Abstracts / Journal of Science and Medicine in Sport 14S (2011) e1–e119
pre-operative to 12-week assessments (p = 0.05). No other
measurements were found to be statistically significant, and
specifically the active vibration group had the similar shoul-
der range of motion and strength pre-operatively, 6 weeks
and at 12 weeks post rotator cuff repair as compared with the
non-active vibration group.
Conclusion: This pilot study found the use of direct vibra-
tion on the rotator cuff following surgery to be of no benefit,
as compared with placebo vibration, in increasing the range-
of-motion or strength of the shoulder at 6 weeks and 3 months
post arthroscopic rotator cuff repair.
doi:10.1016/j.jsams.2011.11.068
67
Ultrasound changes after rotator cuff repair – Is
supraspinatus tendon thickness related to pain?
R. Tham 1,∗ , G. Murrell 2 , L. Briggs 2
1 University
of New South Wales, Australia
2 St George Hospital Orthopaedic Research Institute,
Australia
Introduction: Surgical repair for rotator cuff tears is com-
mon, but little is known about the healing tendon after surgery.
The purpose of this study was to determine whether there are
changes after rotator cuff repair in tendon thickness, anatomi-
cal footprint, tendon vascularity, subacromial bursa, capsular
thickness, and whether tendon and bursal thickness correlate
with pain.
Method: Fifty-one patients completed a validated pain
questionnaire and had their shoulders scanned by the same
experienced ultrasonographer with a General Electric Logiq
E9 (GE Corp, Fairfield, CT) ultrasound machine with a linear
ML6-15MHz transducer using a standardised protocol at 1
week, 6 weeks, 3 months and 6 months post arthroscopic
rotator cuff repair by a single surgeon. The contralateral
shoulders, if uninjured, were also scanned. Data is presented
as mean (SD).
Results: Forty-four of the 51 rotator cuff repairs were intact
at 6 months. Four re-tore at 6 weeks, while three re-tore at
3 months. At 6 weeks, the repaired tendon thickness was
4.2 (0.9) mm, and increased to 4.6 (0.8) mm at 6 months
(p < 0.05) – similar to the contralateral uninjured side: 4.8
(0.8) mm. There was a significant increase in bursal thick-
ness at 1 week [2.0 (0.8) mm] compared with the contralateral
shoulder [0.8 (0.4) mm] (p < 0.001); which decreased at each
time point so that by 6 months it was 0.7 (0.5) mm (p < 0.001).
There was a significant increase in the width of the anatomi-
cal footprint, from 7.0(2.0) mm at 1 week to 9.2 (1.5) mm at 6
months (p < 0.001). Vascularity of the tendon decreased from
mild at 1 week, to none at 6 months (p < 0.001). At 1 week
there was a significant increase in the ipsilateral posterior
capsule thickness 2.3 (0.8) mm, which gradually decreased
to 1.3 (0.6) mm at 6 months (p < 0.001). There was no differ-
ence in the contralateral posterior capsule thickness, which
e33
was 1.2 (0.5) mm at 1 week and 1.2 (0.4) mm at 6 months.
The frequency and severity of pain decreased at 6 months, and
the patient-ranked overall condition of the shoulder improved
(p < 0.001). There was no correlation between tendon thick-
ness or bursal thickness with pain.
Conclusion: This study yielded some novel findings. (1)
After supraspinatus repair, the tendon thickness increased
only 10% between 6 weeks and 6 months. Many other ten-
dons (e.g. Achilles) increase several-fold after repair. (2) The
width of the anatomical footprint of the repaired supraspina-
tus was 30% narrower at 1 week and gradually increased
over 6 months to be comparable with the contralateral
uninjured shoulder. (3) Ipsilateral bursal thickness, tendon
vascularity (as per other studies) and posterior capsule thick-
ness increased significantly compared with the contralateral
shoulder at 1 week post surgery and then gradually decreased
over 6 months. An increase in glenohumeral joint capsule
thickness following rotator cuff repair was unexpected and
may help explain the shoulder loss of range of motion some-
times seen post shoulder trauma.
doi:10.1016/j.jsams.2011.11.069
68
Intra-operative determinants of rotator cuff repair
integrity: An analysis in 500 consecutive repairs
X. Wu ∗ , G. Murrell
St George Hospital Orthopaedic Research Institute,
Australia
Background: Rotator cuff repair has a relatively high
(20–90%) chance of re-tear. Patients with an intact rotator
cuff 6 months post surgery have better subjective and objec-
tive outcomes at 6 months and 2 years following rotator cuff
repair than those who do not have an intact repair. The aim
of this study was to determine if, and if so, which, intra-
operative factors predict an intact repair 6 month after rotator
cuff repair.
Methods: The study consisted of a cohort of 500 con-
secutive patients who had an arthroscopic rotator cuff repair
performed by a single surgeon and an ultrasound evaluation
of the repair 6 months post repair using standard protocols.
Exclusion criteria included previous fractures or shoulder
surgery, incomplete or partial rotator cuff repair and con-
comitant arthroplasty. Rotator cuff tear size was measured
intra-operatively and mapped. The quality of the tendon, ten-
don mobility and repair quality were assessed and ranked
based on pre-determined scales (1–4) and recorded on a
specifically designed form. Logistic regression analysis was
performed with cuff integrity at 6 months as the dependent
variable and repair factors as the independent variables.
Results: The overall post-operative re-tear rate was 19%
at 6 months post repair. The best predictor of rotator cuff
integrity was pre-operative tear size (correlation coefficient,
r = 0.33, p < 0.001). Patients with small (≤ 2 cm2 ) rotator cuff