Purpose. To evaluate the clinical results of arthroscopic repair and open Ahlgren Larsson method in patients with chronic lateral ankle instability. Methods. We retrospectively evaluated 87 patients who were operated in our clinic between 2010 and 2018 with the diagnosis of chronic lateral ankle instability. 16 patients with osteochondral lesion, 5 patients with rheumatoid arthritis, 4 patients with ankle fractures of the same side, 2 patients with a history of active or previous malignancy were excluded. Preoperative and postoperative clinical evaluations were performed with AOFAS ankle-hindfoot score, FAOS and VAS scores. Results. Sixty patients with chronic lateral ankle instability were evaluated. 28 patients, treated with Ahlgren-Larsson method and 32 patients, treated with arthroscopic repair. 36 of the patients were female and 24 were male; the mean age of the arthroscopy group was 44 ± 9; the mean age of the open surgery group was 46 ± 11. There was no significant difference between the groups in terms of demographic features (age, sex, VKI). Postoperative clinical improvement was observed in both groups. There was no statistically significant difference between the groups in terms of functionality. However, there was a statistically significant difference in pain and satisfaction of VAS in favor of arthroscopy group. Conclusions. Ahlgren-Larsson method and arthroscopic repair technique are safe and effective for chronic lateral ankle instability. Arthroscopic technique may be preferred for pain and patient satisfaction as it is less invasive and less morbid

Purpose: We hypothesised that the rate of tendon healing after arthroscopic repair of full-thickness tears of the supraspinatus is equivalent to that obtained with open techniques reported in the literature. Material and methods: We studied prospectively a cohort of 65 patients with arthroscopically repaired full-thickness tears of the supraspinatus. The patients were reviewed a mean 19 months (12–43) after repair. At arthroscopy, patients were aged 59.5 years on average (28–79). Bone-tendon sutures were performed with resorbable thread and self-locking anchors positioned on the lateral aspect of the humerus. Repair was protected with an abduction brace for six weeks. Forty-one patients (63%) accepted an arthroscan performed six months to two years after arthroscopy to assess tendon healing. Results: Ninety-four percent of the patients were satisfied with the outcome. The mean Constant score was 51.6±10.6 points preoperatively and 80.2±13.2 at last follow-up (p< 0.001). The arthroscan showed that the rotator cuff had healed in 70% of the cases (29/41). The supra-spinatus had not healed on the trochiter in eight cases (25%) and was partially healed in two (5%). The size of the residual tendon defect was less than the initial tear in all cases except one. The rate of patient satisfaction and function was not significantly different if the tendon had healed (Constant score 81.3/100, satisfaction 93%) or if there was a residual tendon defect (Constant score 77.5/100, satisfaction 92%). Shoulder force in patients with a healed tendon (6±1.9 kg) was better than in those with a tendon defect (4.5±2.8 kg), but the difference was not significant. Factors affecting tendon healing were age > 65 years (43% healing, p< 0.02), and wide tears. Conclusion: Arthroscopic repair of isolated supraspinatus tears enables tendon healing in 70% of cases as demonstrated by arthroscan. This rate was equivalent to those reported in historical series of open repair. Patients aged over 65 years had significantly less satisfactory healing. The absence of tendon healing does not compromise functional and subjective outcome despite reduced force

The results of arthroscopic repair of tears of the sub-scapularis tendon in nine men and six women, ranging in age from 53 to 73 years, were followed up at a mean of 14 months (6 to 24). Three were complete tears, six 50%-tears and six 30%-tears. In seven patients there were associated tears of the supraspinatus and infraspinatus tendons, which were repaired arthroscopically during the same procedure. In each case the subscapularis tear was identified. In most patients a biceps tenotomy was necessary. The subscapularis footprint was prepared and the tendon was repaired using one or two anchors, each with two sutures, depending on the size of the tear. The mean pre-operative and postoperative Constant scores were 48 and 88 respectively. In most patients, power returned to almost normal and pain was almost completely relieved. Arthroscopic subscapularis repair is a relatively new procedure and seems to give good results

