Clinical outcome and repair integrity of repaired large and massive rotator cuff tear

Abstract

Hypothesis: Although a number of surgical procedures have been developed for rotator cuff tears, retear rates for large and massive rotator cuff tears have been higher than for patients with small tears. We adopted surface-holding repair, which was characterized by the footprint being advanced medially to avoid the strong tension in repaired tendon. The objective of this study was to evaluate clinical results and repair integrity of this procedure.
Methods: 18 shoulders with large and massive rotator cuff tears were repaired using this technique. There were 12 males and 6 females, and the average age was 68.9 years old, and the average follow-up period was 15.7 months. All patients were evaluated clinically, and were examined using the JOA score. In the A-P radiograph, upward migration of humeral head was compared pre- and postoperatively. Repair integrity was evaluated using Sugaya's classification.
Results: The average JOA score improved from 57.5 preoperatively to 88.8 at the time of final follow up. Upward migration progressed in 5.6% and improved in 38.9%. Postoperative MRI scans revealed 7 shoulders with Sugaya's classification type1, 4 shoulders with type2, 6 shoulders with type3, 1 shoulder with type4, and none with type5.
Discussion: Satisfactory clinical results were obtained with the surface-holding repair for massive rotator cuff tears. Although upward migration had progressed postoperatively in some shoulders, the incidence rates were no higher than those associated with other procedures. Therefore, this technique is anticipated to be recognized as an effective surgical method for rotator cuff injuries.