Is residual tendon a predictor of outcome following arthroscopic rotator cuff repair? A preliminary outlook at short-term follow-up

J Shoulder Elbow Surg. 2020 Jul;29(7S):S53-S58. doi: 10.1016/j.jse.2020.01.083. Epub 2020 Apr 10.

Abstract

Background: Multiple factors including muscle atrophy, fatty infiltration, smoking, advanced patient age, and increasing tear size have been identified as risk factors for retear after rotator cuff repair. However, little is known about what effect the length of the residual rotator cuff tendon has on the success of repair and patient outcomes.

Methods: This study included 64 patients. Patients were stratified based on a residual tendon length of greater than 15 mm (group 1, residual tendon) or 15 mm or less (group 2, no residual tendon). Rotator cuff tendon integrity was then evaluated using ultrasound imaging at 6 months. Outcome measures included the Single Assessment Numeric Evaluation score, visual analog scale score, EQ5D Index score, Global Rating of Change score, and Penn Shoulder Score.

Results: No differences were found between groups regarding demographic data or repair configuration. Assessment of tendon healing demonstrated an increased rate of tendons that had "not healed" in group 2 (19.3% [n = 5] vs. 13.2% [n = 5]), but this difference was not statistically significant (P = .55). Functional outcome scores improved significantly from preoperatively to final follow-up in both groups and displayed no differences at 6-month follow-up.

Conclusion: A smaller residual tendon length was not a negative predictor of clinical outcomes following arthroscopic rotator cuff repair in patients with short-term follow-up. Although there was a trend toward a decreased rate of healing in patients with smaller residual tendons, this was not significant.

Keywords: Rotator cuff tear; repair; residual tendon length; retear rate; risk factor; shoulder.

MeSH terms

  • Aged
  • Arthroplasty
  • Arthroscopy
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Rotator Cuff / diagnostic imaging*
  • Rotator Cuff / pathology*
  • Rotator Cuff Injuries / diagnostic imaging
  • Rotator Cuff Injuries / physiopathology
  • Rotator Cuff Injuries / surgery*
  • Shoulder Joint / diagnostic imaging
  • Shoulder Joint / physiopathology
  • Shoulder Joint / surgery
  • Treatment Outcome
  • Ultrasonography