Advertisement

Long-term results of arthroscopic rotator cuff repair (SS-07)

      We have been performing arthroscopic rotator cuff repair since 1991. Short-term results have been previously presented and have been encouraging. Presented here are long-term results (minimum of 8 years postoperative) in a consecutive series of 64 patients who underwent 64 arthroscopic rotator cuff repairs. Three patients had died and 6 could not be located, leaving 55 patients who were reevaluated. We were able to personally interview and examine 48 patients; 7 patients were interviewed by telephone. The average age of these patients was 68 years. The repair technique used in these patients was predominantly our older technique utilizing No. 1 PDS and push-in anchors. Most of the tears were nonretracted crescent shaped tears and were repaired directly end to bone. We have traditionally evaluated our patients using the Modified UCLA (MUCLA) scoring system (45 points maximum). This group of patients was also evaluated using this scoring system. Eight year postoperative American Shoulder and Elbow Society and Constant scores were also determined for this group. For MUCLA scoring, we were able to compare the preoperative scores with the results of our previously published evaluation at 2–3 years and our current evaluation at 8 years. The average preoperative MUCLA score was 17, the 2–3 year score was 41, and the 8 year score was also 41. Excellent results were achieved in 68% at 2–3 years and in 75% at 8 years. Good results were obtained in 25% at 2–3 years and 10% at 8 years. Fair results were obtained in 2% of both 2–3 year and 8 year follow-up groups. Poor results were recorded in 5% at 2–3 years and 13% at 8 years. American Shoulder and Elbow Society Scores at 8 years were as follows: 90.8 average overall score (range 40–100), Average pain score was 0.9. Average ADL score was 27.3. Average strength score was 4.8 (abduction) and 4.9 (IR and ER). Constant Scores at 8 years were as follows: 91.3 average overall score (range 68–100). Average pain score was 13. Average total ADL score was 18.8. Average ROM score was 36.1. Average strength score was 12.3. Average strength score when compared to the unaffected side (operated side score × 25/unaffected side score) was 22.4. We used this comparison value to determine the overall average score. Overall, the results of arthroscopic rotator cuff repair are very good and have shown to be durable at 8 year follow-up. These results compare well to the long-term results of open repairs. It must be noted, however, that these are the results of the repair of only the smaller tears that were undertaken at the time. Currently we are using stronger sutures with higher pull-out strength anchors and are repairing much larger tears. The short-term results of these repairs are also good but their long-term durability must still be determined.