Functional outcome and structural integrity following mini-open repair of large and massive rotator cuff tears: a 3-5 year follow-up study.
BACKGROUND
Mini-open approach has been considered for years the gold standard for rotator cuff repairs. Nevertheless, the rate of tendon-to-bone healing, and that of cuff re-tear, still remains unclear.


METHODS
Between 2001 and 2004, 37 shoulders (32 patients) with a mean age of 54.8 years (range, 34-72) and a large or massive cuff tear were repaired with a mini-open procedure. At a minimum of 3 years postoperatively (range, 36-60 months), 27 shoulders (23 patients) underwent functional evaluation and US investigation of cuff integrity.


RESULTS
The rotator cuff was completely healed and watertight in 13 cases (48.1%), while recurrent defects were detected in the remaining 14 shoulders (51.9%). In 12 cases (92.5%), the recurrent tears were smaller and in 2 (7.5%) larger than the initial tear. Despite the high re-tear rate, the overall Constant and UCLA scores improved from of 38.4 to 72.1 and 11.2 to 29.4, respectively. However, only "large" re-tears were correlated with a worse functional outcome (P < .005). The preoperative tear size was negatively associated with tendon healing. Patients with an intact rotator cuff repair were, on average, 15 years younger (49.9) than those who sustained a tear recurrence (64.14) (P < .005).


CONCLUSIONS
Our results suggest that large and massive rotator cuff tears treated with mini-open technique using a tendon-grasping suture have a very satisfactory clinical outcome, despite a significant re-tear rate. Patient age, the size of the initial tear, as well as the size of a potential re-tear are factors affecting the final clinical outcome.
Papadopoulos
Pericles
P
1st Orthopaedic Department of Aristotelian University of Thessaloniki, G. Papanikolaou General Hospital, Thessaloniki, Greece.
Karataglis
Dimitrios
D
Boutsiadis
Achilleas
A
Fotiadou
Anastasia
A
Christoforidis
John
J
Christodoulou
Anastasios
A
D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D012008:Recurrence; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography