Publications by authors named "Rocco De Vitis"

17 Publications

  • Page 1 of 1

Elastic stable intramedullary fixation using epibloc versus crossed kirschner wires fixation for distal forearm fractures in children: A retrospective analysis.

Afr J Paediatr Surg 2022 Jul-Sep;19(3):153-159

Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Background: Childrens' distal forearm fractures (DFFs) could be treated conservatively with closed reduction and immobilisation, but post-reduction displacements often occur. Displaced DFF should be surgically fixed, to avoid further displacement. Nevertheless, immobilisation after surgery is recommended. Epibloc system (ES), a system of stable elastic nail fixation, is widely used to stabilise adults extra-articular distal radius fractures, with advantages to not requiring post-surgical immobilisation. The present investigation represents a retrospective analysis of paediatric patients with DFF treated with ES applied with a minimal technical variation, to fix both ulna and radius fractures using a unique device.

Materials And Methods: A retrospective analysis was performed on 44 children (age 6-11 years) who underwent closed reduction and internal fixation because of DFF (both ulna and radius). Group A (21 patients): ES fixation. Group B (23 patients): K-wires and short arm cast fixation. The primary outcome was the subsistence of reduction monitored through X-rays. The secondary outcome was the measurement of active range of motion (AROM) and the time of recovery.

Results: No differences were observed comparing Group A and B in terms of the maintenance of reduction (P > 0.05). Seven days after the implant removal, patients in Group A reached significantly better results compared to patients in Group B in terms of AROM (P < 0.05). No differences were revealed in terms of complications between the two groups.

Conclusion: ES applied with a minimal technical variation is safe and effective in treating distal ulna and radius fractures, with minimal requirement of post-surgical rehabilitation.
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http://dx.doi.org/10.4103/ajps.AJPS_178_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9290372PMC
July 2022

Extension Block Pinning Vs Single Kirshner Wiring To Treat Bony Mallet Finger. A Retrospective Study.

Acta Biomed 2022 03 10;92(S3):e2021535. Epub 2022 Mar 10.

Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy. Università Cattolica del Sacro Cuore, Roma, Italia..

Background And Aim: Bony Mallet Finger or Mallet Fracture is a common injury of the hand, which follows a forced flexion of the extended distal interphalangeal joint, that leads to a bony avulsion of the distal phalanx. Depending on fracture extension and dislocation, those lesions can either be treated conservatively or surgically. Several surgical options have been described in the literature. The aim of this study is to compare retrospectively two percutaneous pinning techniques: the extension block technique according to Ishiguro vs an original single Kirshner wiring (Umbrella technique).

Methods: Between January 1998 and December 2019, among all patients treated surgically for a Mallet Fracture with either the Ishiguro' and the Umbrella technique, 98 have been included in this study. All patients have been assessed one year after surgery using the Crawford method.

Results: With both techniques better results have been achieved in younger patients and for those treated early. The umbrella technique seems to have better results in patients with fracture classified as 2b or 2c (Wehbe and Schneider classification), whereas the Ishiguro technique seems more appropriate for patients with a 1b fracture. Complication rate and typology vary depending on the used technique.

Conclusions: The Ishiguro' and the Umbrella technique both lead to good results for the treatment of surgical Mallet Fractures. The choice of the best type of pinning should mainly depend on fracture extension and time elapsed from trauma.
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http://dx.doi.org/10.23750/abm.v92iS3.12484DOI Listing
March 2022

Primary lymphoma of the medial cutaneous nerve of the forearm: the first case in a pure sensory nerve of the upper limb.

BMJ Case Rep 2022 Mar 30;15(3). Epub 2022 Mar 30.

Department of Geriatrics Neurosciences and Orthopedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Lazio, Italy.

