Characteristics of small to medium-sized rotator cuff tears with and without disruption of the anterior supraspinatus tendon.
BACKGROUND
The purpose of this study was to examine the baseline function and results of arthroscopic cuff repair in shoulders with small and medium-sized full-thickness cuff tears with complete supraspinatus disruption compared with those with an intact anterior supraspinatus tendon.


METHODS
The study evaluated 112 subjects with small and medium-sized cuff tears. Subjects were grouped according to anterior supraspinatus integrity (83 shoulders intact, group 1; and 29 shoulders with anterior supraspinatus tendon disruption, group 2). Functional assessments included visual analogue scale for pain, American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test score, and Constant score. Repair integrity was assessed by ultrasound examination.


RESULTS
Group 2 shoulders had greater mean tear width, length, and area (P < .0001) and greater supraspinatus muscle degenerative changes (P < .0001) compared with shoulders with an intact anterior supraspinatus tendon. There were no differences in demographics or baseline function (ASES score: 45 group 1 vs 46 group 2, P = .79; Constant score: 56 group 1 vs 52 group 2, P = .29) before surgery. There were no differences in any functional parameter (ASES score: 92 group 1 vs 93 group 2, P = .71; Constant score: 84 group 1 vs 85 group 2, P = .84) after surgery. There was no difference in tendon healing rates (93% group 1 vs 86% group 2; P = .26).


CONCLUSIONS
In the setting of painful small and medium-sized rotator cuff tears, disruption of the anterior supraspinatus tendon was associated with greater tear size and more advanced supraspinatus muscle degeneration. However, anterior supraspinatus tendon integrity had no influence on the clinical presentation or the functional and structural results of cuff repair surgery.
Washington University in St. Louis, Department of Orthopedic Surgery, St. Louis, MO, USA.
Surena
S
Namdari
Washington University in St. Louis, Department of Orthopedic Surgery, St. Louis, MO, USA.
Ryan P
RP
Donegan
Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO, USA.
Nirvikar
N
Dahiya
Washington University in St. Louis, Department of Orthopedic Surgery, St. Louis, MO, USA.
Leesa M
LM
Galatz
Washington University in St. Louis, Department of Orthopedic Surgery, St. Louis, MO, USA.
Ken
K
Yamaguchi
Washington University in St. Louis, Department of Orthopedic Surgery, St. Louis, MO, USA. Electronic address: keenerj@wudosis.wustl.edu.
Jay D
JD
Keener
D001182:Arthroscopy; D015331:Cohort Studies; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013708:Tendon Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography
Level III; Retrospective Cohort; Rotator cuff; Treatment Study; arthroscopy; rotator cable; supraspinatus tear