Arthroscopic repair of full-thickness tears of the rotator cuff: 2- to 14-year follow-up.
Wilson F, Hinov V, Adams G.
Medicine Institute of Indiana, Indianapolis, Indiana, USA.
This study was performed to evaluate 2 arthroscopic techniques for rotator
cuff repair used by 1 surgeon for more than 12 years. The main objective of
this study was to test the reliability of these arthroscopic repair techniques
not only using clinical assessment during the follow-up, but through
observation of the healing process of the tendons during the arthroscopic
removal of the staples in our first group of patients. Type of Study: This
study was a before/after trial. METHODS: We present the results of
arthroscopic repair of full-thickness rotator cuff tears in 100 patients. In
group I, 35 patients had staple fixation, and in group II, 65 patients had
side-to-side suture and anchor repair. Follow-up ranged from 2 to 14 years.
All shoulders were evaluated using the UCLA rating scale. Shoulders repaired
with staples (group I) were evaluated arthroscopically at staple removal.
Arthroscopic subacromial decompression was performed in 26 of the 35 patients
in group I and in 65 of the 65 patients in group II; 58 patients in group II
had concomitant resection of distal clavicle. RESULTS: In group I, 22 patients
(63%) had excellent results (UCLA scores, 34-35), 7 (20%) had good results
(UCLA scores, 28-33), 4 (11%) had fair results (UCLA scores, 21-27), and 2
(6%) of the patients had poor results (UCLA scores, 0-20). In group II, 47
patients (72%) had excellent results (UCLA scores, 34-35), 12 (19%) had good
results (UCLA scores, 28-33), 2 (3%) had fair results (UCLA scores, 21-27),
and 4 (6%) of the patients had poor results (UCLA scores, 0-20). CONCLUSIONS:
Patients with well-healed rotator cuff tendons had satisfactory postoperative
results and better overall functional results. The arthroscopic techniques for
rotator cuff repair achieve results comparable to the results of traditional
open repair. However, these technically demanding arthroscopic procedures
require advanced arthroscopic skills and have a steep learning curve.