Due to an arthroscopic’s surgery progress, almost all type of rotator cuff lesions including massive tears can be repaired. Correct preoperative surgical planning needs combination of dates coming from clinical history, diagnostic imaging and the demand of patient. Purpose: the goal of this study is to report on the arthroscopic repair of massive rotator cuff tear: surgical techniques used, outcome. Type of study: retrospective study in 2 Orthopedic Center in Rome (Italy). Methods: Between 2000 and 2007, 457 patients underwent arthroscopic repair of rotator cuff tear: 93 of these were complete massive cuff tear. The pre-op and postoperative outcomes were analyzed using the Costant Score (CS), Simple Shoulder Test (SST), a single question reflecting satisfaction. The patients were divided in 2 group: massive antero-superior and massive postero-superior cuff tear. The average age of patients was: 55–74 yrs; the average time from onset of symptoms to surgery was 16,7 months. Results: the CS score improved from 0–3 pre-op to 7–10 post op; the SST score from 18–32 pre-op to 68–90. The patient satisfaction rate was > 90%. Conclusion: The arthroscopic repair of massive rotator cuff tear is an effective procedure for decresing pain and improving function of the shoulder. The patient satisfaction rate is very high. The right indication to surgery, the correct surgical procedure and the appropriate physical terapy are the keys of success

Purpose of the study: Completely arthroscopic repair of rotator cuff tears is widely considered as the standard treatment. We reviewed a multicentric retrospective series of patients. Material and methods: This series of arthroscopic repairs of full-thickness tears of the supraspinatus and infraspinatus were assess with the Constant score together with arthroMRI or arthroscan at one year follow-up at least. Data were analyzed with SPSS10. The series included 576 patients who underwent surgery from January 2001 to June 2003. Mean age was 57.7 years, 52% males and 60% manual laborers. Mean preoperative Constant score was 46.4/100 (r13.4). The tear was limited to the supraspinatus in 69% of patients with extension to the upper third of the infraspinagus for 23.5% and to all tendons for 7.5%. The supraspinatus tear was distal in 41.7% of patients, intermediary for 44%, and retracted for 14.3%. Arthroscopic repair was performed in all cases, with locoregional anesthesia for 60.9%. Implants were resorbable for 33% and metallic for 62.1%. Acromioplasty was performed for 92.7% and capsulotomy for 14.9%. Results: The mean subjective outcome was scored 8.89/10. The Constant score improved from 46.3±13.4 to 82.7±10.3 with 62% of patients being strictly pain free. The force score improved from 8.5±3.7 to 13.6±5.4. Outcome was excellent or very good for 94% of the shoulders at 18.5 mean follow-up. The rate of complications was 6.2% with 3.1% of patients presenting prolonged joint stiffness, 2.7% reflex dystrophy, 0.2% infection and 0.2% implant migration. The cuff was considered normal in 55.7% of the shoulders with an intratendon addition image for 19%, i.e. 74.7% non-torn cuffs. A point leakage was noted in 9.5% with pronounced leakage in 15.7%, i.e. 25.2% recurrent tears. Discussion and conclusion: The functional outcome obtained after arthroscopic repair of rotator cuff tears is good. Arthroscopy has the advantage of a low rate of complications yet provides good clinical and anatomic results. Age is correlated with functional outcome and healing, but should not be considered as a contraindication

Abstract. Aims. We studied the outcomes following arthroscopic primary repair of bucket handle meniscus tears to determine the incidence of re-tears and the functional outcomes of these patients. Methodology. Prospective cohort study. Over a 4-year period (2016 to 2020), 35 adult patients presented with a bucket handle tear of the meniscus. Arthroscopic meniscal repair was performed using either the all inside technique or a combination of all-inside and inside-out techniques. 15 patients also underwent simultaneous arthroscopic anterior cruciate ligament reconstruction. Functional knee scores were assessed using IKDC and Lysholm scores. Results. Mean patient age at surgery was 27 years (range, 17 to 53years). Medial meniscus was torn in 20 and lateral in 15 cases. Zone of tear was white on white in 19, red on white in 9 and red on red in 7 cases. Average delay from injury to surgery was 4 months. At a mean follow-up of 4.5 years, the meniscus repair failed in 3 patients (8.5 %). Outcome following re-tear was meniscus excision. Average IKDC scores in patients with intact repair were 74.04 against 56.67 in patients with a failed repair (p< 0.0001). Similarly, Lyshlom scores were 88.96 and 67.333, respectively (p<0.0001). Conclusion. The survivorship of primary repair of bucket handle meniscus tears in our series was 91.5% at medium term follow-up. Functional outcomes were significantly poor in patients with a failed repair compared to those with an intact repair

