This is a multicenter retrospective study of 10-year outcomes after repair of massive posterosuperior rotator cuff tears. It asks whether repair holds up long-term and whether partial subscapularis extension worsens results. Outcomes were Constant-Murley score plus MRI repair integrity by Sugaya classification.
When you counsel a patient with a massive posterosuperior cuff tear, this paper supports offering repair rather than defaulting to reverse arthroplasty, especially in younger patients. The durable 25-point Constant gain at a full decade is the headline. Even with a 34% retear rate, most patients kept meaningful function.
Learn the framework this paper validates: the Collin classification for tear pattern, the Sugaya grades for repair integrity, and the Patte and Goutallier systems for retraction and fatty infiltration. The key decision driver is infraspinatus retraction, the only independent predictor of poor 10-year function. Weigh it more heavily than subscapularis involvement, which did not affect outcomes.
Remember the caveats: Level IV retrospective design, 33% lost to follow-up, and a cohort with unusually low fatty infiltration (only 2% stage 3, none stage 4), which may explain why fatty infiltration did not predict outcome here as it does elsewhere.
This is a multicenter retrospective study of 10-year outcomes after repair of massive posterosuperior rotator cuff tears. It asks whether repair holds up long-term and whether partial subscapularis extension worsens results. Outcomes were Constant-Murley score plus MRI repair integrity by Sugaya classification.
When you counsel a patient with a massive posterosuperior cuff tear, this paper supports offering repair rather than defaulting to reverse arthroplasty, especially in younger patients. The durable 25-point Constant gain at a full decade is the headline. Even with a 34% retear rate, most patients kept meaningful function.
Learn the framework this paper validates: the Collin classification for tear pattern, the Sugaya grades for repair integrity, and the Patte and Goutallier systems for retraction and fatty infiltration. The key decision driver is infraspinatus retraction, the only independent predictor of poor 10-year function. Weigh it more heavily than subscapularis involvement, which did not affect outcomes.
Remember the caveats: Level IV retrospective design, 33% lost to follow-up, and a cohort with unusually low fatty infiltration (only 2% stage 3, none stage 4), which may explain why fatty infiltration did not predict outcome here as it does elsewhere.