BACKGROUND: The reported rate of failure after arthroscopic rotator
cuff repair has varied widely. The influence of the repair technique on the
failure rates and functional outcomes after open or arthroscopic rotator cuff
repair remains controversial. The purpose of the present study was to evaluate
the functional and anatomic results of arthroscopic rotator cuff repairs
performed with the double-row suture anchor technique on the basis of computed
tomography or magnetic resonance imaging arthrography in order to determine
the postoperative integrity of the repairs.
METHODS: A prospective series of 105 consecutive shoulders
undergoing arthroscopic double-row rotator cuff repair of the supraspinatus or
a combination of the supraspinatus and infraspinatus were evaluated at a
minimum of two years after surgery. The evaluation included a routine history
and physical examination as well as determination of the preoperative and
postoperative strength, pain, range of motion, and Constant scores. All
shoulders had a preoperative and postoperative computed tomography arthrogram
(103 shoulders) or magnetic resonance imaging arthrogram (two shoulders).
RESULTS: There were thirty-six small rotator cuff tears, forty-seven
large isolated supraspinatus or combined supraspinatus and infraspinatus
tendon tears, and twenty-two massive rotator cuff tears. The mean Constant
score (and standard deviation) was 43.2 ± 15.1 points (range, 8 to 83
points) preoperatively and 80.1 ± 11.1 points (range, 46 to 100 points)
postoperatively. Twelve of the 105 repairs failed. Intact rotator cuff repairs
were associated with significantly increased strength and active range of
motion.
CONCLUSIONS: Arthroscopic repair of a rotator cuff tear with use of
the double-row suture anchor technique results in a much lower rate of failure
than has previously been reported in association with either open or
arthroscopic repair methods. Patients with an intact rotator cuff repair have
better pain relief than those with a failed repair. After repair, large and
massive rotator cuff tears result in more postoperative weakness than small
tears do.
LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions to Authors
for a complete description of levels of evidence.
ORIGINAL ABSTRACT CITATION: "The Outcome and Structural Integrity of
Arthroscopic Rotator Cuff Repair with Use of the Double-Row Suture Anchor
Technique"
(2007;89:1533-41).