Aims. We studied the outcomes following arthroscopic primary repair of bucket handle meniscus tears to determine the incidence of re-tears and the functional outcomes of these patients. Methodology. Prospective cohort study. Over a 4-year period (2016 to 2020), 35 adult patients presented with a bucket handle tear of the meniscus. Arthroscopic meniscal repair was performed using either the all inside technique or a combination of all-inside and inside-out techniques. 15 patients also underwent simultaneous arthroscopic anterior cruciate ligament reconstruction. Functional knee scores were assessed using IKDC and Lysholm scores. Results. Mean patient age at surgery was 27 years (range, 17 to 53years). Medial meniscus was torn in 20 and lateral in 15 cases. Zone of tear was white on white in 19, red on white in 9 and red on red in 7 cases. Average delay from injury to surgery was 4 months. At a mean follow-up of 4.5 years, the meniscus repair failed in 3 patients (8.5 %). Outcome following re-tear was meniscus excision. Average IKDC scores in patients with intact repair were 74.04 against 56.67 in patients with a failed repair (p< 0.0001). Similarly, Lyshlom scores were 88.96 and 67.333, respectively (p<0.0001). Conclusion. The survivorship of primary repair of bucket handle meniscus tears in our series was 91.5% at medium term follow-up. Functional outcomes were significantly poor in patients with a failed repair compared to those with an intact repair

The purpose of the study was to determine how suture materials commonly used in arthroscopic surgery were affected by electrocautery. The effects of electrocautery were evaluated on four different suture materials commonly used in arthroscopic surgery; PDS, Ethibond, Orthocord and Fibrewire. Single suture strands were tied around two plastic rods immersed in a saline filled water bath at 37°C. Sutures were exposed to heat using the Mitek VAPR 3 electrosurgical unit and a corresponding side electrode. This was used on the high intensity vaporisation setting, at a power level of 240W. The electrode was applied directly to the suture strand, under tension, until the strand was completely burnt through. Fibrewire demonstrated a significantly higher burn through time in comparison to the other materials tested (83.30±38.69s, p< 0.001). Orthocord also demonstrated high heat tolerance (38.96±12.64s), which was significantly higher than both PDS (1.61±0.25s) and Ethibond (0.93s±0.06s) (p< 0.001). This is the first study to our knowledge assessing the tolerance of suture materials to electrocautery. This has important implications for the arthroscopic surgeon. On completion of an arthroscopic repair, the surgeon must always be extremely cautious, for fear of damaging the suture material and compromising their soft tissue repair. This study demonstrates that both Fibrewire and Orthocord can tolerate prolonged, direct heat application from electrocautery. We therefore conclude that short bursts of soft tissue vaporisation, after completing an arthroscopic repair with Fibrewire or Orthocord, are unlikely to have a detrimental effect on the suture material. However care should be exercised by the surgeon using Ethibond or PDS

Postoperative stiffness (POS) of the shoulder may occur after an apparently successful reconstruction of a rotator cuff tear. The role of the peripheral nervous system in tissue healing has only recently been recognized. We determined the plasma levels of SP in patients with postoperative stiffness after arthroscopic repair of a rotator cuff tear, and compared them with those in patients with a good outcome after arthroscopic rotator cuff repair. Plasma samples were obtained at 15 months from surgery from 2 groups of patients who underwent arthroscopic repair of a rotator cuff tear. In Group 1, 30 subjects (14 men and 16 women, mean age: 64.6 years, range 47 to 78) with shoulder stiffness 15 months after arthroscopic rotator cuff repair were recruited. In Group 2, 30 patients (11 men and 19 women, mean age: 57.8 years, range 45 to 77) were evaluated 15 months after successful arthroscopic rotator cuff repair. Immunoassays were performed with commercially available assay kits to detect the plasma levels of SP. Statistical analysis were performed with Wilcoxon Sign Rank test. Significance was set at P< 0.05. The concentrations of the neuropeptide SP in sera were measurable in all patients. Patients with postoperative stiffness had statistically significant greater plasma levels of SP than patients in whom arthroscopic repair of rotator cuff tears had resulted in a good outcome (P < 0.05). Postoperative stiffness (POS) of the shoulder may occur after an apparently successful reconstruction of a rotator cuff tear. An increased amount of SP in the subacromial bursa has been correlated with the pain caused by rotator cuff disease. SP stimulates DNA synthesis in fibroblasts, which are the cellular components of the adhesive capsulitis of the shoulder. Also, SP is a pain transmitter peptide, and pain may cause a secondary muscular and/or capsular contracture. Our results show that the plasma concentrations of substance P in patients with shoulder stiffness after arthroscopic rotator cuff repair are higher compared to plasma levels of SP in patients with a good postoperative outcome. We cannot determine the cause of POS in our patients, but the findings of this study suggest a possible neuronal role in the pathophysiology of POS after arthroscopic repair of rotator cuff tears. The knowledge of the pathophysiological role of sensory nerve peptides in tissue repair in these patients could open new therapeutic options to manage conditions of the musculo-skeletal system with impaired tissue-nervous system interaction

