title: Longitudinal Long-term Magnetic Resonance Imaging and Clinical Follow-up After Single-Row Arthroscopic Rotator Cuff Repair: Clinical Superiority of Structural Tendon Integrity.
abstract: BACKGROUND
  The number of arthroscopic rotator cuff surgeries is consistently increasing. Although generally considered successful, the reported number of retears after rotator cuff repair is substantial. Short-term clinical outcomes are reported to be rarely impaired by tendon retears, whereas to our knowledge, there is no study documenting long-term clinical outcomes and tendon integrity after arthroscopic rotator cuff repair.
  
  
  OBJECTIVE
  To investigate longitudinal long-term repair integrity and clinical outcomes after arthroscopic rotator cuff reconstruction.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  Thirty patients who underwent arthroscopic rotator cuff repair with suture anchors for a full-tendon full-thickness tear of the supraspinatus or a partial-tendon full-thickness tear of the infraspinatus were included. Two and 10 years after initial arthroscopic surgery, tendon integrity was analyzed using magnetic resonance imaging (MRI). The University of California, Los Angeles (UCLA) score and Constant score as well as subjective questions regarding satisfaction with the procedure and return to normal activity were used to evaluate short- and long-term outcomes.
  
  
  RESULTS
  At the early MRI follow-up, 42% of patients showed a full-thickness rerupture, while 25% had a partial rerupture, and 33% of tendons remained intact. The 10-year MRI follow-up (129 ± 11 months) showed 50% with a total rerupture, while the other half of the tendons were partially reruptured (25%) or intact (25%). The UCLA and Constant scores significantly improved from preoperatively (UCLA total: 50.6% ± 20.2%; Constant total: 44.7 ± 10.5 points) to 2 years (UCLA total: 91.4% ± 16.0% [ P < .001]; Constant total: 87.8 ± 15.3 points [ P < .001]) and remained significantly higher after 10 years (UCLA total: 89.7% ± 15.9% [ P < .001]; Constant total: 77.5 ± 15.6 points [ P < .001]). The Constant total score and Constant strength subscore, but not the UCLA score, were also significantly better at 10 years postoperatively in patients with intact tendons compared with patients with retorn tendons (Constant total: 89.0 ± 7.8 points vs 75.7 ± 14.1 points, respectively [ P = .034]; Constant strength: 18.0 ± 4.9 points vs 9.2 ± 5.2 points, respectively [ P = .006]). The majority of patients rated their satisfaction with the procedure as "excellent" (83.3%), and 87.5% returned to their normal daily activities.
  
  
  CONCLUSIONS
  Arthroscopic rotator cuff repair showed good clinical long-term results despite a high rate of retears. Nonetheless, intact tendons provided significantly superior clinical long-term outcomes, making the improvement of tendon healing and repair integrity important goals of future research efforts.
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.|Austrian Research Group for Regenerative and Orthopedic Medicine, Vienna, Austria.
authors.forename: Philipp R
authors.initials: PR
authors.lastname: Heuberer
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.
authors.forename: Daniel
authors.initials: D
authors.lastname: Smolen
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.
authors.forename: Leo
authors.initials: L
authors.lastname: Pauzenberger
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.
authors.forename: Fabian
authors.initials: F
authors.lastname: Plachel
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Salem
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.|Austrian Research Group for Regenerative and Orthopedic Medicine, Vienna, Austria.
authors.forename: Brenda
authors.initials: B
authors.lastname: Laky
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Kriegleder
authors.affiliation: Department of Orthopedic Surgery, St Vincent Hospital, Vienna, Austria.|Austrian Research Group for Regenerative and Orthopedic Medicine, Vienna, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Anderl
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000000981:diagnostic imaging / Q000502:physiology*; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D014945:Wound Healing
keywords: arthroscopic rotator cuff repair; long-term outcome; magnetic resonance imaging; tendon integrity