Purpose
This study aimed to evaluate the effect of retear on long-term functional outcomes
and glenohumeral joint osteoarthritis (OA) progression after arthroscopic rotator
cuff repair (ASRCR).
Methods
We retrospectively reviewed 201 patients who underwent ASRCR and were followed up
for at least 5 years. Rotator cuff tendon structural integrity was evaluated using
magnetic resonance imaging and/or ultrasonography. Pain, active range of motion, and
the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES)
were evaluated for functional outcomes. To evaluate deterioration over time, the minimal
clinically important difference value of pain and ASES were used.
Results
The mean follow-up period was 8.6 ± 2.2 years and overall retear rate was 21.4%. OA
progression was strongly associated with retear (odds ratio 5.1, P < .001). Functional outcomes at the 2-year postoperative follow-up significantly
improved compared to the preoperative status (all P < .017), regardless of retear. However, the retear group presented worse functional
outcomes at the final follow-up (pain: 3.1 ± 2.6; ASES: 72.0 ± 17.4) than at the 2-year
postoperative follow-up (pain: 1.2 ± 2.3, P = .014; ASES: 91.1 ± 9.9, P= .015) than the healed tendon group at final follow-up (pain: .6 ± 1.7; P < .001; ASES 95.5 ± 11.8; P < .001). The time for deterioration of pain (healed group vs. retear group: 5.5 ±
0.5 vs. 10.6 ± 0.4 years; P < .001) and ASES (healed group vs. retear group: 7.5 ± 0.5 vs. 12.8 ± 0.2 years;
P < .001) decreased in the retear group.
Conclusions
The functional status improved after ASRCR in short- and long-term follow-up, regardless
of retear. However, retear was strongly associated with OA progression, and long-term
functional outcomes deteriorated over time in retear cases, which was not observed
during short-term follow-up.
Study Design
III, retrospective cohort study.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to ArthroscopyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Outcomes of rotator cuff repair in patients with comorbid disability in the extremities.Clin Orthop Surg. 2017; 9: 77-82
- Arthroscopic repair of massive rotator cuff tears: Outcome and analysis of factors associated with healing failure or poor postoperative function.Am J Sports Med. 2013; 41: 1674-1683
- Operative versus nonoperative treatment for the management of full-thickness rotator cuff tears: A systematic review and meta-analysis.J Shoulder Elbow Surg. 2018; 27: 572-576
- Risk factors for and prognosis of folded rotator cuff tears: A comparative study using propensity score matching.J Shoulder Elbow Surg. 2021; 30: 826-835
- The outcome and repair integrity of completely arthroscopically repaired large and massive rotator cuff tears.J Bone Joint Surg Am. 2004; 86: 219-224
- The rotator cuff healing index: A new scoring system to predict rotator cuff healing after surgical repair.Am J Sports Med. 2019; 47: 173-180
- Structural integrity after rotator cuff repair does not correlate with patient function and pain: A meta-analysis.J Bone Joint Surg Am. 2014; 96: 265-271
- Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: A systematic review and meta-analysis of level I randomized clinical trials.J Shoulder Elbow Surg. 2014; 23: 586-597
- What influence does progression of a nonhealing rotator cuff tear have on shoulder pain and function?.Clin Orthop Relat Res. 2017; 475: 1596-1604
- A prospective evaluation of survivorship of asymptomatic degenerative rotator cuff tears.J Bone Joint Surg Am. 2015; 97: 89-98
- The impact of re-tear on the clinical outcome after rotator cuff repair using open or arthroscopic techniques—A systematic review.Open Orthop J. 2017; 11: 95-107
- The pathogenesis and management of cuff tear arthropathy.J Shoulder Elbow Surg. 2018; 27: 2271-2283
- Osteoarthritis after rotator cuff repair: A 10-year follow-up study.Orthop Traumatol Surg Res. 2017; 103: 477-481
- Osteoarthritis progression of the shoulder: A long-term follow-up after mini-open rotator cuff repair.J Orthop Surg (Hong Kong). 2018; 26 (2309499018768106)
- The clinical and structural long-term results of open repair of massive tears of the rotator cuff.J Bone Joint Surg Am. 2008; 90: 2423-2431
- Clinical and MRI outcomes 10 years after repair of massive posterosuperior rotator cuff tears.J Bone Joint Surg Am. 2018; 100: 1854-1863
- Arthroscopic rotator cuff repair with a knotless suture bridge technique: Functional and radiological outcomes after a minimum follow-up of 5 years.Arthroscopy. 2019; 35: 2003-2011
- At a 10-year follow-up, tendon repair is superior to physiotherapy in the treatment of small and medium-sized rotator cuff tears.J Bone Joint Surg Am. 2019; 101: 1050-1060
- Clinical and structural outcome 20 years after repair of massive rotator cuff tears.J Shoulder Elbow Surg. 2020; 29: 521-526
- High-grade bursal-side partial rotator cuff tears: Comparison of mid- and long-term results following arthroscopic repair after conversion to a full-thickness tear.J Orthop Surg Res. 2017; 12: 118
