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Traumatic rotator cuff injury: does delayed surgery worsen functional outcomes?

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Abstract

Purpose

The optimal timing of surgery after traumatic rotator cuff tears (RCT) is unclear, with its impact on functional outcomes under debate. This study aimed to review functional outcomes after RCT repair in patients who underwent early vs delayed surgery at our unit.

Methods

This was single-centre retrospective evaluation. Patients with an acute traumatic RCT that underwent repair between 2017 and 2019 and had local follow-up were included and placed into two groups: early surgery (within 6 months from injury) and delayed surgery (more than 6 months from injury). Patient demographics, RCT data and pre- and post-operative (after 12 months) Oxford Shoulder Score (OSS) were extracted from medical records. Data was analysed to compare OSS scores between groups, as well as the effect of cuff tear sizes on OSS scores.

Results

Forty-nine patients were included in the analysis (15 early, 34 delayed). There were no significant differences in age, sex or cuff tear sizes between groups. No difference was identified in the mean post-operative OSS between early vs delayed groups (40.9 ± 6.34 vs 40.5 ± 7.65, p = 0.86). The mean improvement in OSS after surgery was also similar between groups (22.5 ± 7.81 vs 20.97 ± 7.19, p = 0.498). Having a large or massive RCT did not worsen OSS compared to small or medium RCT (p = 0.44), even when stratified by early or delayed surgery.

Conclusion

Delayed surgery for traumatic RCT greater than 6 months from injury did not negatively impact long-term functional outcomes at our unit. Patients should be reassured as applicable before surgery in the event of prolonged or unavoidable delays.

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Data availability

The dataset used in this study to evaluate practice is not openly available due to reasons of sensitivity and confidentiality. Reasonable requests for access may be considered by contacting the corresponding author.

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Funding

This work received no specific grant from any funding agency in the public, commercial, or not-for profit sectors.

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Authors and Affiliations

  1. Department of Trauma & Orthopaedics, West Hertfordshire Teaching Hospitals NHS Trust, Hertfordshire, UK

    Russell de Sa, Abdelmonem Hassan, Emad Soliman, Mustafa Al-Yaseen, Prathamesh Kane, Hussain Selmi & Daoud Makki

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  1. Russell de Sa
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  2. Abdelmonem Hassan
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  3. Emad Soliman
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  4. Mustafa Al-Yaseen
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  6. Hussain Selmi
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  7. Daoud Makki
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by RDS, AH, ES and MA-Y. The first draft of the manuscript was written by RDS, and all authors commented on previous versions of the manuscript. All authors read and approved final versions of the manuscript.

Corresponding author

Correspondence to Russell de Sa.

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Ethical approval

This study was registered with the local audit department of our Trust as part of an evaluation of our orthopaedic service. It followed local protocols for data collection, analysis and presentation, and ethical committee review was not required for this work as per local policy.

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The authors declare no competing interests.

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de Sa, R., Hassan, A., Soliman, E. et al. Traumatic rotator cuff injury: does delayed surgery worsen functional outcomes?. International Orthopaedics (SICOT) 48, 1271–1275 (2024). https://doi.org/10.1007/s00264-024-06127-2

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  • DOI: https://doi.org/10.1007/s00264-024-06127-2

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