Trauma versus no trauma: an analysis of the effect of tear mechanism on tendon healing in 1300 consecutive patients after arthroscopic rotator cuff repair.
BACKGROUND
Patients with rotator cuff tears often recall a specific initiating event (traumatic), whereas many cannot (nontraumatic). It is unclear how important a history of trauma is to the outcomes of rotator cuff repair.


METHODS
This question was addressed in a study cohort of 1300 consecutive patients who completed a preoperative questionnaire regarding their shoulder injury and had a systematic evaluation of shoulder range of motion and strength, a primary arthroscopic rotator cuff repair performed by a single surgeon, an ultrasound scan, and the same subjective and objective measurements made of their shoulder 6 months after surgery. Post hoc, this cohort was separated into 2 groups: those who reported no history of trauma on presentation (n = 489) and those with a history of traumatic injury (n = 811).


RESULTS
The retear rate in the group with no history of trauma was 12%, whereas that of the group with a history of trauma was 14% (P = .36). Those patients with a history of shoulder trauma who waited longer than 24 months had higher retear rates (20%) than those who had their surgery earlier (13%) (P = .040).


CONCLUSIONS
Recollection of a traumatic initiating event had little effect on the outcome of arthroscopic rotator cuff repair. Duration of symptoms was important in predicting retears if patients recalled a specific initiating event but not in patients who did not recall any specific initiating event. Patients with a history of trauma should be encouraged to have their rotator cuff tear repaired within 2 years.
Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, NSW, Australia.
Martin
M
Tan
Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, NSW, Australia.
Patrick H
PH
Lam
Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, NSW, Australia.
Brian T N
BT
Le
Orthopaedic Research Institute, St George Hospital Campus, University of New South Wales, Sydney, NSW, Australia. Electronic address: murrell.g@ori.org.au.
George A C
GA
Murrell
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy; D005260:Female; D006801:Humans; D022125:Lacerations / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012421:Rupture / Q000209:etiology / Q000601:surgery; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery; D011795:Surveys and Questionnaires; D013708:Tendon Injuries / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
Shoulder; injury; muscle injuries; retear; rotator cuff; trauma