- Long-term Results of Arthroscopic Rotator Cuff Repair: A Follow-up Study Comparing Single-row versus double-row fixation techniques.Am J Sports Med. 2020; 48: 1568-1574
- Long-term results of arthroscopic rotator cuff repair: Initial tear size matters: A prospective study on clinical and radiological results at a minimum follow-up of 10 years.Am J Sports Med. 2019; 47: 2659-2669
- Structural integrity of rotator cuff at 16 years following repair: good long-term outcomes despite recurrent tears.Shoulder Elbow. 2019; 11: 26-34
- Ten-year clinical and anatomic follow-up after repair of anterosuperior rotator cuff tears: Influence of the subscapularis.J Shoulder Elbow Surg. 2017; 26: 1826-1833
- Long-term clinical and imaging outcomes after primary repair of small- to medium-sized rotator cuff tears.J Orthop Surg (Hong Kong). 2019; 27 (2309499019883985)
- Clinical and anatomic results of rotator cuff repair at 10 years depend on tear type.Knee Surg Sports Traumatol Arthrosc. 2018; 26: 2490-2497
- Longitudinal long-term magnetic resonance imaging and clinical follow-up after single-row arthroscopic rotator cuff repair: Clinical superiority of structural tendon integrity.Am J Sports Med. 2017; 45: 1283-1288
- Tendon repair leads to better long-term clinical outcome than debridement in massive rotator cuff tears.Open Orthop J. 2017; 11: 546-553
- Long-term outcomes after arthroscopic transosseous-equivalent repair: Clinical and magnetic resonance imaging results of rotator cuff tears at a minimum follow-up of 10 years.J Shoulder Elbow Surg. 2021; 30: 2767-2777
- Which Is the Best Outcome Measure for Rotator Cuff Tears?.Clin Orthop Relat Res. 2019; 477: 1869-1878
- American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form, patient self-report section: reliability, validity, and responsiveness.J Shoulder Elbow Surg. 2002; 11: 587-594
- Minimal clinically important differences (MCID) and patient acceptable symptomatic state (PASS) for visual analog scales (VAS) measuring pain in patients treated for rotator cuff disease.J Shoulder Elbow Surg. 2009; 18: 927-932
- Establishing clinically significant outcome after arthroscopic rotator cuff repair.J Shoulder Elbow Surg. 2019; 28: 939-948
- Predictability of early postoperative ultrasonography after arthroscopic rotator cuff repair.Orthopedics. 2017; 40: e975-e981
- Functional and structural outcome after arthroscopic full-thickness rotator cuff repair: single-row versus dual-row fixation.Arthroscopy. 2005; 21: 1307-1316
- Dislocation arthropathy of the shoulder.J Bone Joint Surg Am. 1983; 65: 456-460
- Long-term results of the Latarjet procedure for the treatment of anterior instability of the shoulder.J Bone Joint Surg Am. 1998; 80: 841-852
- Results of a second attempt at surgical repair of a failed initial rotator-cuff repair.J Bone Joint Surg Am. 1984; 66: 563-567
- Postoperative new-onset pseudoparalysis: A retrospective analysis of 430 consecutive arthroscopic repairs for large to massive rotator cuff tears.Am J Sports Med. 2018; 46: 1701-1710
- Electromyographic analysis of the glenohumeral muscles during a baseball rehabilitation program.Am J Sports Med. 1991; 19: 264-272
- Treatment of instability of the shoulder with an exercise program.J Bone Joint Surg Am. 1992; 74: 890-896
- ∗Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behav Res Methods. 2007; 39: 175-191
- No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: A randomized controlled trial.Am J Sports Med. 2008; 36: 247-253
- Results of concomitant rotator cuff and SLAP repair are not affected by unhealed SLAP lesion.J Shoulder Elbow Surg. 2011; 20: 138-145
- The formation of perianchor fluid associated with various suture anchors used in rotator cuff repair: All-suture, polyetheretherketone, and biocomposite anchors.Bone Joint J. 2019; 101-B: 1506-1511
- Outcomes of single-row and double-row arthroscopic rotator cuff repair: A systematic review.J Bone Joint Surg Am. 2010; 92: 732-742
- Which method of rotator cuff repair leads to the highest rate of structural healing? A systematic review.Am J Sports Med. 2010; 38: 835-841
- Evaluation of repair tension in arthroscopic rotator cuff repair: Does it really matter to the integrity of the rotator cuff?.Am J Sports Med. 2016; 44: 2807-2812
- Glenoid osteophyte and rotator cuff tears: An anatomic study.J Shoulder Elbow Surg. 2002; 11: 72-79
- Natural history of glenoid bone loss in primary glenohumeral osteoarthritis: How does bone loss progress over a decade?.J Shoulder Elbow Surg. 2021; 30: 324-330
- Rotator cuff tear and glenohumeral instability: A systematic review.Clin Orthop Relat Res. 2014; 472: 2448-2456
Article info
Publication history
Published online: February 24, 2022
Accepted:
February 11,
2022
Received:
September 28,
2021
Footnotes
See commentary on page 2413
The authors report 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
© 2022 by the Arthroscopy Association of North America