Purpose: Arthroscopic repair of type II SLAP lesions can lead to improved clinical outcomes. However, the structural integrity of arthroscopically repaired type II SLAP lesions is unknown. The purpose of this study was to evaluate the clinical outcome of arthroscopically repaired type II SLAP lesions, and to evaluate the appearance of the repair on MRI arthrogram performed at least 1 year post-operatively. Method: Between March 2003 and June 2006, the senior author performed isolated repairs of 25 type II SLAP lesions in 25 patients (18 male, 7 female) with a mean age of 40 +/− 12 years. The mean duration of symptoms was 32 months. None of the patients had undergone previous surgery on the affected shoulder. All tears were repaired using standard arthroscopic suture anchor repair to bone. All patients were reviewed using a standardized clinical examination by a blinded, independent observer, and using the ASES shoulder index and the simple shoulder test (SST). Paired and unpaired t-tests were used to determine significant differences between pre-operative and post-operative scores and re-torn and intact SLAP repairs, respectively. A p< 0.05 was considered statistically significant. In addition, 20 of the 25 patients were evaluated by MRI arthrography at least 1 year post-operatively which was interpreted by a musculoskeletal trained radiologist who was blinded to the patient’s clinical outcome. Results: Follow-up was an average of 24.9 months. The mean ASES scores improved from 51.7 pre-operatively to 86.3 Follow-up was an average of 24.9 months. The mean ASES scores improved from 51.7 pre-operatively to 86.3 post-operatively (p< 0.0001) and the SST scores from 7.76 to 10.76 (p< 0.001). Twenty-two out of the 25 patients stated that they would have surgery again and there was a mean patient satistifaction of 8.7+/− 1.4 out of 10. Of the 20 patients who had post-operative MRI arthrograms, no patient had an obvious recurrent type II SLAP lesion, 8 patients had equivocal MRI arthrograms with a small amount of Gadolium insinuiating between labum and bone, and 12 patient had a completely intact superior labrum. There was no significant difference in ASES, SST and patient satisfication scores between patients with equivocal or competely intact repairs (ASES= 87.7 versus 85.4; p = 0.71; SST = 10.8 versus 10.8; p = 0.97; Pt satistifaction = 8.2 versus 8.8; p = 0.40). However, of the three patients who were not satisfied with the procedure (i.e. would not have the surgery again) two had postoperative MRI arthograms and both had equivocal SLAP repairs. Conclusion: Clinical outcomes following arthroscopic repair of type II SLAP lesions showed statistically significant improvement in shoulder scores from pre to post-operative. MRI arthrogram results do not necessarily correlate with clinical outcome

Purpose: the purpose of this study was to evaluate the outcome of arthroscopic repair of the medial patello femoral joint capsule (MPFJC) and its supporting structures in traumatic patello femoral instability (TPFI). Type of study: prospective case series. Material and methods: 24 patients 15 male and 9 female with traumatic patello femoral instability (TPFI) were treated with arthroscopic repair of the medial patello femoral joint capsule regardless of the injury chronology using 2/0 vicryle stitches by outside-in technique lateral release were not required, average age at the operation was 23,2 years (range 20–26) with 1 patient was 33, average time from injury to operation 3mounths (range 1–8 months) with 1 patient had the injury for 3 years. The patients evaluated at 10 days, 3 weeks, 6 weeks, 3 months and every 3 months afterward up to 1 year. Average follow up was 9,3 months (range 3–12mounths). Subjective data were calculated using the IKDC system, objective data included a comprehensive knee examination and evaluation and comparing it with normal side, which was used as a reference. Results: at the final review all patients were satisfied with their knees, the IKDC final score improves from 54pre op to 93. There has been no recurrence of the instability or tenderness around the knee, nil infection rate, normal side-to-side movement of the patella comparing with normal side, full range of motion, and normal quadriceps belly and strength. The patient returned to light sports activities at 6 weeks, and to their pre injury level of sport at 3 months. Conclusion: we feel that our approach to treat TPFI is a reliable, safe, and cost effective. Our results are encouraging, although we feel that longer follow up might be required

