title: Long-term survivorship of rotator cuff repairs using ultrasound and magnetic resonance imaging analysis.
abstract: BACKGROUND
  Important differences in clinical outcomes likely exist between patients with healed and nonhealed rotator cuff repairs. The survival probability of rotator cuff repairs has not been published in a time-dependent manner up to now.
  
  
  OBJECTIVE
  Recurrent tears occur more frequently in the early postoperative period. Early failures of the repair are a prognostic factor for the long-term outcome.
  
  
  METHODS
  Cohort study; Level of evidence, 3.
  
  
  METHODS
  A series of 107 consecutive patients undergoing arthroscopically assisted mini-open repair of the rotator cuff between 1998 and 2002 were evaluated in a prospective study. Of these, 95 patients finished the study after a maximum follow-up of 11 years. The evaluation included 1 postoperative magnetic resonance imaging scan as well as multiple ultrasonographies and determinations of the American Shoulder and Elbow Surgeons (ASES) and Constant scores at 3 months, 6 months, 1 year, and then yearly with a median follow-up of 96 months.
  
  
  RESULTS
  The overall failure rate was 33% (35 of 107). The survivorship analysis revealed that 74% of all failures occurred atraumatically in the first 3 months and 11% occurred between the third and the sixth month after the repair. The remaining reruptures (14%) happened 2 to 5 years postoperatively and were related to sports activities or direct trauma. The overall clinical results did not deteriorate over time. The parameters healed tendon, rerupture of less than 2 cm(2), and rerupture of more than 2 cm(2) at 6 months were predictors of the gender- and age-adjusted (normalized) Constant score at 84 months (P < .0001).
  
  
  CONCLUSIONS
  The majority of recurrent tears occurred in the first 3 months after surgical repair. The parameters "recurrent tear" as well as "healed tendon" evaluated at 6 months postoperatively appear to be predictors for the clinical outcomes at 7 years. Efforts to improve healing during the initial 3 months have long-term implications for maintenance of cuff integrity and clinical outcomes.
authors: Department of Orthopedics, SMZOst Donauspital, Vienna, Austria. rainer.kluger@wienkav.at
authors: Rainer
authors: R
authors: Kluger
authors: Peter
authors: P
authors: Bock
authors: Martina
authors: M
authors: Mittlböck
authors: Wolfgang
authors: W
authors: Krampla
authors: Alfred
authors: A
authors: Engel