Rotator Cuff Integrity Correlates With Clinical and Functional Results at a Minimum 16 Years After Open Repair
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Recurrent or persistent defects in the rotator cuff after its repair are common. Short- and medium-term surveys have revealed, after open repair, patients with an intact rotator cuff have increased function and ROM. However, no long-term studies have verified cuff integrity on MR arthrography or correlated it with clinical and functional outcomes.
We evaluated long-term cuff integrity and fatty infiltration after open repair using MR arthrography and determined whether these findings correlated with clinical and functional results.
Using MR arthrography, we retrospectively evaluated 67 patients (48 men, 19 women) who underwent open rotator cuff repair between 1980 and 1989. Their mean age at surgery was 52 years. Minimum followup was 16 years (mean, 20 years; range, 16–25 years).
The retear rate was 94%, and mean size of rerupture was 3.5 × 3.6 cm (ranges, 0.5–5.0 cm × 0.5–5.2 cm; median, 4 × 4 cm). The remaining four patients had a partial supraspinatus tendon tear. Fatty infiltration was marked in the supraspinatus and infraspinatus tendons. Cuff integrity correlated with clinical results: active external rotation and forward flexion, and flexion, abduction, and external rotation strengths, were better in patients with an intact rotator cuff or a small retear of 4 cm2 or less than in patients with larger tears. Cuff integrity also correlated with functional results.
Rotator cuff integrity was lost in 94% of patients after a minimum followup of 16 years. Cuff integrity correlates well with clinical and functional results even several years postoperatively. A large retear seems to be the most important factor in deteriorating long-term clinical and functional results after open rotator cuff repair.
Level of Evidence
Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
KeywordsRotator Cuff Rotator Cuff Tear Fatty Infiltration Rotator Cuff Repair Arthroscopic Rotator Cuff Repair
We thank Pekka Tervahartiala MD, PhD and Martti Kiuru MD, PhD for MRI evaluation; Leena Ristolainen PT, PhD for statistical help; and Carol Norris PhD for language revision.
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