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Subject Area

Orthopedic Surgery

Article Type

Original Study

Abstract

Objective To evaluate arthroscopic-assisted versus all-arthroscopic suture-anchor repair of massive rotator-cuff tears (RCTs), especially regarding postoperative patient's return to work. Background Massive RCTs represent a challenging problem for shoulder surgeons. Management of RCT aims at pain relief, movement restoration, and improvement of the shoulder function. Patients and methods A prospective study of 38 patients having massive RCT, conducted at Menoufia University Hospital and Neurosurgery Hospital between September 2019 and March 2021. Patients were divided into group A, which included 19 patients who were managed by arthroscopic-assisted technique. Group B included 19 patients who were managed by all-arthroscopic technique. Full history taking with complete clinical examination. All patients have completed 6-month postoperative follow-up. Primary outcome Postoperative patient's time to return to work. Results Our results found that postoperatively, there was statistically highly significant improvement in range of motion and University of California, Los Angles score in each group with a statistically nonsignificant difference between both groups. Comparison between both groups in time to return to work: postoperatively, there was a statistically nonsignificant difference between both groups in time to return to work, but in the all-arthroscopic group (group B), the patient returned to work slightly earlier. Conclusion Both arthroscopic-assisted and all-arthroscopic procedures are effective in management of massive RCTs and result in significant improvement in clinical, functional outcomes, and patients' return to preinjury level of activity and work with a statistically nonsignificant difference between them, and both procedures could be used as an alternative repair method for massive RCTs.

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