Harryman and colleagues asked whether shoulder function years after rotator cuff repair depends on whether the repaired cuff is still intact on ultrasound.
105 repairs in 89 patients, followed 2 to 11 years (mean 5).
Methods
Data source
Shoulder and Elbow Service, University of Washington, Seattle
Patients
105 repairs in 89 patients
86 primary repairs
19 repeat repairs
Exposure
Cuff integrity on ultrasound at follow‑up
Operative tear type (1A, 1B, 2, 3)
Follow-up
Mean 5 years (2 to 11)
Outcomes
Pain
Patient satisfaction
Activities of daily living
Active flexion and rotation
Isometric strength of flexion, abduction, extension and rotation
Key Findings
Shoulders whose repair was intact at follow‑up had better daily‑living function and more active flexion (129 ± 20° vs 71 ± 41°) than shoulders with a large recurrent defect.
Of the 105 repaired cuffs, 68 (65%) were intact at a mean of 5 years.
Recurrent defects were more prevalent in older patients and after repair of larger tears.
Most patients were satisfied even with a recurrent defect (87% vs 96% with an intact cuff), and the authors found retears hard to detect by clinical examination alone.
Recurrent defects were more common after repeat repairs (58%) than after primary repairs (30%), but intact repeat repairs functioned as well as intact primary repairs.
When the cuff was not intact, functional loss increased with the size of the recurrent defect.
Board pearl
Cuff integrity at follow‑up, not the size of the tear at repair, was the major determinant of outcome, and larger tears did worse mainly because they were less likely to stay intact.
Authors' conclusion
In summary, the integrity of the rotator cuff at the time of follow-up, not the size of the tear at the time of repair, is the major determinant of the outcome of an operative repair of a tear of the rotator cuff.
Harryman and colleagues asked whether shoulder function years after rotator cuff repair depends on whether the repaired cuff is still intact on ultrasound.
105 repairs in 89 patients, followed 2 to 11 years (mean 5).
Methods
Data source
Shoulder and Elbow Service, University of Washington, Seattle
Patients
105 repairs in 89 patients
86 primary repairs
19 repeat repairs
Exposure
Cuff integrity on ultrasound at follow‑up
Operative tear type (1A, 1B, 2, 3)
Follow-up
Mean 5 years (2 to 11)
Outcomes
Pain
Patient satisfaction
Activities of daily living
Active flexion and rotation
Isometric strength of flexion, abduction, extension and rotation
Key Findings
Shoulders whose repair was intact at follow‑up had better daily‑living function and more active flexion (129 ± 20° vs 71 ± 41°) than shoulders with a large recurrent defect.
Of the 105 repaired cuffs, 68 (65%) were intact at a mean of 5 years.
Recurrent defects were more prevalent in older patients and after repair of larger tears.
Most patients were satisfied even with a recurrent defect (87% vs 96% with an intact cuff), and the authors found retears hard to detect by clinical examination alone.
Recurrent defects were more common after repeat repairs (58%) than after primary repairs (30%), but intact repeat repairs functioned as well as intact primary repairs.
When the cuff was not intact, functional loss increased with the size of the recurrent defect.
Board pearl
Cuff integrity at follow‑up, not the size of the tear at repair, was the major determinant of outcome, and larger tears did worse mainly because they were less likely to stay intact.
Authors' conclusion
In summary, the integrity of the rotator cuff at the time of follow-up, not the size of the tear at the time of repair, is the major determinant of the outcome of an operative repair of a tear of the rotator cuff.