Arthroscopic repair of full-thickness tears of the rotator cuff: 2- to 14-year follow-up.
Authors: Wilson F, Hinov V, Adams G.
References: Arthroscopy 2002 Feb;18(2):136-44
PURPOSE: 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.