Clinical and structural outcome twenty years after repair of isolated supraspinatus tendon tears

J Shoulder Elbow Surg. 2019 Jan;28(1):196-202. doi: 10.1016/j.jse.2018.07.023. Epub 2018 Oct 12.


Background: This study evaluated the clinical and structural outcome 20 years after repair of isolated supraspinatus tendon tears. We hypothesized that the results would deteriorate over time.

Materials and methods: For this retrospective multicenter study, 137 patients were recalled for a clinical and imaging assessment. Six patients (4.3%) had died from unrelated causes, 52 (38.0%) were lost to follow-up, and 13 (9.5%) had undergone reoperations. This left 66 patients for clinical evaluation. Radiographs and magnetic resonance imaging were additionally performed for 45 patients, allowing assessment of osteoarthritis, tendon healing, fatty infiltration (FI), and muscle atrophy.

Results: The Constant Score (CS) improved from 51.5 ± 14.1 points preoperatively to 71 points (P < .05) with a mean Subjective Shoulder Value (SSV) of 77.2% ± 22%. Tendon discontinuity (Sugaya IV-V) was present in 19 of 45 patients (42 %), and there was advanced FI (Goutallier III-IV) of the supraspinatus in 12 (27%) and of the infraspinatus muscle in 16 (35%). Supraspinatus atrophy was present in 12 patients (28%), advanced arthritis in 6, and cuff tear arthropathy in 12 (30%). The CS and SSV were significantly inferior for shoulders with FI of stages III to IV (P < .05). The CS was lower in cuff tear arthropathy and correlated with infraspinatus FI.

Conclusions: At 20 years after surgical repair of isolated supraspinatus tears, the clinical outcome remains significantly above the preoperative state. FI of the infraspinatus is the most influential factor on long-term clinical outcome.

Keywords: MRI; Rotator cuff; long follow-up; open repair; supraspinatus; tear.

Publication types

  • Multicenter Study
  • Review

MeSH terms

  • Adipose Tissue / diagnostic imaging
  • Adult
  • Aged
  • Arthritis / diagnostic imaging
  • Arthritis / etiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Muscular Atrophy / diagnostic imaging
  • Muscular Atrophy / etiology
  • Retrospective Studies
  • Rotator Cuff Injuries / surgery*
  • Rotator Cuff Tear Arthropathy / diagnostic imaging
  • Rotator Cuff Tear Arthropathy / etiology
  • Shoulder Joint / diagnostic imaging