Three-month Delay in Rotator Cuff Repair: 2-year Follow-up

J Am Acad Orthop Surg Glob Res Rev. 2024 Jan 22;8(1):e23.00283. doi: 10.5435/JAAOSGlobal-D-23-00283. eCollection 2024 Jan 1.

Abstract

Introduction: This study examined 2-year outcomes of patients who underwent delayed rotator cuff repair (RCR) compared with those who underwent RCR without delay.

Methods: In this prospective comparative study, two groups were formed: (1) patients planning RCR during a 6-week elective surgery ban and (2) patients undergoing RCR at least 6 weeks after the ban. The Simple Shoulder Test, American Shoulder and Elbow Surgeon score, and visual analog scale for pain were collected preoperatively and at 2 years postoperatively. Magnetic resonance imaging assessed healing 6 months postoperatively.

Results: With a 93.3% 2-year follow-up (13/15 delay group, 15/15 control), there was an 87-day difference in presentation to surgery (P = 0.001), with no significant preoperative demographic or tear characteristic differences between groups. Intraoperatively, there were no differences between groups in repair characteristics. Preoperative versus postoperative differences in American Shoulder and Elbow Surgeon score (P < 0.001), visual analog scale (P < 0.001), and Simple Shoulder Test scores (P < 0.001) were significant but not between groups (P = 0.650, 0.586, 0.525). On MRI, 58% in the delay group and 85% in the control group had healed (P = 0.202).

Discussion: Although a 3-month delay showed no statistically significant effect on outcomes, the delay group had an approximately 27% higher failure rate. Thus, although a 3-month period of nonsurgical treatment before RCR may be reasonable, larger studies are warranted for definitive conclusions.

MeSH terms

  • Arthroplasty
  • Elbow Joint*
  • Follow-Up Studies
  • Humans
  • Prospective Studies
  • Rotator Cuff* / diagnostic imaging
  • Rotator Cuff* / surgery