Joe Tippet Staged Rotator Cuff Repair

METHOD 26 patients year follow-up 26 patients year follow-up

METHOD UCLA Scale Xray Cybex Physical exam UCLA Scale Xray Cybex Physical exam

ASSOCIATED FINDINGS 5 full thickness rotator cuff tears 5 partial thickness tears 4 glenohumeral DJD 5 full thickness rotator cuff tears 5 partial thickness tears 4 glenohumeral DJD

ASSOCIATED SURGERY 4 rotator cuff repairs 1 rotator cuff debridement 4 rotator cuff repairs 1 rotator cuff debridement

RESULTS UCLA Score –Mean 32/35 –Range UCLA Score –Mean 32/35 –Range

RESULTS - UCLA Excellent20 Good 2 Fair 2 Poor 2 Excellent20 Good 2 Fair 2 Poor 2

RESULTS - PHYSICAL EXAM ROM Full 22 ROM decreased 4 AC joint tenderness 1 ROM Full 22 ROM decreased 4 AC joint tenderness 1

RESULTS - XRAY cm resection Calcification 5/ cm resection Calcification 5/26

Joe Tippet Staged Rotator Cuff Repair

Results – AANA patients Stage I 75% good & excellent 7.5 patients Stage I 75% good & excellent

Results – AANA Patients Stage II 95% good & excellent 30 Patients Stage II 95% good & excellent

Conclusions Residual defect is not painful Debridment vs Repair Ogilvie – Harris Residual defect is not painful Debridment vs Repair Ogilvie – Harris

Conclusions Goal is to restore biomechanics Allografts and tendon transfer not necessary Goal is to restore biomechanics Allografts and tendon transfer not necessary

Results – AANA Patients Stage II 95% good & excellent 30 Patients Stage II 95% good & excellent

Results – AANA patients Stage I 75% good & excellent 7.5 patients Stage I 75% good & excellent

Rotator Cuff Tears Partial and Staged John F. Meyers, M.D.

Rationale

Harryman Ultrasound 50% of tears > supraspinatus had recurrent defect Ultrasound 50% of tears > supraspinatus had recurrent defect

Calvert Arthrogram 18 of 20 shoulders leaked 17 no pain 15 full elevation Arthrogram 18 of 20 shoulders leaked 17 no pain 15 full elevation

Burkhart “Functional Rotator Cuff Repair”

Anatomically deficient Biomechanically intact Anatomically deficient Biomechanically intact

Average Tear 20.1cm 4x5 cm 20.1cm 4x5 cm

Average Residual defect 2.9 cm 1x3 cm 2.9 cm 1x3 cm

Results 2 excellent 6 good 5 fair 1 poor 2 excellent 6 good 5 fair 1 poor

Results Gained 90° forward flexion Gained 2.3 grades of strength Gained 90° forward flexion Gained 2.3 grades of strength

Conclusions Residual defect is not painful Debridement vs repair Ogilvie – Harris Residual defect is not painful Debridement vs repair Ogilvie – Harris

Conclusions Goal is to restore biomechanics Allografts and tendon transfer not necessary Goal is to restore biomechanics Allografts and tendon transfer not necessary

Rotator Cuff Tears Partial and Staged Repair John F. Meyers, M.D.