Long-term clinical and MRI results of open repair of the supraspinatus tendon.
Open repair of full-thickness tears of the rotator cuff generally improves function, although anatomic failures are not uncommon. We asked whether the presence or absence of an anatomic repair influenced outcomes. We retrospectively analyzed 47 patients (49 shoulders) treated by open proximalized reinsertion of the supraspinatus tendon for chronic retracted detachment. The mean age of the patients at the time of surgery was 59 years. At a minimum 60-month followup (mean, 87 months; range, 60-133 months), we observed an improvement in the age- and gender-adjusted Constant-Murley score from 67% preoperatively to 95% postoperatively and in the pain score. With the last followup MRI, the supraspinatus tendon had reruptured in five patients (12%); the presence of a rerupture did not negatively influence the functional result. Once healing of the repaired tendons was achieved, supraspinatus muscle atrophy never worsened. However, on MRI, fatty infiltration of the supraspinatus, infraspinatus, and subscapularis muscles increased postoperatively despite tendon healing. Radiographic centering of the humeral head was preserved and glenohumeral arthritis remained stable. Functional results were better when the standardized supraspinatus muscle area was greater than 0.5 at the final evaluation.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Nich
Christophe
C
Department of Traumatology and Orthopaedic Surgery, European Hospital of Paris, Assistance Publique-Hôpitaux de Paris, Paris Cedex 15, France. chrnich@gmail.com
Mütschler
Céline
C
Vandenbussche
Eric
E
Augereau
Bernard
B
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000209:etiology / Q000473:pathology; D019637:Orthopedic Procedures; D010147:Pain Measurement; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012008:Recurrence; D012092:Replantation; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012785:Shoulder Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control; D013708:Tendon Injuries / Q000150:complications / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing