title: Arthroscopic rotator cuff repair: prospective evaluation with sequential ultrasonography.
abstract: BACKGROUND
  Recent studies have demonstrated predictable healing after arthroscopic rotator cuff repair at a single time point, but few studies have evaluated tendon healing over time.
  
  
  OBJECTIVE
  Rotator cuff tears that are intact on ultrasound at 1 time point will remain intact, and clinical results will improve regardless of healing status.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  The Arthroscopic Rotator Cuff Registry was established to determine the effectiveness of arthroscopic rotator cuff repair with clinical outcomes using the American Shoulder and Elbow Surgeons score and ultrasound at 1 and 2 years, postoperatively. Patients were assigned to 1 of 3 groups based on ultrasound appearance: group 1, rotator cuff tendon intact at 1 and 2 years (n = 63); group 2, rotator cuff tendon defect at 1 and 2 years (n = 23); group 3, rotator cuff tendon defect at 1 year but no defect at 2 years (n = 7).
  
  
  RESULTS
  The ultrasound appearance was consistent at 1 and 2 years for 86 of the 93 patients (92.5%). The patients in group 1 had a significantly lower mean age (57.8 +/- 9.8 years) than the patients of group 2 (63.6 +/- 8.6 years; P = .04). Group 2 had a significantly greater rotator cuff tear size (4.36 +/- 1.6 cm) than group 1 (2.84 +/- 1.1 cm; P = .00025). Each group had a significant improvement in American Shoulder and Elbow Surgeons scores from baseline to 2-year follow-up. CONCLUSION All intact rotator cuff tendons at 1 year remained intact at 2 years. A small group of patients with postoperative imaging did not appear healed by ultrasound at 1 year but did so at 2 years. Patients demonstrated improvement in American Shoulder and Elbow Surgeons shoulder scores, range of motion, and strength, regardless of tendon healing status on ultrasound.
authors.affiliation: Sports Medicine and Shoulder Surgery Service, Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, New York, USA. snho@hotmail.com
authors.forename: Shane J
authors.initials: SJ
authors.lastname: Nho
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Adler
authors.forename: Daniel P
authors.initials: DP
authors.lastname: Tomlinson
authors.forename: Answorth A
authors.initials: AA
authors.lastname: Allen
authors.forename: Frank A
authors.initials: FA
authors.lastname: Cordasco
authors.forename: Russell F
authors.initials: RF
authors.lastname: Warren
authors.forename: David W
authors.initials: DW
authors.lastname: Altchek
authors.forename: John D
authors.initials: JD
authors.lastname: MacGillivray
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D020127:Recovery of Function; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery; D000070636:Rotator Cuff Injuries; D016896:Treatment Outcome; D014463:Ultrasonography