Prospective analysis of arthroscopic rotator cuff repair: Subgroup analysis

Nho, Shane J.; Shindle, Michael K.; Adler, Ronald S.; Warren, Russell F.; Altchek, David W.; MacGillivray, John D.

doi:10.1016/j.jse.2008.11.018

« Previous Next »Journal of Shoulder and Elbow Surgery
Volume 18, Issue 5 , Pages 697-704, September 2009

Prospective analysis of arthroscopic rotator cuff repair: Subgroup analysis

Shane J. Nho, MD
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY
- Reprint requests: Shane J. Nho, MD, Rush University Medical Center, 1725 West Harrison Street, Suite 1063, Chicago, IL 60612.
Michael K. Shindle, MD
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY
Ronald S. Adler, PhD, MD
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Medical, College of Cornell University, New York, NY
Russell F. Warren, MD
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY
David W. Altchek, MD
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY
John D. MacGillivray, MD
- Department of Orthopedic Surgery, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY

published online 09 March 2009.

Background

The rotator cuff registry was established to evaluate prospectively the effectiveness of arthroscopic rotator cuff repair. The purpose of the present study is to report the preliminary data at the 1- and 2-year time point and perform subgroup analysis to identify factors that may affect outcome.

Methods

A total of 193 patients underwent all-arthroscopic repair of a rotator cuff tear and met the inclusion criteria and 127 (65.8%) completed 2-year follow-up. The outcome measurements included physical examination, manual muscle testing, the American Shoulder and Elbow Surgeons (ASES) score, and ultrasonography.

Results

The pre-operative ASES score was 52.37 ± 24.09 and improved to 83.88 ± 19.28 at 1 year (P < .0001) and 92.65 ± 11.36 at 2 years (P < 0.0001). The percent healing for all patients was 64.10% at 3 months and 64.34% at 1 year (P = .4080). At 2 years, there was a significant increase in the percentage of healed tendon at 75.42% compared to the 3-month (P ¼ .0001) and 1-year (P = 0.0332) time points. Patients with intact tendons had an ASES score of 93.9 ± 10.2 compared to tendon defects with a score of 88.0 ± 15.6 (P = .0623). Gender, tear size, and acromioclavicular joint involvement have a significant effect on ASES score. Rotator cuff characteristics such as tear size, biceps pathology, acromioclavicular joint pathology, and tissue quality have a significant effect on postoperative tendon integrity.

Conclusion

Arthroscopic rotator cuff repair demonstrates significant improvement in clinical outcomes and good rate of healing by postoperative ultrasound. Longer-term studies are necessary to determine the efficacy over time.