Agout C, et al. - The proposition explored herein was that 10 years following repair of rotator cuff tear, the clinical and anatomic results depended on the extension of the tear. Given the long follow-up period of this study, large series of patients and magnetic resonance imaging (MRI) evaluation of tendon repair, experts illustrated that 10 years following rotator cuff tear repair, between 68% and 81% of tendons had healed. They yielded data aided in speculating response to surgical treatment. A higher risk of retear was brought to light in tears with posterior extension. Regardless of the overall rate of complications and repeat surgery, the surgical repair displayed a good functional outcome whatever the type of tear.

Methods

• Researchers examined the data of 965 patients who underwent repair of rotator cuff tears in 2003.
• Case review was performed in 2014 for evaluation at a minimum follow-up of 10 years.
• Clinical evaluation was conducted of 511 patients, among whom 397 were also evaluated using MRI.
• A total of 289 isolated supraspinatus tears (SS), 94 tears with posterior extension (P), 92 with anterior extension (A) and 36 with anteroposterior (AP) extension were identified.

Results

• A substantial improvement was noted in the Constant score from 53.8 ± 14.7 preoperatively to 77.7 ± 12.1 (P < 0.0001) at 10 years.
• No prominent variation was revealed between the four groups.
• Findings illustrated lower rate of retear (Sugaya IV, V) in the SS group (19%) and higher in the P (32%) and AP groups (31%).
• A notably greater 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 substantially greater (Fuchs > 2) in the A (P < 0.001) and AP (P < 0.001) groups, at review.
• Data exhibited prominently higher rate of osteoarthritis (Samilson > 2) at 11% (P=0.001) in the A group.
• It was determined that the failure rate was considerably lower (P=0.044) in the SS group (25%) when compared to the massive rotator cuff tear groups (A, P and AP groups) (35%).
• The occurrence of complications was noted in 51 shoulders (10%), with the necessity of repeat surgery in 62 shoulders (12%), displaying no variation between the four groups.