Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Dec 18, 2021; 12(12): 991-1000
Published online Dec 18, 2021. doi: 10.5312/wjo.v12.i12.991
Role of biomechanical assessment in rotator cuff tear repair: Arthroscopic vs mini-open approach
Giuseppe Solarino, Ilaria Bortone, Giovanni Vicenti, Davide Bizzoca, Michele Coviello, Giuseppe Maccagnano, Biagio Moretti, Fabio D'Angelo
Giuseppe Solarino, Ilaria Bortone, Giovanni Vicenti, Michele Coviello, Biagio Moretti, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Bari 70124, Italy
Davide Bizzoca, Department of Biomedical Sciences and Human Oncology, University of Bari "Aldo Moro", Bari 70124, Italy
Giuseppe Maccagnano, Orthopaedic and Trauma Unit, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Foggia, General Hospital, Foggia 76545, Italy
Fabio D'Angelo, Division of Orthopaedics and Traumatology, ASST Sette Laghi, Department of Biotechnologies and Life Sciences, Università degli Studi dell'Insubria, Varese 21100, Italy
Author contributions: Bortone I and Solarino G contributed to the conceptualization, data curation, formal analysis, investigation, methodology, software, validation, visualization, roles/writing - original draft, writing – review, and editing of the manuscript; Bizzoca D contributed to the conceptualization, data curation, investigation, methodology, writing - review and editing of the manuscript; Coviello M contributed to the conceptualization, resources, writing - review and editing of the manuscript; Vicenti G and Maccagnano G contributed to the data curation, investigation, writing - review and editing of the manuscript; D’Angelo F and Moretti B contributed to the supervision, writing - review and editing of the manuscript.
Institutional review board statement: The study was approved by the Local Ethical Committee (ORTHO-SHOULDER, n. 6480, Prot. n. 0054602).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare having no conflicts of interest, either real or perceivable.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ilaria Bortone, PhD, Adjunct Professor, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari "Aldo Moro", Piazza Giulio Cesare, 11, Bari 70124, Italy. ilaria.bortone@uniba.it
Received: April 23, 2021
Peer-review started: April 23, 2021
First decision: June 16, 2021
Revised: June 28, 2021
Accepted: December 8, 2021
Article in press: December 8, 2021
Published online: December 18, 2021
Processing time: 234 Days and 10.3 Hours
Abstract
BACKGROUND

Rotator cuff (RC) tears are one of the most frequent pathologies within the shoulder girdle. Hand dominance and older age are associated with RC tears. Two different surgical procedures, the mini-open (MO) and all-arthroscopic (AA) approach, represented the standard of treatment.

AIM

To compare the clinical and biomechanical outcomes of two surgical techniques (AA vs MO procedure) performed to address the painful shoulder syndrome with partial or total supraspinatus tendon tear.

METHODS

Eighty-eight participants, 50 following RC repair with AA and 38 with MO approach, were recruited in the present cross-sectional case-control study (ORTHO-SHOULDER, Prot. 0054602). All patients underwent postoperative clinical evaluation for pain (Visual analogic scale), impairment, and disability (disability of the arm, shoulder, and hand) and limitation in daily activity (Constant-Murley score). Patients’ shoulder mobility was also assessed in our Laboratory of Functional Movement through a wearable inertial sensor and surface electromyography to monitor kinematics and muscle activity during the movement on the frontal (abduction/adduction) and sagittal (flexion-extension) planes.

RESULTS

No statistically significant differences between the two procedures were observed in either main clinical score or range of motion. A significant increase in velocity during the movement execution and a higher contribution of upper trapezius muscles were found in the AA group compared with MO patients.

CONCLUSION

In terms of clinical scores, our findings were in line with previous results. However, the use of technology-based assessment of shoulder mobility has revealed significant differences between the two techniques in terms of mean velocity and pattern of muscle activation.

Keywords: Rotator cuff tear; Arthroscopic; Mini-open; Wearable sensors; Surface electromyography

Core Tip: Wearable technologies could be useful in clinical practice since they could provide clinical information during the performance of a motor task. The present work represents a preliminary attempt in making use of novel wearable technologies in common clinical practice.