Primary lymphoma of the peripheral nerve is very rare and occurs most frequently in sciatic nerves. We describe the first patient reported in literature with a primary lymphoma in a pure sensory peripheral nerve of the upper limb. A woman in her 40s, with painful swelling and dysaesthesias in her left forearm in the past 3 months, was presented at our unit. Clinical MRI and ultrasound findings revealed a lesion that showed signs of a peripheral nerve sheath tumour. After complete excision, morpho-pathological evaluation revealed a primary B-cell lymphoma. The patient underwent radiotherapy and at the last follow-up there were no signs of residual pathology. Peripheral neuropathy may be caused by a lymphoma involving the nerve. Hand surgeons have to distinguish primary lymphoma of the peripheral nerves from schwannoma for their different clinical behaviour.
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http://dx.doi.org/10.1136/bcr-2021-248597DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8968523PMC
March 2022

The Italian Version of the Michigan Hand Outcomes Questionnaire (MHQ): Translation, Cross-Cultural Adaptation and Validation.

J Hand Surg Asian Pac Vol 2021 Dec;26(4):666-683

Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

: Patient-reported outcome measures are largely used in clinical practice and scientific community. Michigan hand questionnaire (MHQ) is widely recognized as a standardized reliable instrument for the assessment of any kind of hand disorders. Aim of the study: translation, cross-cultural adaptation and validation of the Italian version of MHQ. : The study was composed by two phases. Phase 1 consisted in translation and cross-cultural adaptation of MHQ, from original language version (English) into Italian, according to the standard procedure of translation and back translation. The final Italian version of MHQ was tested on 136 Italian patients with hand disorders (Phase 2), in addition to Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, Visual analogue scale (VAS) for pain assessment and grip strength, to psychometric properties of the new version, 55 patients repeated the questionnaire after 7 days for test-retest to assess the reproducibility of the questionnaire. All data were subsequently analyzed (descriptive statistics, multitrait analysis, reliability and construct validity assessment). : Phase 1 was performed without major problems, thus the final Italian version was approved for Phase 2. The questionnaire was clear and easily understood (missing data 0-2.9%). Multitrait analysis brought very good results for each outcome measure. High reliability (Cronbach's alpha: 0.91-0.99) and very good reproducibility (Intraclass correlation coefficients: 0.83-0.98) were revealed. High to moderate correlation was found between MHQ and DASH, grip strength and VAS. : The Italian version of MHQ has demonstrated to be reliable and valid.
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http://dx.doi.org/10.1142/S242483552150065XDOI Listing
December 2021

Secondary Wrist Arthritis in Active Workers: Does Capitate Pyrocarbon Resurfacing (RCPI) Improve Proximal Row Carpectomy? A Retrospective Cohort Study.

J Hand Surg Asian Pac Vol 2021 Dec;26(4):625-634

Department of Orthopaedics, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

: Proximal Row Carpectomy (PRC) is a widespread, safe and effective salvage surgical procedure for wrist arthritis. Some authors believe that PRC results in low grip strength (GS), due to the loss of carpal height, supporting the idea to discourage PRC in high-demanding patients. Resurfacing Capitate Prosthesis Implant (RCPI) allows extending the indication for PRC also in case of deformity and/or arthritis of the head of capitate, with possible implications of clinical outcomes, including GS. : Retrospective multicentre study on a population of active workers, affected by secondary post traumatic wrist arthritis, who underwent PRC (27 patients) or PRC + RCPI (20 patients), Primary outcome was to assess GS between PRC and PRC + RCPI. Secondary outcome was to assess CHR and to search for any possible contributors to GS. Active range of motion (AROM), hand function (DASH, Work-DASH, VAS, PRWHE), pain, time to return to work, job maintenance, major complications and general satisfaction were also assessed. : PRC + RCPI results in more GS maintenance compared with PRC alone, with higher values of CHR. CHR values were associated with GS with a good correlation. According to linear regression model analysis within PRC + RCPI group (GS-CHR), it is esteemed that the increase in parameter CHR is associated with an increase in parameter GS. Looking at a multiple linear regression model analysis built on the whole sample (GS% increase - (group × CHR) + GS% pre-operative). It is estimated that the increase of one unit of the GS coefficient is associated with an increase in GS% increase. Furthermore, higher pre-operative GS values positively influence post-operative GS. No differences were revealed between the two treatments in terms of the remaining secondary outcomes. : PRC alone and PRC + RCPI are both effective salvage procedures for wrist arthritis. RCPI provides a better GS preservation, in part due to the carpal height preservation.
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http://dx.doi.org/10.1142/S2424835521500600DOI Listing
December 2021

Skin manifestations in COVID-19 patients, state of the art. A systematic review.

Int J Dermatol 2021 May 2;60(5):547-553. Epub 2021 Feb 2.

Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.

Introduction: Since COVID-19 has become a pandemic, extensive literature has been produced. The commonest symptoms of COVID-19 disease are fever, cough, anosmia, and lymphocytopenia. However, other apparently less common clinical symptoms have been described, including skin lesions. We conducted a systematic review to evaluate skin involvement in COVID-19.

Methods: The authors performed a systematic review of literature, in accordance with the Preferred Reporting Items for Systematic and Meta-Analysis (PRISMA). The search was reiterated until May 06, 2020.

Results: Overall, 1593 patients (M/F ratio: 1 : 9) with suspect of COVID-19 were examined. The mean age was 37.8 (range 0-91) years. Among the analyzed patients, 84 (5.3%) were pediatrics (<18 years). Chilblains are very common among skin lesions and represent almost half of all skin lesions reported (46%); in 75% of patients with cutaneous manifestation, the latter presented before other typical clinical manifestation of COVID-19. Vasculitis or thrombosis was identified in almost 70% of patients who suffered from skin manifestations.

Conclusion: The present study highlights the importance of skin involvement in COVID-19. Limbs should be examined to eventually foresee the onset of further typical symptoms. Chilblains can be considered typical features. Studies with higher scientific evidence are required.
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http://dx.doi.org/10.1111/ijd.15414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014166PMC
May 2021

Feasibility of Homodigital Flexor Digitorum Superficialis transposition, a new technique for A2-C1 pulleys reconstruction: A kinematic cadaver study.

J Orthop 2020 Sep-Oct;21:483-486. Epub 2020 Sep 8.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Del Sacro Cuore, Istituto di Clinica Ortopedica, Roma, Italy.

Introduction: Homodigital flexor digitorum superficialis transposition (HFT) is proposed as a new technique for A2-C1 pulley reconstruction. Flexor digitorum superficialis is transposed on the proximal phalanx and inserted on the pulley rims, crossing over flexor digitorum profundus and acting as a pulley.

Materials And Methods: The kinematic feasibility was investigated in a cadaveric bowstring model (after A2 and C1 pulley removal) on 22 fingers (thumb excluded).

Results: HFT was effective in restoring the correct flexion of proximal and distal interphalangeal joints, compared to bowstring model. No adverse events were registered.

Conclusion: HFT is a feasible technique. Clinical application is encouraged.
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http://dx.doi.org/10.1016/j.jor.2020.09.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7498708PMC
September 2020

Arthroscopic treatment of an unusual distal clavicle ostheochondroma causing rotator cuff impingement: case report and literature review.

Orthop Rev (Pavia) 2020 Jun 26;12(Suppl 1):8683. Epub 2020 Jun 26.

Orthopaedic Institute, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

Chronic shoulder impingement is one of the most common causes of shoulder pain. Intrinsic, extrinsic and secondary factors play a role in this syndrome; however the etiology of the pathology is still under debate. In rare cases, it can be caused by tumors, such as an osteochondroma. In the present study, a 49-year-old patient presented with shoulder pain for 6 months. Initially he underwent conservative treatment, without relief of symptoms. Xrays and MRI were then performed and showed the presence of an exostotic formation on the undersurface of the lateral third of the clavicle. The formation was arthroscopically removed. Histologic examination confirmed the diagnosis of osteochondroma. After surgery, the patient resumed fully activities with no symptoms within 3 months. At 1 year follow up, there are still no clinical or radiological signs of recurrence. This is, to our knowledge, the first case where an arthroscopic approach was used to remove an ostochondroma of the distal third of the clavicle.
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http://dx.doi.org/10.4081/or.2020.8683DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459371PMC
June 2020

Hand's aneurysmal bone cyst: A rare localization. Case report and systematic literature review.

