenced clinical outcomes.
“Microfractures did not significantly influence clinical outcome of arthroscopic rotator cuff repair but significantly increased the healing rate of large cuff tears,” Milano said.
- Milano G, Deriu L, Saccomanno MF, et al. Efficacy of marrow-stimulating technique in arthroscopic rotator cuff repair: A prospective randomized study. Paper #SS-15. Presented at the Arthroscopy Association of North America Annual Meeting 2012. May 17-19. Orlando.
- Disclosure: Milano has no relevant financial disclosures.