title: Repair integrity and functional outcomes for arthroscopic margin convergence of rotator cuff tears.
abstract: BACKGROUND
  We evaluated the clinical outcomes of arthroscopic margin convergence for rotator cuff tears.
  
  
  METHODS
  Twenty-four consecutive patients with full-thickness rotator cuff tears, in which the free tendon edge could not be reduced to the footprint after the release and mobilization of the rotator cuff tendon, were included. Rotator cuff repair integrity was determined by magnetic resonance imaging or ultrasonography after the operation. The mean age and follow-up period for the patients were 59.6 years (range, forty-eight to seventy-three years) and 30.6 months (range, twenty-four to sixty months), respectively. Five outcome measures were used before surgery and at the time of the final follow-up: a visual analog scale (VAS) pain score, the American Shoulder and Elbow Surgeons (ASES) score, the Shoulder Rating Scale of the University of California Los Angeles (UCLA), the Constant-Murley score, and the range of shoulder motion.
  
  
  RESULTS
  The follow-up rate for imaging was 95.8%, and the follow-up rate for clinical evaluation was 91.7%. The mean UCLA score (and standard deviation) improved from 17.4 ± 5.5 preoperatively to 31.6 ± 4.0 at the time of the final follow-up (p < 0.001). The mean ASES score improved from 54.9 ± 23.3 to 91.3 ± 11.8, respectively (p < 0.001). The mean Constant-Murley score improved from 45.9 ± 17.6 to 79.1 ± 12.6 (p < 0.001). The mean VAS score improved from 6.5 ± 1.7 to 1.3 ± 1.5 (p < 0.001). The mean range of motion (forward flexion) improved from 117.9° ± 37.7° to 166.8° ± 16.7° (p < 0.001). The postoperative imaging examinations showed cuff integrity without a retear in 52.2% of the shoulders. However, the UCLA, ASES, and Constant-Murley scores were not significantly different between healed and unhealed groups (p = 0.800, p = 0.322, and p = 0.597, respectively).
  
  
  CONCLUSIONS
  Reducing tension by margin convergence followed by a repair of the resulting free edge to bone has reasonable short-term clinical results but a substantial retear rate (47.8%). However, the retears tended to be smaller than the original tear size. No significant difference was observed in the short-term clinical results between the groups with or without a retear.
authors.affiliation: Department of Orthopaedic Surgery, Chungnam National University Hospital, 640 Daesa-Dong, Jung-Gu, Daejeon 301-721, South Korea. kckim@cnu.ac.kr
authors.forename: Kyung Cheon
authors.initials: KC
authors.lastname: Kim
authors.forename: Hyun Dae
authors.initials: HD
authors.lastname: Shin
authors.forename: Soo Min
authors.initials: SM
authors.lastname: Cha
authors.forename: Joung Hun
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010147:Pain Measurement; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000601:surgery; D000070636:Rotator Cuff Injuries; D016037:Single-Blind Method; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography