Long-term results after arthroscopic transosseous rotator cuff repair

J Shoulder Elbow Surg. 2019 Apr;28(4):706-714. doi: 10.1016/j.jse.2018.09.003. Epub 2018 Dec 17.

Abstract

Background: The purpose of this study was to evaluate the long-term clinical and radiologic results after arthroscopic transosseous rotator cuff repair (TORCR).

Methods: A total of 69 patients with full-thickness supraspinatus tendon tears with or without infraspinatus tendon tears treated with arthroscopic TORCR by a single surgeon between 1998 and 2003 were included. Among them, 56 patients (81%) with a mean age of 58 ± 5 years (range, 42-70 years) were available for final follow-up examination after an average of 15 ± 2 years (range, 12-18 years). The Subjective Shoulder Value, Constant score (CS), University of California at Los Angeles score, and American Shoulder and Elbow Surgeons score were recorded. Magnetic resonance imaging (MRI) was performed to visualize tendon integrity in 66% of patients.

Results: At final follow-up, the mean CS was 84 ± 8 points; mean University of California at Los Angeles score, 33 ± 2 points; mean American Shoulder and Elbow Surgeons score, 92 ± 10 points; and mean Subjective Shoulder Value, 89% ± 17%. MRI revealed asymptomatic repair failure in 9 patients (27%). Moreover, 4 patients (7%) underwent revision surgery because of a symptomatic rerupture, resulting in an overall retear rate of 33%. Patients with intact repairs at final follow-up showed a significantly higher CS (P = .019) and abduction strength (P = .016) than patients with retears.

Conclusion: Arthroscopic TORCR for the treatment of full-thickness rotator cuff tears provided good clinical results 12 to 18 years after surgery. Cuff integrity on follow-up MRI scans had a positive effect on the clinical outcome.

Keywords: Rotator cuff tear; arthroscopy; cuff integrity; long-term follow-up; magnetic resonance imaging; transosseous fixation technique.

MeSH terms

  • Adult
  • Aged
  • Arthroscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Recurrence
  • Reoperation
  • Rotator Cuff Injuries / diagnostic imaging*
  • Rotator Cuff Injuries / surgery*
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / physiopathology*
  • Time Factors
  • Treatment Failure