Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair.
BACKGROUND
Recurrent or persistent defects in the rotator cuff after its repair are common. Short- and medium-term surveys have revealed, after open repair, patients with an intact rotator cuff have increased function and ROM. However, no long-term studies have verified cuff integrity on MR arthrography or correlated it with clinical and functional outcomes.


OBJECTIVE
We evaluated long-term cuff integrity and fatty infiltration after open repair using MR arthrography and determined whether these findings correlated with clinical and functional results.


METHODS
Using MR arthrography, we retrospectively evaluated 67 patients (48 men, 19 women) who underwent open rotator cuff repair between 1980 and 1989. Their mean age at surgery was 52 years. Minimum followup was 16 years (mean, 20 years; range, 16-25 years).


RESULTS
The retear rate was 94%, and mean size of rerupture was 3.5 × 3.6 cm (ranges, 0.5-5.0 cm × 0.5-5.2 cm; median, 4 × 4 cm). The remaining four patients had a partial supraspinatus tendon tear. Fatty infiltration was marked in the supraspinatus and infraspinatus tendons. Cuff integrity correlated with clinical results: active external rotation and forward flexion, and flexion, abduction, and external rotation strengths, were better in patients with an intact rotator cuff or a small retear of 4 cm(2) or less than in patients with larger tears. Cuff integrity also correlated with functional results.


CONCLUSIONS
Rotator cuff integrity was lost in 94% of patients after a minimum followup of 16 years. Cuff integrity correlates well with clinical and functional results even several years postoperatively. A large retear seems to be the most important factor in deteriorating long-term clinical and functional results after open rotator cuff repair.


METHODS
Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
ORTON Research Institute and ORTON Hospital, Invalid Foundation, Tenholantie 10, 00280, Helsinki, Finland. martti.vastamaki@orton.fi
Martti
M
Vastamäki
Martina
M
Lohman
Niclas
N
Borgmästars
D000328:Adult; D000368:Aged; D001175:Arthrography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging* / Q000502:physiology / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome