BACKGROUND: Important differences in clinical outcomes likely exist between patients with healed and nonhealed rotator cuff repairs. The survival probability of rotator cuff repairs has not been published in a time-dependent manner up to now. HYPOTHESES: Recurrent tears occur more frequently in the early postoperative period. Early failures of the repair are a prognostic factor for the long-term outcome. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A series of 107 consecutive patients undergoing arthroscopically assisted mini-open repair of the rotator cuff between 1998 and 2002 were evaluated in a prospective study. Of these, 95 patients finished the study after a maximum follow-up of 11 years. The evaluation included 1 postoperative magnetic resonance imaging scan as well as multiple ultrasonographies and determinations of the American Shoulder and Elbow Surgeons (ASES) and Constant scores at 3 months, 6 months, 1 year, and then yearly with a median follow-up of 96 months. RESULTS: The overall failure rate was 33% (35 of 107). The survivorship analysis revealed that 74% of all failures occurred atraumatically in the first 3 months and 11% occurred between the third and the sixth month after the repair. The remaining reruptures (14%) happened 2 to 5 years postoperatively and were related to sports activities or direct trauma. The overall clinical results did not deteriorate over time. The parameters healed tendon, rerupture of less than 2 cm(2), and rerupture of more than 2 cm(2) at 6 months were predictors of the gender- and age-adjusted (normalized) Constant score at 84 months (P < .0001). CONCLUSION: The majority of recurrent tears occurred in the first 3 months after surgical repair. The parameters "recurrent tear" as well as "healed tendon" evaluated at 6 months postoperatively appear to be predictors for the clinical outcomes at 7 years. Efforts to improve healing during the initial 3 months have long-term implications for maintenance of cuff integrity and clinical outcomes.
BACKGROUND: Important differences in clinical outcomes likely exist between patients with healed and nonhealed rotator cuff repairs. The survival probability of rotator cuff repairs has not been published in a time-dependent manner up to now. HYPOTHESES: Recurrent tears occur more frequently in the early postoperative period. Early failures of the repair are a prognostic factor for the long-term outcome. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: A series of 107 consecutive patients undergoing arthroscopically assisted mini-open repair of the rotator cuff between 1998 and 2002 were evaluated in a prospective study. Of these, 95 patients finished the study after a maximum follow-up of 11 years. The evaluation included 1 postoperative magnetic resonance imaging scan as well as multiple ultrasonographies and determinations of the American Shoulder and Elbow Surgeons (ASES) and Constant scores at 3 months, 6 months, 1 year, and then yearly with a median follow-up of 96 months. RESULTS: The overall failure rate was 33% (35 of 107). The survivorship analysis revealed that 74% of all failures occurred atraumatically in the first 3 months and 11% occurred between the third and the sixth month after the repair. The remaining reruptures (14%) happened 2 to 5 years postoperatively and were related to sports activities or direct trauma. The overall clinical results did not deteriorate over time. The parameters healed tendon, rerupture of less than 2 cm(2), and rerupture of more than 2 cm(2) at 6 months were predictors of the gender- and age-adjusted (normalized) Constant score at 84 months (P < .0001). CONCLUSION: The majority of recurrent tears occurred in the first 3 months after surgical repair. The parameters "recurrent tear" as well as "healed tendon" evaluated at 6 months postoperatively appear to be predictors for the clinical outcomes at 7 years. Efforts to improve healing during the initial 3 months have long-term implications for maintenance of cuff integrity and clinical outcomes.
Authors: Patricio Melean; Sven Lichtenberg; Fredy Montoya; Stephan Riedmann; Petra Magosch; Peter Habermeyer Journal: Int Orthop Date: 2013-06-22 Impact factor: 3.075
Authors: Maristella F Saccomanno; Gianpiero Cazzato; Mario Fodale; Giuseppe Sircana; Giuseppe Milano Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-01-04 Impact factor: 4.342
Authors: Maristella F Saccomanno; Giuseppe Sircana; Gianpiero Cazzato; Fabrizio Donati; Pietro Randelli; Giuseppe Milano Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-07-22 Impact factor: 4.342
Authors: James W Genuario; Ryan P Donegan; Daniel Hamman; John-Erik Bell; Martin Boublik; Theodore Schlegel; Anna N A Tosteson Journal: J Bone Joint Surg Am Date: 2012-08-01 Impact factor: 5.284