Long-term outcome for arthroscopic repair of partial articular-sided supraspinatus tendon avulsion.

PURPOSE: To assess the long-term clinical outcome of arthroscopic transtendon repair of partial articular-sided supraspinatus tendon avulsion (PASTA) lesions using University of California, Los Angeles (UCLA) and Short Form 36 (SF-36) scores. METHODS: We prospectively collected and retrospectively reviewed data on 15 patients who underwent arthroscopic transtendon PASTA repair between 1997 to 2001. The mean patient age was 50.4 years (range, 31 to 68 years). Mean follow-up was 13.5 years (range, 12 to 15 years). To determine clinical outcome, UCLA and SF-36 scores were obtained preoperatively, at 1 to 3 years postoperatively, and again at final postoperative evaluation. RESULTS: Of the 15 patients enrolled in this study, 13 underwent concomitant procedures, including 10 subacromial decompressions, 2 open and one arthroscopic biceps tenodesis, 2 SLAP repairs, and one Bankart repair. There were no complications. A revision rotator cuff repair was performed 8 years after the index procedure in one patient (7%), indicating a 93% long-term success rate for arthroscopic PASTA repair. A significant difference (P < .0001) was noted between preoperative and postoperative UCLA scores. Pain and shoulder function improved in all patients. SF-36 scores showed improvement in physical health, physical functioning, and bodily pain (P = .003, P = .005, and P = .005, respectively). All 15 patients were satisfied with the surgery. CONCLUSIONS: Long-term follow-up shows that arthroscopic transtendon PASTA repair provides reliable and sustained pain relief and improvement in shoulder function. LEVEL OF EVIDENCE: Level IV, therapeutic case series.

Utility of polymer cerclage cables in revision shoulder arthroplasty.

Revision shoulder arthroplasty often requires humeral osteotomy for stem extraction or is complicated by periprosthetic fracture. In these situations, various modes of fixation are used, including cerclage wires, cable plates, and allograft strut augmentation. The use of metal wires and cables, however, has been associated with soft tissue irritation, sharps injuries, and accelerated wear of joint arthroplasty bearing surfaces. As an alternative to traditional metal cables, the SuperCable (Kinamed Inc, Camarillo, California) contains braided ultra-high molecular-weight polyethylene fibers surrounding a nylon core. To date, no studies have examined the use of nonmetallic cerclage cables in shoulder arthroplasty.A retrospective review was performed of 11 patients who underwent shoulder arthroplasty for which nonmetallic cerclage cables were used. Clinical and radiographic data were examined regarding patient age, procedure performed, indication for cerclage cabling, time to healing of osteotomy or fracture, and any complications associated with the use of these cerclage cables. Minimum follow-up was 1 year. Ten patients underwent reverse total shoulder arthroplasty, and 1 patient underwent revision unconstrained total shoulder arthroplasty. Mean follow-up was 20.5 months. Ten patients required humeral osteotomy for stem or cement removal. Allograft augmentation was performed in 7 patients. Mean time to healing was 3.2 months. No patients experienced loosening or migration of hardware or allograft, and no complications directly related to the use of nonmetallic cerclage cables were identified.