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Adjudication committee
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First opponent: Senior Consultant Jaap Willems, Lairesse Kliniek
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Second opponent: Adjuct professor Ville Äärimaa, Turku University Hospital
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Chair of the Committee: Professor Inger Holm, University of Oslo
Principal supervisors
Overlege Sigbjørn Dimmen, Lovisenberg Diakonale Sykehus
Chair of the Public Defence
Professor Hanne Solveig Dagfinrud, University of Oslo
Summary
Arthroscopic repair of rotator cuff tears has become more common and there is still a lack of knowledge of some subjects. Kjersti Kaul Jenssen and her co-workers have in the thesis “Arthroscopic rotator cuff repair in the shoulder. Clinical outcomes and radiological results. Prognostic factors, postoperative rehabilitation and treatment of acute postoperative infection” aimed to obtain empirical evidence about which patients were the best candidates for rotator cuff surgery, what prognosis they have, how to handle complications such as postoperative infections and how to facilitate their long rehabilitation.
The first and third parts of the study make use of data from a prospective cohort of patients treated with rotator cuff repairs at Lovisenberg Diaconal Hospital from 2009 to 2014. In the first study, we reviewed all postoperative infections, how they were treated and the functional and radiological outcomes. In the third study, they researched prognostic factors of successful shoulder function at 2-year follow-up after rotator cuff repair. The second study was planned as a RCT to elucidate whether 3 weeks of postoperative immobilization is non-inferior to the commonly used regimen involving 6 weeks of immobilization with regard to functional results at 12-month follow-up.
Patients treated adequately with surgical intervention and antibiotics for postoperative infection have good functional results, and the results were comparable to those in the third and second study. Healing rate of the tendon-to-bone evaluated on MRI was also high and acceptable in all 3 studies: 80% in studies I and III and 89% in study II.
In the RCT, we found that the shoulder function at final follow-up was no worse with 3 weeks of immobilization than 6 weeks of immobilization, and thus, we concluded that it was safe for patients to be immobilized for 3 weeks after rotator cuff repair.
Overall, rotator cuff repair results in good shoulder function, even after postoperative acute infection. Although not all prognostic factors identified in the third study are modifiable, this cohort study suggests that if selection of patients is done properly, it is possible to influence a successful outcome. Furthermore, based on the second study, we might be able to facilitate rehabilitation after rotator cuff repair, as patients often want individualization of their rehabilitation program.
Additional information
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