Purpose of the study: Surgical treatment of rotator cuff tears (RCT) in the older subject is genearlly considered to best involve simple debridement without any attempt at repair. This is however no evidence concerning the healing capacity of tendon repairs after RCT in the older subject. The purpose of this study was to assess the functional outcome of arthroscopically repaired RCT in subjects aged over 65 and to determine the healing pattern. Materials and Methods: This was a non-randomized prospective study which included patients aged over 65 years who presented a full thickness RCT repaired arthroscopically. The patients were evaluated preoperatively and at last follow-up with the simple shoulder test (SST) and the Constant score. A control arthroscan was obtained systematically six months postoperatively. Results: From January 2001 through December 2004, 88 patients, mean age 70 years were included in this study with a mean follow-up of three years (range 2–5 years). The tear involved two tendons in 45 shoulders, the frontal retraction was distal in 58 shoulders, the index of fatty degeneration was 0.6 (range 0–3) preoperatively and 13 patients presented stage 1 chondral lesions. The SST improved from 2.4 (range 1–6) preoperatively to 9.7 (3–12) at last follow-up (p< 0.001) and the Constant score from 45 (10–70) to 77.7 (49–93) (p< 0.001) Seventy-seven patients (87.5%) had a control arthroscan and 45 had an intact cuff. For the patients with an intact cuff, the SST was 10.6 and the Constant score 81.6 versus respectively 7.8 and 72.1 for patients with a non intact cuff (p< 0.001). Factors predictive of non healing were size of the tear (p=0.02), its frontal extension (p=0.01), its tendinous aspect (p=0.02) and difficult reduction (p=0.005). There was no increase in the size of the tears (p=0.46). Six patients presented Hamada stage 1 osteoarthritis at last follow-up. Discussion: This study is the first to demonstrate objective evidence of tendon healing after arthroscopic repair of RCT in patients aged over 65 years. In 59% of the patients, the arthroscan demonstrated intact cuffs with a significant improvement in the functional results. Conclusion: Arthroscopic repair of RCT in subjects aged over 65 years provides satisfactory results and can be proposed as treatment

Aim: To evaluate the results of arthroscopic repair of anterior and superior glenoid labral tears in the shoulder with metallic knotless suture anchors with an average follow up of 31 months. Material and methods: Between 2000 and 2002, 55 patients with labral tears underwent arthroscopic repair with metallic knotless suture anchors (Mitek, Ethicon Ltd). Their average age was 36 years (range 16 to 67). Thirty-seven patients presented with anterior instability. Twenty-one patients presented with painful shoulder without instability. In the instability group there were eight acute dislocations and twenty-nine recurrent dislocations. All patients underwent examination under anaesthesia, arthroscopic repair of labral tears using the metallic knotless suture anchors, thermal capsulorraphy and closure of the rotator interval. Subacromial decompression was performed when indicated. Rehabilitation consisted of sling immobilisation for four weeks followed by gradual strengthening program over three months with the physiotherapist. Contact sports were allowed at 1 year. Evaluation: Patients were evaluated preoperatively and at the time of final follow-up using Constant score and Modified Rowe – Zarin score system. Results: Three out of the thirty-seven patients in the instability group had recurrent dislocation. A fourth patient had pain with a positive anterior apprehension test thus making the overall recurrence rate of 11%. In the painful shoulder group, good and excellent results were recorded in twenty out of twenty-one patients (95%). Of the fifty five patients who had labral repair, five had poor functional outcome secondary to pain in their shoulder (9%). One patient had a fall and required further surgery to replace one dislodged anchor. Conclusions: We found the metallic knotless suture anchor easy to use and stabilised the torn labrum well. The success rate for instability compares well with the published literature. However, we have some concern of our observation of early degenerative changes in some of our patients treated for recurrent dislocation

