CLINICAL OUTCOME OF SINGLE ROW ROTATOR CUFF REPAIR WITH CRIMSON DUVET MANEUVER FOR COFIELD MEDIUM AND LARGE ROTATOR CUFF TEARS

Abstract

Background
Shoulder pain and dysfunction are frequently caused by rotator cuff tears (RCTs), which frequently necessitate surgery for both clinical relief and functional rehabilitation. Even while single-row (SR) rotator cuff repair is still often performed, questions about its capacity to heal still exist, especially for medium and large injuries that fall under the Cofield classification. A biological augmentation technique to improve tendon healing is the crimson duvet maneuver (CDM), which involves microfracture-induced marrow activation at the footprint. Its therapeutic effectiveness in SR repair has not yet been thoroughly determined, nevertheless.
Objectives
The purpose of this study is to assess the radiological and clinical results of single-row rotator cuff repair combined with the crimson duvet maneuver in patients who have large and Cofield medium rotator cuff injuries. While tendon integrity, healing rates, and the incidence of complications are secondary objectives, the main goal is to evaluate postoperative functional improvement.
Methods
Patients with medium and large full-thickness RCTs who had arthroscopic single-row repair enhanced by the crimson duvet maneuver were the subjects of a prospective research. The Visual Analog Scale (VAS) for pain, the American Shoulder and Elbow Surgeons (ASES) Score were used to evaluate functional outcomes. At six and twelve months, MRI was used to assess postoperative tendon repair. Preoperative and postoperative functional scores and healing were compared using statistical analysis.
Results
Trauma was the most common cause of rotator cuff tears, observed in 83.33% of patients, while degenerative changes accounted for 16.66%. Most patients (80.55%) did not receive intra-articular steroid injections. The predominant symptom was an inability to lift the shoulder (72.22%), followed by shoulder pain (27.77%). The most common complication was a limitation of the range of motion (16.66%), with minor occurrences of wound infection, scar dysesthesia, and instability. Postoperative outcomes showed significant improvement, with the ASES score rising from 23.7 preoperatively to 92.2 at six months. The Modified UCLA Score also demonstrated substantial progress, reflecting better pain management, function, and patient satisfaction.
Conclusion
Significant functional improvement, decreased pain, and good tendon healing rates were observed when the crimson duvet maneuver was used in single-row rotator cuff repair for medium and large Cofield rotator cuff injuries. In rotator cuff repair surgery, this augmentation method might be a useful biological tactic to promote healing and improve clinical results.