Medium-Sized Rotator Cuff Tears Repaired With Transosseous-Equivalent Technique Plus Bone Marrow Stimulation Yielded Similar Short-Term Outcomes Regardless of Whether Complete or Incomplete Footprint Coverage Was Achieved

Abstract

Purpose: To compare clinical outcomes and retear rates of medium-sized rotator cuff tears repaired with incomplete footprint coverage using the transosseous-equivalent technique versus those with complete footprint coverage plus bone marrow stimulation.

Methods: The retrospective study, conducted from March 2019 to December 2021, included consecutive patients with medium-sized (1-3 cm) posterosuperior rotator cuff tears repaired using the transosseous-equivalent technique and bone marrow stimulation, with a minimum follow-up of 2 years. Patients were divided into 2 groups based on the degree of footprint coverage achieved: group C (complete coverage) and group I (incomplete coverage). Functional outcomes were assessed preoperatively and at the 2-year follow-up. The outcomes collected included the visual analog scale pain score; subjective shoulder value; American Shoulder and Elbow Surgeons score; University of California, Los Angeles shoulder score; and active range of motion. The structural integrity of the repaired tendon was assessed using magnetic resonance imaging scans 6 months after surgery.

Results: A total of 94 patients (42 in group I and 52 in group C) were enrolled. Both groups showed significant improvement in all functional outcome measures at 2 years after surgery, without significant differences between the groups in any variable. Furthermore, the percentage of participants exceeding the minimal clinically important difference was comparable for both groups across all variables. The retear rate for group I was 9.5% (6/42, 1 type I retear and 5 type II retears), and that for group C was 7.7% (5/52, all 5 type II retears). There was no significant difference in retear rates between the groups.

Conclusions: Despite incomplete footprint coverage, repair using a transosseous-equivalent technique with bone marrow stimulation in both groups yielded clinical outcomes and retear rates similar to those of complete coverage in medium-sized rotator cuff tears at short-term follow-up.

Level of evidence: Level III, retrospective comparative study.