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Clinical and anatomic results of rotator cuff repair at 10 years depend on tear type

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Although good short-term and mid-term outcomes are reported for rotator cuff repair, few studies have investigated long-term outcome with clinical and MRI evaluation. The hypothesis was that 10 years following repair of rotator cuff tear, the clinical and anatomic results depend on the extension of the tear.

Methods

The records of all 965 patients who underwent repair of rotator cuff tears in 2003 were retrieved. The patients were reviewed in 2014 for evaluation at a minimum follow-up of 10 years. A total of 511 patients were evaluated clinically, of whom 397 were also evaluated using MRI. There were 289 isolated supraspinatus tears (SS), 94 tears with posterior extension (P), 92 with anterior extension (A) and 36 with anteroposterior (AP) extension.

Results

The Constant score had significantly improved from 53.8 ± 14.7 preoperatively to 77.7 ± 12.1 (P < 0.0001) at 10 years, with no significant difference between the four groups. The rate of retear (Sugaya IV, V) was lower in the SS group (19%) and higher in the P (32%) and AP groups (31%). At review, infraspinatus fatty degeneration was significantly greater (Fuchs > 2) in the P (P < 0.001) and AP (P < 0.001) groups and subscapularis fatty degeneration was significantly greater (Fuchs > 2) in the A (P < 0.001) and AP (P < 0.001) groups. The rate of osteoarthritis (Samilson > 2) was significantly higher at 11% (P = 0.001) in the A group. The failure rate was significantly lower (P = 0.044) in the SS group (25%) than the massive rotator cuff tear groups (A, P and AP groups) (35%). Complications occurred in 51 shoulders (10%) and repeat surgery was required in 62 shoulders (12%), with no difference between the four groups.

Conclusions

The long follow-up period of this study, large series of patients and MRI evaluation of tendon repair allowed us to demonstrate that 10 years following rotator cuff tear repair, between 68 and 81% of tendons had healed. These findings are of value in predicting response to surgical treatment. Tears with posterior extension had a higher risk of retear. However, surgical repair appeared to give a good functional outcome whatever the type of tear, despite the overall rate of complications and repeat surgery.

Level of evidence

IV.

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Abbreviations

A:

Anterior extension

AP:

Anteroposterior extension

P:

Posterior extension

SS:

Supraspinatus

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Acknowledgements

The authors thank Bernard Augereau, PhD, Pascal Boileau, PhD, Michel Colmar, MD, Pierre-Henri Flurin, MD, Christian Gerber, PhD, Philippe Hardy, PhD, Laurent Lafosse, MD, Pierre Mansat, PhD, Nicolas Meyer, PhD, Daniel Molé, PhD, Christophe Nich, PhD, Laurent Nové-Josserand, MD, Hervé Thomazeau, PhD, Philippe Valenti, MD, and Gilles Walch, MD, for their participation in this study. Funding was provided by SoFCOT (Société Française de Chirurgie Orthopédique et Traumatologique).

Author information

Authors and Affiliations

  1. Services de Chirurgie Orthopédique 1 et 2, Hôpital Trousseau, CHRU de Tours, Avenue de la République, 37170, Chambray-Lès-Tours, France

    Charles Agout, Julien Berhouet & Luc Favard

  2. Institut de la Main Nantes-Atlantique, Clinique Jeanne-d’Arc, 21 Rue Des Martyrs, 44100, Nantes, France

    Yves Bouju

  3. Centre Orthopédique Santy, Hôpital Privé Jean Mermoz (Ramsay Général De Santé), Lyon, France

    Arnaud Godenèche

  4. CHP Saint Grégoire VIVALTO Santé, Saint Grégoire, France

    Philippe Collin

  5. Centre de Traumatologie, Hôpitaux Universitaires de Strasbourg, Illkirch-Graffenstaden, France

    Jean-François Kempf

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  1. Charles Agout
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  2. Julien Berhouet
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  3. Yves Bouju
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  7. Luc Favard
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Corresponding author

Correspondence to Charles Agout.

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Conflict of interest

The authors declared that they have no conflict of interest.

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.

Ethical approval

The Ethical committee of the Medical university of Strasbourg gave a favorable opinion on your request about project of clinical research: Ten-year multi-center clinical and MRI evaluation of isolated supraspinatus repairs (No: IDR 2013-A01788-37).

Informed consent

Patients were informed, and they consented to conduct the study.

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Agout, C., Berhouet, J., Bouju, Y. et al. Clinical and anatomic results of rotator cuff repair at 10 years depend on tear type. Knee Surg Sports Traumatol Arthrosc 26, 2490–2497 (2018). https://doi.org/10.1007/s00167-018-4854-1

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