Purpose
The purpose of this study was to evaluate the clinical results and healing status
of rotator cuff repairs with less than 50% footprint coverage.
Methods
During the 18-month period from October 2005 to March 2007, 89 large to massive rotator
cuff tears were arthroscopically repaired. Among them, 23 consecutive large to massive
rotator cuff tears were repaired completely but with less than 50% of the original
footprint. All tears were arthroscopically repaired with suture anchors. Preoperative
and postoperative clinical assessments were performed with the Constant score, American
Shoulder and Elbow Surgeons score, and pain visual analog scale. The healing status
of repaired tendon was evaluated by postoperative magnetic resonance imaging with
a focus on tendon integrity, muscle fatty degeneration, and muscle atrophy.
Results
The mean follow-up period was 30.2 months (range, 24 to 41 months). At final follow-up
visits, American Shoulder and Elbow Surgeons score, Constant score, and score on pain
visual analog scale were found to have improved significantly from 40.1, 35.9, and
57.7 to 82.4, 86.6, and 12.3, respectively (P < .01). The overall retear rate was 45.5% (10 cases). However, clinical results showed
no difference between the retear group and no retear group. Furthermore, rerupture
size was smaller than original tear size in all 10 patients, and no significant progression
of fatty degeneration or muscle atrophy of rotator cuff muscles was observed.
Conclusions
Less-than-optimal coverage of the original greater tuberosity footprint during arthroscopic
repair of large to massive rotator cuff tears was found to be associated with a relatively
high retear rate (45.5%). However, clinical results improved significantly, and no
significant difference was observed in the clinical results between the retear and
no retear groups.
Level of Evidence
Level IV, therapeutic case series.
Key Words
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Article info
Publication history
Accepted:
July 8,
2009
Received:
April 24,
2009
Footnotes
The authors report no conflict of interest.
Identification
Copyright
© 2009 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
