title: Prospective evaluation of arthroscopic rotator cuff repairs at 5 years: part II--prognostic factors for clinical and radiographic outcomes.
abstract: BACKGROUND
  A rotator cuff registry was established to prospectively evaluate the effectiveness of all-arthroscopic repairs. The purpose of this study is to report prognostic factors for successful clinical and radiographic outcomes at 5 years.
  
  
  METHODS
  One-hundred ninety-three patients underwent all-arthroscopic rotator cuff repairs. Pre- and intraoperative data were compared to the American Shoulder and Elbow Surgeon (ASES) score, range of motion, muscle strength, and ultrasound results at 5 years using univariate, and multivariate analyses.
  
  
  RESULTS
  At 5 years, 106 patients completed follow-up. There were no pre- or intraoperative variables that were predictive of an ASES score >90. Factors predictive of a radiographic defect were larger size of the lesion (OR 1.72, 95% CI 1.04-2.85, P = .03), multiple tendon involvement (OR 5.56, 95% CI 1.23-25.22, P = .02), older age (OR 1.15, 95% CI 1.04-1.28, P = .01), concomitant biceps (OR 16.16, 95% CI 3.01-86.65, P = .001), and acromioclavicular joint procedures (OR 6.70, 95% CI 1.46-30.73, P = .01). Radiographic healing did not correspond to clinical outcomes. Resolution of a radiographic defect was seen in 14 patients. Younger age (OR 0.84, 95% CI 0.74-0.95, P = .004) and single-tendon tears (OR 7.59, 95% CI 1.71-84.45, P = .04) were predictive.
  
  
  CONCLUSIONS
  Larger tears in older patients who undergo concomitant procedures are predictive of radiographic defects at 5 years; however, radiographic healing did not correspond to clinical results. Younger patients with single tendon tears are more likely to undergo spontaneous resolution of a radiographic defect. This information can be useful in counseling patients regarding the mid-term results of this procedure.
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY 10021, USA. GulottaL@hss.edu
authors: Lawrence V
authors: LV
authors: Gulotta
authors: Shane J
authors: SJ
authors: Nho
authors: Christopher C
authors: CC
authors: Dodson
authors: Ronald S
authors: RS
authors: Adler
authors: David W
authors: DW
authors: Altchek
authors: John D
authors: JD
authors: MacGillivray
mesh_terms: D001182:Arthroscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013997:Time Factors; D014463:Ultrasonography