title: Comparison of outcomes with arthroscopic repair of acute-on-chronic within 6 months and chronic rotator cuff tears.
abstract: BACKGROUND
  The purpose of this study was to define preoperative and intraoperative findings of acute-on-chronic rotator cuff tears (RCTs). This study also compared the functional and clinical outcomes with acute-on-chronic RCTs and chronic RCTs.
  
  
  METHODS
  This study was conducted between December 2007 and December 2013. An acute-on-chronic full-thickness RCT was diagnosed with preoperative and intraoperative findings on arthroscopy. The study group consisted of 36 patients with preoperative and intraoperative findings (surgery performed within 6 months of trauma) indicative of an acute-on-chronic RCT. Another 36 patients matched for age, sex, and tear size, who underwent arthroscopic rotator cuff repair after 6 months of onset of symptoms (chronic RCT group), were selected from our institution's database within the same time frame. Postoperative indirect magnetic resonance arthrogram was obtained 6 months after the repair, and rotator cuff integrity was graded according to the guidelines as described by Sugaya. Patients were evaluated using the visual analog scale for pain, American Shoulder and Elbow Surgeons Shoulder Assessment score, and Constant scores. Scores and measurements were obtained preoperatively and at 6, 12, and 24 months after surgery.
  
  
  RESULTS
  The clinical outcomes and range of motion recovery were better in the acute-on-chronic RCT group. Although statistically not significant, the acute-on-chronic RCT group's repair appeared closer to the complete repair and was associated with a lesser incidence of retear than the chronic RCT group.
  
  
  CONCLUSIONS
  Early repair of an acute-on-chronic full-thickness RCT results in a statistically and clinically superior improvement in outcomes compared with repairs of chronic RCTs.
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jeung Yeol
authors.initials: JY
authors.lastname: Jeong
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors.forename: Seung Yeop
authors.initials: SY
authors.lastname: Song
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea. Electronic address: shoulderyoo@gmail.com.
authors.forename: Jae Chul
authors.initials: JC
authors.lastname: Yoo
authors.affiliation: Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea.
authors.forename: Keun Min
authors.initials: KM
authors.lastname: Park
authors.affiliation: Division of Sports Medicine, Department of Physical Medicine and Rehabilitation, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Min
authors.initials: SM
authors.lastname: Lee
mesh_terms: D000208:Acute Disease; D001182:Arthroscopy / Q000009:adverse effects; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D011184:Postoperative Period; D016059:Range of Motion, Articular; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D020069:Shoulder Pain / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: MRA; MRI; Rotator cuff tear; acute on chronic; acute rotator cuff tear; arthroscopic finding; arthroscopy; chronic rotator cuff tear