This is a long-term (mean 9.9-year) follow-up of a prospective cohort of open repairs of massive rotator cuff tears. The same 23 patients were re-examined clinically, radiographically, and with MRI using identical methodology to the earlier 3.1-year study. It asks whether early clinical gains hold up, how the tendon and muscle change structurally, and what predicts retear.
When counseling a patient before open repair of a massive cuff tear, this paper lets you promise durable relief without promising a healed tendon. Even with a 57% retear rate at ten years, 96% stayed satisfied and clinical gains held. Repair is still justified because intact repairs function measurably better than failed ones (Constant 95% vs 77%, abduction 5.5 vs 2.6 kg).
The key structural lesson is that fatty infiltration is a one-way street. It progresses even after a successful repair and is driven by the preoperative tear itself, which argues for earlier repair before the muscle degenerates.
On the preoperative radiograph, measure the acromion index. A high index (near 0.75) flags a shoulder at higher risk of retear and supports the concept that wide lateral acromial anatomy contributes to cuff disease.
This is a long-term (mean 9.9-year) follow-up of a prospective cohort of open repairs of massive rotator cuff tears. The same 23 patients were re-examined clinically, radiographically, and with MRI using identical methodology to the earlier 3.1-year study. It asks whether early clinical gains hold up, how the tendon and muscle change structurally, and what predicts retear.
When counseling a patient before open repair of a massive cuff tear, this paper lets you promise durable relief without promising a healed tendon. Even with a 57% retear rate at ten years, 96% stayed satisfied and clinical gains held. Repair is still justified because intact repairs function measurably better than failed ones (Constant 95% vs 77%, abduction 5.5 vs 2.6 kg).
The key structural lesson is that fatty infiltration is a one-way street. It progresses even after a successful repair and is driven by the preoperative tear itself, which argues for earlier repair before the muscle degenerates.
On the preoperative radiograph, measure the acromion index. A high index (near 0.75) flags a shoulder at higher risk of retear and supports the concept that wide lateral acromial anatomy contributes to cuff disease.