Purpose
To evaluate the clinical and structural outcomes of arthroscopic side-to-side repair
of large U-shaped full-thickness rotator cuff tears (FTRCTs) by assessing the functional
score of the patients and the integrity of the tendon repair using magnetic resonance
imaging with a minimum follow-up duration of 2 years.
Methods
In this case series, 59 consecutive patients who underwent arthroscopic side-to-side
repair of large U-shaped FTRCTs, with a minimum follow-up duration of 2 years (range
25 to 72 months), were retrospectively enrolled. The mean patient age was 58.6 years.
Patients' functional scores and integrity of the tendon repairs were evaluated.
Results
The mean visual analog scale score improved from 5.7 ± 2.1 preoperatively to 2.4 ±
1.3 postoperatively (P < .001). The mean range of motion (forward flexion) improved from 152.7° ± 11.4°
to 164.5° ± 9.5° (P < .001). The mean Constant-Murley score improved from 57.3 ± 7.2 preoperatively to
77.8 ± 6.9 postoperatively (P < .001). Postoperative magnetic resonance imaging examinations demonstrated cuff
integrity with a retear rate of 54.2%. The retear rate of patients who underwent anchor
fixation to the medial row (45%) was significantly lower than that of patients who
underwent simple side-to-side repair (73.7%) (P = .039). The University of California at Los Angeles shoulder rating and Constant-Murley
scores were not significantly different between the healed and retear groups (P = .639 and P = .863, respectively).
Conclusions
Arthroscopic side-to-side repair of large U-shaped FTRCTs demonstrated satisfactory
clinical outcomes. However, the retear rate was higher than expected when simple side-to-side
fixation was performed without footprint fixation. Therefore, medial row fixation
is recommended if arthroscopic side-to-side repair is performed.
Level of Evidence
III, comparative therapeutic trial.
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Article info
Publication history
Published online: November 07, 2019
Accepted:
July 3,
2019
Received:
January 14,
2019
Footnotes
See commentary on page 3219
The authors, their immediate families, and any research foundation with which they are affiliated have not received any financial payments or other benefits from any commercial entity related to the subject of this article. Final approval of the exemption from review by the Institutional Review Board was obtained for this study because of the study's retrospective nature (KHUH IRB 2018-07-067).
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2019 by the Arthroscopy Association of North America
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Access this article on ScienceDirectLinked Article
- Editorial Commentary: Side-to-side Rotator Cuff Repairs—Are Perfectly Placed Sutures Enough?ArthroscopyVol. 35Issue 12
- PreviewArthroscopic side-to-side rotator cuff repair of large U-shaped tears should incorporate repair of the greater tuberosity. Recent research has found that pain at rest and with motion, range of motion, strength, and University of California–Los Angeles and Constant scores improved overall in patients with side-to-side repairs. Although the clinical results were quite good overall, rotator cuff healing was found to be significantly better, with 28% improvement confirmed by magnetic resonance imaging evidence of healing when the side-to-side repair was further repaired to the tuberosity.
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