Arthroscopic Partial Repair of Large to Massive Rotator Cuff Tears Shows Clinical Outcomes and Survivorship at Minimum 10-Year Follow-Up Comparable to Those of Arthroscopic Complete Repair

Abstract

Purpose: To compare the survival rate (revision surgery) and clinical and radiologic outcomes of arthroscopic partial versus complete repair for large to massive rotator cuff tears over a minimum 10-year follow-up period.

Methods: We conducted a retrospective analysis of patients who underwent arthroscopic partial or complete repair of large to massive rotator cuff tears between 2008 and 2013, with minimum 10-year follow-up. Functional outcomes were measured using the visual analog scale pain score, Subjective Shoulder Value, American Shoulder and Elbow Surgeons score, University of California, Los Angeles shoulder score, and passive range of motion preoperatively and at the last follow-up. Failure was defined as the need for revision surgery (reverse shoulder arthroplasty) owing to significant pain and functional loss. Radiographic assessments included radiography (preoperatively and at the latest follow-up) and magnetic resonance arthrography (preoperatively and at 6 months postoperatively). The groups were compared regarding subjective and objective outcomes.

Results: The study included 90 participants, 34 in the partial repair group (group P) and 56 in the complete repair group (group C). At the latest follow-up, no significant differences in clinical scores were found and the percentage of participants exceeding the minimal clinically important difference was comparable in both groups for all variables. Groups P and C showed forward flexion of 133° ± 7° and 136° ± 10°, respectively (P = .319); external rotation of 41° ± 5° and 42° ± 6°, respectively (P = .465); and internal rotation of 11 ± 1 and 11 ± 2, respectively (P = .284). Despite differences in retear size at 6 months (P < .001) and acromiohumeral distance at the latest follow-up (4.5 ± 1.1 mm in group P vs 5.8 ± 0.7 mm in group C), the survival rates at 10 years were similar: 77% (n = 8) in group P and 84% (n = 11) in group C (P = .674).

Conclusions: Although radiologic outcomes were inferior in the partial repair group, both groups had comparable survival rates and clinical outcomes over the 10-year follow-up period.

Level of evidence: Level III, retrospective comparative study.