This narrative review synthesizes the clinical and technical factors that predict outcome after surgical repair of full-thickness rotator cuff tears. It examines tear size, timing, age, injections, and surgical technique, then surveys the major shoulder outcome scoring systems.
When you counsel a patient before cuff repair, tear size is your most powerful predictor. Pain relief is reliable regardless of size, but strength and active elevation track directly with how large the tear was.
A key teaching point: you do not need a watertight, fully healed cuff for a satisfied patient. Restoring a mechanically effective tendon unit and decompressing the subacromial space drives pain relief.
Know the numbers that shape decisions. Tears under 2.5 cm do better. Postoperative defects occur in 20% to 50% of repairs, more so with multi-tendon tears, and reduce strength without hurting satisfaction. Avoid repeated steroid injections in a surgical candidate. More than three predicts a worse result and a softer, less repairable cuff.
Finally, the review flags a persistent problem: the lack of a standardized outcome tool. Know the Constant score structure (35 points subjective, 65 objective) for boards.
This narrative review synthesizes the clinical and technical factors that predict outcome after surgical repair of full-thickness rotator cuff tears. It examines tear size, timing, age, injections, and surgical technique, then surveys the major shoulder outcome scoring systems.
When you counsel a patient before cuff repair, tear size is your most powerful predictor. Pain relief is reliable regardless of size, but strength and active elevation track directly with how large the tear was.
A key teaching point: you do not need a watertight, fully healed cuff for a satisfied patient. Restoring a mechanically effective tendon unit and decompressing the subacromial space drives pain relief.
Know the numbers that shape decisions. Tears under 2.5 cm do better. Postoperative defects occur in 20% to 50% of repairs, more so with multi-tendon tears, and reduce strength without hurting satisfaction. Avoid repeated steroid injections in a surgical candidate. More than three predicts a worse result and a softer, less repairable cuff.
Finally, the review flags a persistent problem: the lack of a standardized outcome tool. Know the Constant score structure (35 points subjective, 65 objective) for boards.