Orthop Rev (Pavia) 2020 Jun 25;12(Suppl 1):8658. Epub 2020 Jun 25.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome.

Aneurysmal bone cysts are benign, rare bony tumours frequently observed among children and young adults principally located in the long bones, pelvis, and spine and rarely in other anatomical district such as the hand. We report the case of a 12-year-old girl with an aneurysmal bone cyst, in active stage, involving the still-open epiphysis of the fourth metacarpal of the right hand, which was in a first time treated by curettage, and 3 months later, occurring a recurrence, by a radically excision of the bone and reconstruction with a graft from the iliac crest. At 10-year follow-up the patient had good cosmetic results and a functioning hand. We also performed a systematic Literature review in order to retrieve the key information regarding: the diagnosis, the clinical features and the treatment.
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http://dx.doi.org/10.4081/or.2020.8658DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459386PMC
June 2020

Unusual Intranodular Collagenase Injection: A Case of Bilateral Ledderhose Disease.

Plast Reconstr Surg Glob Open 2020 Apr 27;8(4):e2754. Epub 2020 Apr 27.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia.

Ledderhose disease (LD) is a rare plantar fibromatosis of the foot, frequently associated with Dupuytren disease. Collagenase of has recently revolutionized the way to treat Dupuytren disease. Nevertheless, the literature is still critically lacking about the use of collagenase injection in LD. We report a case of a man with bilateral symptomatic LD treated with collagenase. Injections (0.58 mg of collagenase of ) were performed into nodules. Forced extension after injection was not performed. The patient could walk normally immediately after procedure. The procedure was a complete success without side effects or complications on either foot. Currently, at 14 months after treatment of the right foot and 12 months after treatment of the left foot, no recurrence has been observed. Collagenase injection was only effective in treating symptomatic LD in this one patient we reported on.
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http://dx.doi.org/10.1097/GOX.0000000000002754DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7209861PMC
April 2020

Extraphyseal distal radius fracture in children: is the cast always needed? A retrospective analysis comparing Epibloc system and K-wire pinning.

Eur J Orthop Surg Traumatol 2020 Oct 13;30(7):1243-1250. Epub 2020 May 13.

Istituto Di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Roma, Italia.

Introduction: Closed reduction and internal fixation are a widespread surgical treatment for pediatrics displaced extraphyseal distal radius fractures. Post-surgical cast immobilization is usually needed. Epibloc system (ES) is a device used to fix Colles fractures in adults, not requiring post-surgical immobilization. The aim of the study is to investigate the effectiveness of ES in a pediatric population suffering from displaced extraphyseal distal radius fractures.

Methods: We retrospectively analyzed 52 patients (age 8-12 years) who underwent CRIF. Patients were divided into two groups. Group A (25 patients): ES osteosynthesis. Group B (27 patients): K-wires and short arm cast osteosynthesis. The primary outcome is the maintenance of reduction in radiographs (displacement on frontal and lateral view). The secondary outcome is the reaching of the complete active range of motion recovery (compared with the contralateral side) and the time needed to obtain it. The need of further additional treatment (physiotherapy) and the presence of complication were also assessed.

Results: Reduction was equally maintained in both groups (p > 0.05). Physiotherapy was mandatory for 11 patients in group B; only for 3 patients in group A, the difference was statistically significant (p = 0.03) according to Fisher test. Otherwise, the difference was not statistically significant regarding complications. (p > 0.05). At the last follow-up, complete functional recovery was reached in all patients.

