Clinical outcomes and structural integrity of C-shaped rotator cuff tears after arthroscopic repair: comparison with crescent-shaped tears.

Abstract

BACKGROUND:

We aimed to describe a new C-shaped tear configuration, and to compare clinical outcomes and structural integrity between the C-shaped and the established crescent-shaped small to medium-sized rotator cuff tears after arthroscopic repair.

METHODS:

This retrospective study included 102 patients who underwent arthroscopic repair in a single-row fashion for small- to medium-sized rotator cuff tears of either C or crescent shape from March 2009 to June 2014. Visual analogue scale (VAS) pain score, subjective shoulder value (SSV), American Shoulder and Elbow Surgeon (ASES) score, and active range of motion (ROM) were evaluated for functional outcomes. Postoperative magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months postoperatively to assess structural integrity.

RESULTS:

After 2 years of follow-up, both groups showed no significant difference in VAS pain score, functional scores, or ROM, although the C-shaped tear group exhibited significantly inferior outcomes 3 months after surgery. There was no significant difference in the re-tear rate on follow-up MRA and CTA between groups A and B (24.4 vs. 19.7%, respectively; p = 0.570). The postoperative stiffness rate was significantly higher in the C-shaped tear group than that in crescent-shaped tear group only at 3-month follow-up point after surgery (26.8 vs. 9.8%, respectively; p = 0.024).

CONCLUSIONS:

Contrary to our hypothesis, there were no significant differences in functional outcomes and structural integrity between C-shaped and crescent-shaped small- to medium-sized tears 2 years after arthroscopic repair. However, C-shaped tears exhibited significantly worse clinical outcomes, including a higher postoperative stiffness rate than crescent-shaped tears in the early postoperative period at the 3-month follow-up point.