Purpose of the study: Arthroscopic repair of rotator cuff tendons is a well-described technique. Clinical outcome is good. The purpose of this work was to assess tendon healing as observed with the arthroscan after arthroscopic repair of rotator cuff tears. We search for epidemiological, anatomic, and technical factors predictive of healing. Material and methods: This was a prospective consecutive non-randomized series of 167 shoulders. All patients were assessed preoperatively with the Constant clinical score and had a standard imaging protocol for assessing the status of the rotator cuff. Arthroscopic repair was used in all cases. Outcome was assessed with the Constant score and an arthroscan was available for 148 patients. Results: Mean patient age was 59 years, 49% male and 77% dominant side. Mean duration of symptoms before repair was nine months. The tear resulted from trauma in 28% and was a work accident in 9%. The preoperative functional assessment was 52.48. An isolated supraspinatus tear was observed in 68% of the shoulders. Frontal retraction of the supraspinatus was distal in 74%. For 29 shoulders, reduction was difficult and the quality of the tendon was considered normal in 56. Non-anatomic repair was required in six cases. The Constant score at last follow-up (19 months) was 80. An arthroscan was available for 148 shoulders: healing was anatomic in 69, defective healing was observed in 27 and repeated tears were noted in 52. Factors predictive of healing were: demographic (lesion duration less than six months, non-dominant side, young patient, female gender, sedentary lifestyle); anatomic (isolated lesion of the supraspinatus with little extension and no retraction); technical (normal easily reduced tendon, good quality bone). Discussion: The time before surgical management of rotator cuff tears was an important factor in this study. Tendon and muscle alterations after rotator cuff tears could explain, at least in part, healing failures. Conclusion: This study confirmed the good functional and anatomic results obtained with arthroscopic repair of rotator cuff tears

We evaluated the effectiveness of arthroscopic repair in patients with shoulder instability owing to a bony fragment as part of the Bankart lesion, using spiked Suretacs, sutures and anchors. Over a two-year period, we followed up 23 of 25 consecutive cases, all with a bony fragment as part of the Bankart lesion. The mean age of patients, all of whom were male, was 21 years (17 to 35). Almost all injuries were sustained playing sports. Patients were clinically evaluated at six weeks and 20 weeks postoperatively and interviewed telephonically. Full arthroscopic examination was performed in a lateral decubitus position. The affected capsular structures and labrum, with its attached bony fragment, were fully mobilised. The bony fragment was always attached to the capsular structures, with labral ring intact. We used a spiked Suretac anchor to reattach the bony fragment to its original anatomical position, and Mitek anchors and no. 1 Ticron sutures for individual reattachment of the capsule and ligaments. Postoperatively patients were immobilised in a shoulder sling for six weeks. Early restricted active and passive movements were advised. Patients routinely received postoperative physical and biokinetic rehabilitation. The mean follow up period was 16 months (5 to 29). There was no redislocation or subjective instability. This technique yields excellent results, but because it is technically difficult should be used only by experienced shoulder arthroscopists with thorough knowledge of pathological shoulder anatomy

To analyze the relationship between functional outcome and tissue quality after arthroscopic rotator cuff repair. One hundred and forty-five patients who had undergone arthroscopic repair of rotator cuff tear, during the period of 2003–2008, were evaluated. All operations were performed under the same surgeons. The mean follow-up period was 2.4±1.2 years (range, 0.5 to 5 ys). The patients were devided in two groups:. patients with good tissue quality and. patients with poor tissue quality. As good tissue quality is defined the tendon with enough mass for suturing (thickness> 3mm) and good elasticity (the footprint is covered properly under tendon traction with tissue grasper). The independent variable studied here was the tissue quality of rotator cuff tendon. Clinical outcomes preoperatively and postoperatively, were assessed with use of ASES, CONSTANT and UCLA scores. Statistical analysis was performed by using STATA 8.0. Good tissue quality was identified in 119 patients (82%) and poor tissue quality in 26 (18%) patients respectively. At the follow up the patients with good tissue quality achieved Constant score: 86.85±12.49, ASES score: 84±3.4, UCLA score: 28.7±1.9 and the patients with poor tissue quality achieved Constant score: 62.35±13.85, ASES score: 61.49±8.9, UCLA score: 21±3.2. Significant difference between the two groups concerning the clinical outcome was observed after adjusted the data for age. Besides high correlation was noticed between old age and increased rate of poor tissue quality (r=0.88). Better clinical outcomes are expected in patients associated with good tissue quality, adjusted for age. So the tissue quality is positively correlated with the final functional outcome

