Prospective analysis of arthroscopic rotator cuff repair: subgroup analysis

J Shoulder Elbow Surg. 2009 Sep-Oct;18(5):697-704. doi: 10.1016/j.jse.2008.11.018. Epub 2009 Mar 9.

Abstract

Background: The rotator cuff registry was established to evaluate prospectively the effectiveness of arthroscopic rotator cuff repair. The purpose of the present study is to report the preliminary data at the 1- and 2-year time point and perform subgroup analysis to identify factors that may affect outcome.

Methods: A total of 193 patients underwent all-arthroscopic repair of a rotator cuff tear and met the inclusion criteria and 127 (65.8%) completed 2-year follow-up. The outcome measurements included physical examination, manual muscle testing, the American Shoulder and Elbow Surgeons (ASES) score, and ultrasonography.

Results: The pre-operative ASES score was 52.37 +/- 24.09 and improved to 83.88 +/- 19.28 at 1 year (P < .0001) and 92.65 +/- 11.36 at 2 years (P < 0.0001). The percent healing for all patients was 64.10% at 3 months and 64.34% at 1 year (P = .4080). At 2 years, there was a significant increase in the percentage of healed tendon at 75.42% compared to the 3-month (P (1/4) .0001) and 1-year (P = 0.0332) time points. Patients with intact tendons had an ASES score of 93.9 +/- 10.2 compared to tendon defects with a score of 88.0 +/- 15.6 (P = .0623). Gender, tear size, and acromioclavicular joint involvement have a significant effect on ASES score. Rotator cuff characteristics such as tear size, biceps pathology, acromioclavicular joint pathology, and tissue quality have a significant effect on postoperative tendon integrity.

Conclusion: Arthroscopic rotator cuff repair demonstrates significant improvement in clinical outcomes and good rate of healing by postoperative ultrasound. Longer-term studies are necessary to determine the efficacy over time.

MeSH terms

  • Aged
  • Arthroscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Pain Measurement
  • Physical Examination / methods
  • Postoperative Care
  • Preoperative Care / methods
  • Probability
  • Prospective Studies
  • Range of Motion, Articular / physiology*
  • Recovery of Function
  • Registries
  • Rotator Cuff / diagnostic imaging*
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries
  • Shoulder Injuries
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / surgery*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler
  • United States