Prospective cohort of 65 patients undergoing all-arthroscopic supraspinatus repair using a tension-band suture technique. Postoperative CT arthrography or MRI at a mean 18 months objectively assessed tendon-to-bone healing and its relationship to functional outcomes. The central question: does the tendon actually heal, and does healing matter clinically?
In 2005, all-arthroscopic rotator cuff repair was viewed skeptically, with critics arguing it couldn't match the healing biology of open surgery. This paper answered that challenge directly with prospective imaging data.
When counseling a patient before supraspinatus repair, the key predictors of failure are age over 65 (43% healing) and sagittal delamination into the subscapularis or rotator interval (46% healing). Both warrant explicit discussion — not because the patient will have worse pain, but because they will likely have less strength recovery.
When a repair fails structurally, don't expect the patient to feel it. Satisfaction rates were 95% in both healed and unhealed groups. This is why imaging-confirmed healing, not functional scores, became the gold-standard primary endpoint in subsequent rotator cuff trials.
The paper also established that small, isolated supraspinatus tears without sagittal delamination (Stage I/D) heal universally. These are your best-prognosis repairs and the clearest indication for arthroscopic fixation.
Prospective cohort of 65 patients undergoing all-arthroscopic supraspinatus repair using a tension-band suture technique. Postoperative CT arthrography or MRI at a mean 18 months objectively assessed tendon-to-bone healing and its relationship to functional outcomes. The central question: does the tendon actually heal, and does healing matter clinically?
In 2005, all-arthroscopic rotator cuff repair was viewed skeptically, with critics arguing it couldn't match the healing biology of open surgery. This paper answered that challenge directly with prospective imaging data.
When counseling a patient before supraspinatus repair, the key predictors of failure are age over 65 (43% healing) and sagittal delamination into the subscapularis or rotator interval (46% healing). Both warrant explicit discussion — not because the patient will have worse pain, but because they will likely have less strength recovery.
When a repair fails structurally, don't expect the patient to feel it. Satisfaction rates were 95% in both healed and unhealed groups. This is why imaging-confirmed healing, not functional scores, became the gold-standard primary endpoint in subsequent rotator cuff trials.
The paper also established that small, isolated supraspinatus tears without sagittal delamination (Stage I/D) heal universally. These are your best-prognosis repairs and the clearest indication for arthroscopic fixation.