Purpose: The aims of this study were to describe our technique and outcome of arthroscopic repair of small rotator cuff tears. Methods: The technique involves two screw-in anchors placed into the footprint area, linked with a double-loop No. 1 Polydioxanone suture. It is quick and simple, providing a similar fixation to other commonly used methods. Between 1999 and 2001, 20 repairs were performed using this technique in patients with rotator cuff tears < 2cm in size. Prospective follow-up was conducted on these patients. Mean age was 56.5yrs (range 37–72yrs) with 10 males and 10 females (8 left and 12 right sided cuff tears). Results: Mean follow-up period was 13mths (range 10–28mths). Constant scores improved from preoperative mean 34 (range 22–53) to postoperative mean 85 (range 76–96). Pain scores (/15) improved from preoperative mean 3.7 to postoperative mean 13.4. All regained full range of movement. All were satisfied with the operation. There was an average 90% subjective improvement. There were no complications. Conclusion: Arthroscopic rotator cuff repair for small tears produces satisfactory results using this technique

This is a retrospective study of 33 of 48 arthroscopic repairs of partial rotator cuff tears performed more than 2 years ago. Repairs were done by one of four techniques: transtendon, side-to-side, completion of tear and side-to-side, or completion of tear and anchor repair. All patients completed UCLA shoulder score and Western Ontario Rotator Cuff (WORC)© score questionnaires. We had 91% excellent or good UCLA shoulder scores and 85% excellent or good WORC© scores. Repair technique, tear classification, comorbidity or postoperative stiffness (experienced by 36% of patients) did not significantly affect outcome scores

Patient outcomes for arthroscopic repairs rotator cuff repairs have been analyzed almost exclusively by means of a single post-operative follow-up date. The purpose of this study was to examine the results of arthroscopic repairs of large rotator cuff tears performed by a single surgeon, both serially and at a two-year endpoint following surgery. Seventeen patients with retracted U-shaped tears involving the supraspinatus were repaired arthroscopically between June 2002 and October 2003 using marginal convergence suturing followed by tendon-to-bone fixation. Patients were assessed at six weeks, three months, six months, one year, and two years following surgery. Each assessment consisted of a medical history, physical examination, and the Western Ontario Rotator Cuff (WORC®) questionnaire. Evaluation at the two-year study endpoint also included range of motion measurements and a modified University of California Los Angeles (UCLA) scoring system. During the follow-up period, the three-month average WORC score (63.1%) was the first statistically significant difference from the pre-operation mean of 40.7%. WORC scores peaked at six months post-op (75.5%), and plateaued after this date. The one- and two-year average WORC scores (74.2% and 69.5%, respectively) did not differ significantly from the peak score achieved after six months. At the final two-year follow-up, the average UCLA score was 27.1. Fourteen of seventeen patients (78%) were satisfied with their surgical outcome. When workers’ compensation claimants were excluded from the results, the average UCLA score was 32.0 and patient satisfaction was 100%. There was no significant difference in average range of motion between the surgically-repaired shoulder and the unaffected shoulder. This study shows that shoulder function improved significantly by three months after arthroscopic rotator cuff surgery and plateaued at six months post-op as measured by the WORC index. There was no statistically significant change in WORC score after six months post-op

The assessment of the long –term outcome (5 years) of patients treated with arthroscopic stabilization for acute traumatic patellar dislocation. From September 2004 until April 2009 we treated 29 patients (25 male, 4 female) with a median age of 18 years (range 14–23 years), two of them had suffered from traumatic dislocation of the patella of the other knee joint in the past. The median range from injury to our surgical intervention was 20 days (7–29 days). The return in sporting activities, the possible redislocation or joint instability and the subjective assessment of the symptoms of the patients, were evaluated in a 5 years follow-up. After 5 years, 23 patients (20 males, 3 females), were re-evaluated. After the arthroscopic medial retinacular repair all the patients return to sporting activities. All the patients presented chondral lesions at the medial facet of the patella and to the lateral femoral condyle and hemarthrosis too. The functional outcomes were evaluated with Kujala scoring scale, with Visual analog scale and Tenger scale the range of results was good. The acute arthroscopic repair of the medial retinacular ligaments, protects the patient from redislocation or subluxation, allows the evaluation and stabilisation of the chondral lesions, the removal of free chondral bodies, as well as the evaluation of the possible damage to the menisci or ACL, PCL ligaments. All the patients returned to normal sporting activity avoiding further injury, or the development of osteoarthritis of the knee joint