Trans- Cuff Portals Heal by Six Weeks – An Ultrasonography Based Study

Abstract Introduction Various arthroscopic portals have been described for repair of SLAP (Superior labrum anterior posterior) lesions. The difficulty in doing repair through the rotator interval and the problems in direction and placement of anchors still persist. Functional outcomes of the patients after treating them using trans-cuff portal are well established in literature, but the actual healing of the portal is not clear. We made a sincere effort to identify healing of the trans-cuff portal with ultrasound guidance and functional outcome using ASES score (American Shoulder and Elbow Surgeons Shoulder Score), Constant Shoulder score and Oxford Shoulder score. Material and Methods 22 patients with SLAP or labral tears and with normal contralateral shoulders were included. Surgery was done using trans-cuff portal as viewing or working portal for biceps repair and labral repair. Rehabilitation was initiated from day 1 and followed up on 6 weeks, 3 months and, 6 months with maximum follow-up of 2 years .Ultrasound was used to measure the depth of healing and graded at 6 weeks postoperative follow-up. Functional outcomes were measured using ASES score, Constant shoulder score and Oxford shoulder score were measured at 6 months. Observations and Results 17 patients were Grade 1 (complete healing); 1 patient was grade 2 (more than 50 percent healing); 1 with grade 3 (less than 50 percent healing) and 3 were lost to follow-up. 14 patients out of 19 had excellent ASES scores, 4 patients had good and 1 patient was considered as poor with average of ASES score of 84.51 (Range 93-48) and standard deviation of 10.37. ASES score indicated that healing of the rotator cuff portal is directly related to the functional outcome of the shoulder. The Constant Shoulder score and Oxford Shoulder score on the contrary were statistically not significant indicating no relation of the oxford and constant scores with healing of the rotator cuff portals. Conclusion –Trans-cuff portal is safe, gives proper angle for insertion of anchors and can be used for repair of SLAP lesions with ease. USG (Ultrasonography) helps in confirming the healing of portal.