Rotator cuff integrity after arthroscopic repair for large tears with less-than-optimal footprint coverage.
OBJECTIVE
The purpose of this study was to evaluate the clinical results and healing status of rotator cuff repairs with less than 50% footprint coverage.


METHODS
During the 18-month period from October 2005 to March 2007, 89 large to massive rotator cuff tears were arthroscopically repaired. Among them, 23 consecutive large to massive rotator cuff tears were repaired completely but with less than 50% of the original footprint. All tears were arthroscopically repaired with suture anchors. Preoperative and postoperative clinical assessments were performed with the Constant score, American Shoulder and Elbow Surgeons score, and pain visual analog scale. The healing status of repaired tendon was evaluated by postoperative magnetic resonance imaging with a focus on tendon integrity, muscle fatty degeneration, and muscle atrophy.


RESULTS
The mean follow-up period was 30.2 months (range, 24 to 41 months). At final follow-up visits, American Shoulder and Elbow Surgeons score, Constant score, and score on pain visual analog scale were found to have improved significantly from 40.1, 35.9, and 57.7 to 82.4, 86.6, and 12.3, respectively (P < .01). The overall retear rate was 45.5% (10 cases). However, clinical results showed no difference between the retear group and no retear group. Furthermore, rerupture size was smaller than original tear size in all 10 patients, and no significant progression of fatty degeneration or muscle atrophy of rotator cuff muscles was observed.


CONCLUSIONS
Less-than-optimal coverage of the original greater tuberosity footprint during arthroscopic repair of large to massive rotator cuff tears was found to be associated with a relatively high retear rate (45.5%). However, clinical results improved significantly, and no significant difference was observed in the clinical results between the retear and no retear groups.


METHODS
Level IV, therapeutic case series.
Yoo
Jae Chul
JC
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea.
Ahn
Jin Hwan
JH
Koh
Kyoung Hwan
KH
Lim
Kyung Sub
KS
D000273:Adipose Tissue / Q000473:pathology; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006811:Humerus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D010149:Postoperative Pain / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012008:Recurrence; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D020069:Shoulder Pain / Q000453:epidemiology; D053441:Suture Anchors; D013710:Tendons / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome