Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair

J Shoulder Elbow Surg. 2016 Jan;25(1):12-21. doi: 10.1016/j.jse.2015.06.023. Epub 2015 Aug 8.


Background: Patients with rotator cuff tears often recall a specific initiating event (traumatic), whereas many cannot (nontraumatic). It is unclear how important a history of trauma is to the outcomes of rotator cuff repair.

Methods: This question was addressed in a study cohort of 1300 consecutive patients who completed a preoperative questionnaire regarding their shoulder injury and had a systematic evaluation of shoulder range of motion and strength, a primary arthroscopic rotator cuff repair performed by a single surgeon, an ultrasound scan, and the same subjective and objective measurements made of their shoulder 6 months after surgery. Post hoc, this cohort was separated into 2 groups: those who reported no history of trauma on presentation (n = 489) and those with a history of traumatic injury (n = 811).

Results: The retear rate in the group with no history of trauma was 12%, whereas that of the group with a history of trauma was 14% (P = .36). Those patients with a history of shoulder trauma who waited longer than 24 months had higher retear rates (20%) than those who had their surgery earlier (13%) (P = .040).

Conclusion: Recollection of a traumatic initiating event had little effect on the outcome of arthroscopic rotator cuff repair. Duration of symptoms was important in predicting retears if patients recalled a specific initiating event but not in patients who did not recall any specific initiating event. Patients with a history of trauma should be encouraged to have their rotator cuff tear repaired within 2 years.

Keywords: Shoulder; injury; muscle injuries; retear; rotator cuff; trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Arthroscopy
  • Female
  • Humans
  • Lacerations / etiology*
  • Lacerations / physiopathology
  • Lacerations / surgery
  • Male
  • Middle Aged
  • Muscle Strength
  • Range of Motion, Articular
  • Recurrence
  • Retrospective Studies
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries*
  • Rupture / etiology
  • Rupture / surgery
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery
  • Surveys and Questionnaires
  • Tendon Injuries / etiology*
  • Tendon Injuries / physiopathology
  • Tendon Injuries / surgery
  • Time Factors
  • Treatment Outcome
  • Wound Healing*
  • Young Adult