Conclusions: Functional recovery is faster, and postoperative physiotherapy is rarely required with ES. This device allows us to go beyond the traditional concept of mandatory postoperative immobilization after pediatric wrist fractures surgery.
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http://dx.doi.org/10.1007/s00590-020-02698-zDOI Listing
October 2020

Comparison of Shape Memory Staple and Gelled Platelet-Rich Plasma versus Shape Memory Staple alone for the Treatment of Waist Scaphoid Nonunion: A Single-Center Experience.

Joints 2019 Sep 6;7(3):84-90. Epub 2020 May 6.

Istituto di Clinica Ortopedica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.

 The aim of this study was to analyze the results of two different methods of surgical treatment of waist scaphoid nonunions (SNUs). We retrospectively analyzed data from 87 patients referred to our department from January 2010 to December 2017 who were surgically treated for waist SNU.  The mean period of time passed from trauma was 11.2 (±5.6) months. Patients were divided into two groups based on surgical treatment received: volar exposure osteosynthesis with shape memory staple (SMS) (group A) and volar exposure osteosynthesis with SMS and gelled platelet-rich plasma (GPRP) application at the bone defect level (group B). A cast (thumb excluded) was maintained for 4 weeks. Healing was checked clinically (pain, QuickDASH [Disabilities of the Arm, Shoulder, and Hand] score, Mayo Wrist Score) and radiologically (standard X-ray).  Union was achieved in 40 patients in group A (95.2%) and in all patients in group B (45 patients; 100%). A statistically significant difference was observed in the improvement of the Mayo Wrist Score, QuickDASH score, and pain (measured through the visual analog scale) after 3 months from surgery (  = 0.02).  SMS is effective in treating waist SNU at more than 6 months from trauma. GPRP application can improve bone healing and upper limb function.  This is a retrospective observational Level III study.
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http://dx.doi.org/10.1055/s-0040-1710387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8236327PMC
September 2019

Seven-year clinical outcomes after collagenase injection in patients with Dupuytren's disease: A prospective study.

J Orthop 2020 Sep-Oct;21:218-222. Epub 2020 Mar 29.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.

Introduction: This investigation is a prospective cohort study examining the use of collagenase injection (CCH) for the treatment of Dupuytren's disease (DD) with a 7 years follow-up.

Methods: Forty-five monodigital DD patients were injected with CCH on a single joint. Assessment included measurement of residual passive extension deficit (PED), function (using QuickDASH) and patient satisfaction.

Results: 86.7% of PIPJ and 65.6% of MPJ had a worsening of PED. Nevertheless, thirty-nine patients (86.7%) concluded their treatment with only one injection, without any further treatment.

Conclusion: CCH provides a long-term effective solution. Recurrence occurs, especially in PIPJ, with acceptable rates.
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http://dx.doi.org/10.1016/j.jor.2020.03.028DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7132050PMC
March 2020

Intramedullary nailing for treatment of forearm non-union: Is it useful? - A case series.

J Orthop 2020 Jul-Aug;20:97-104. Epub 2020 Jan 10.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.

Introduction: Intramedullary osteosynthesis is often considered a second-order method for treatment of forearm non-union.

Methods: We evaluated clinical and functional results from 49 patients affected by radio and/or ulna non-union treated using intramedullary nailing, with possible tricortical autologous bone grafting. Healing rate (primary outcome), healing time and functional status have been assessed.

Results: Healing was observed in 46 cases (93.9%), the average healing time was 6.3 (SD ± 2.5) months. Excellent result (Anderson score) was reached in 38 cases (77.6%), satisfactory in 7 cases (14.3%).

Conclusions: Forearm non-unions represent a therapeutic challenge. Intramedullary nailing is a successful option of treatment.
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http://dx.doi.org/10.1016/j.jor.2020.01.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6997666PMC
January 2020

Modified Matti-Russe technique using a "butterfly bone graft" for treatment of scaphoid non-union.

J Orthop 2020 May-Jun;19:63-66. Epub 2019 Nov 27.

Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.

Introduction: Autologous bone grafts are used to treat scaphoid non-union with shortening and humpback deformity. The superiority of internally fixed bone graft to embedded bone graft has not been clearly proven.

Methods: Retrospectively analyzed 42 cases of scaphoid waist non-union treated using the "butterfly bone graft" (modified Matti-Russe technique).

Results: Complete healing was reached by all patients, with an average time of 4.4 (SD ± 0.7) months. Mayo Wrist Score improved from and QuickDASH score significantly improved in all patients after treatment.

Conclusions: Butterfly bone graft is effective and reliable in treating scaphoid non-union with shortening and humpback deformity.
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http://dx.doi.org/10.1016/j.jor.2019.11.030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6994792PMC
November 2019

Surgical treatment of trapeziometacarpal joint osteoarthritis.

Joints 2013 Jul-Sep;1(3):138-44. Epub 2014 Jan 8.

Orthopaedics and Hand Surgery, Catholic University, Columbus Hospital, Rome, Italy.

Trapeziometacarpal joint osteoarthritis is a common cause of radial-sided wrist pain that prevalently affects women. It is diagnosed on the basis of a thorough history, physical examination, and radiographic evaluation. While radiographs are used to determine the stage of disease, treatment is dependent on the severity of the symptoms. Non-surgical treatment frequently consists of activity modification, non-steroidal anti-inflammatory drugs, splinting and corticosteroid injections. After failure of conservative treatment, various surgical options exist depending on the stage of the disease. These options range from ligament reconstruction or osteotomy, for early painful laxity, to trapeziectomy, arthrodesis and arthroplasty for more severe osteoarthritis. This article reviews the literature supporting the various surgical treatment options and analyzes the surgical techniques most frequently used in the different disease stages.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4295705PMC
January 2015

Efficacy of marrow-stimulating technique in arthroscopic rotator cuff repair: a prospective randomized study.

Arthroscopy 2013 May 21;29(5):802-10. Epub 2013 Mar 21.

Department of Orthopaedics and Traumatology, Catholic University, Rome, Italy.

Purpose: To evaluate the efficacy of a marrow-stimulating technique with microfractures of the greater tuberosity during arthroscopic rotator cuff repair.

Methods: Eighty patients with a full-thickness rotator cuff tear underwent an arthroscopic single-row repair. Patients were divided into 2 groups of 40 cases each. In group 1, standard repair was performed; in group 2, microfractures of the greater tuberosity were performed to enhance tendon repair. Clinical outcome was assessed with the Disabilities of the Arm, Shoulder and Hand (DASH) score and normalized Constant score. Tendon integrity was assessed with magnetic resonance imaging. Multivariate analysis was performed to determine which predictors were independently associated with the outcome. Significance was set at P < .05.

Results: The mean follow-up was 28.1 ± 3 months. Seven patients were lost to follow-up (2 in group 1 and 5 in group 2). Comparison between groups did not show significant differences for baseline characteristics. The mean DASH score was 28.6 ± 21.3 points in group 1 and 23.3 ± 20.1 points in group 2. Although the difference was not statistically significant, the confidence interval included a 10-point value (minimal clinically important difference) in favor of the microfracture group. The difference in the Constant score between groups was not significant. The tendon healing rate was 52.6% in group 1 and 65.7% in group 2, without a significant difference between groups. Subgroup analysis for tear size showed that group 2 had a significantly greater healing rate than group 1 for large tears (P = .040). Multivariate analysis showed that age, timing of symptoms, tear location, tendon retraction, and fatty infiltration significantly affected the outcomes.

Conclusions: Postoperative magnetic resonance imaging did not show any significant difference between groups in structural integrity. However, subgroup analysis showed a significantly greater healing rate in the microfracture group for large tears involving the supraspinatus and infraspinatus.

Level Of Evidence: Level I, high-quality randomized controlled trial with no statistically significant difference but narrow confidence intervals.
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http://dx.doi.org/10.1016/j.arthro.2013.01.019DOI Listing
May 2013
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