Primary Arthroscopic Repair for Massive Rotator Cuff Tears Results in Good Shoulder Function, Low Pain, and Satisfactory Outcomes at 2-Year Minimum Follow-Up

Jessica Rosenblum; Rashad Madi; Hannah Lee; Yixuan Amy Pei; Steven Du; Ali S Farooqi; Alexander Lee; John D Kelly 4th

doi:10.1016/j.arthro.2024.02.026

Primary Arthroscopic Repair for Massive Rotator Cuff Tears Results in Good Shoulder Function, Low Pain, and Satisfactory Outcomes at 2-Year Minimum Follow-Up

Arthroscopy. 2024 Feb 28:S0749-8063(24)00161-0. doi: 10.1016/j.arthro.2024.02.026. Online ahead of print.

Authors

Jessica Rosenblum¹, Rashad Madi², Hannah Lee², Yixuan Amy Pei², Steven Du², Ali S Farooqi³, Alexander Lee⁴, John D Kelly 4th²

Affiliations

¹ Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.. Electronic address: jessica.rosenblum@pennmedicine.upenn.edu.
² Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
³ Department of Orthopedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A.
⁴ Department of Orthopedic Surgery, Ohio State University, Columbus, Ohio, U.S.A.

PMID: 38428700
DOI: 10.1016/j.arthro.2024.02.026

Abstract

Purpose: To evaluate outcomes of patients who underwent primary arthroscopic repair for massive rotator cuff tears (MRCTs).

Methods: Patients with MRCTs (full-thickness tear of 2 or more tendons or full-thickness tear ≥5 cm) who underwent arthroscopic repair with a minimum follow-up of 2 years were retrospectively reviewed (n = 51). All patients had preoperative magnetic resonance imaging used to characterize pattern of tear, degree of fatty degeneration (Goutallier classification), and degree of rotator cuff arthropathy (Hamada classification). Outcomes were determined by American Shoulder and Elbow Surgeons (ASES) scores and Penn Shoulder Scores (PSS).

Results: A total of 51 patients with a minimum 2.3-year follow-up (mean, 5.4 years; range, 2.3-9.7 years) were included in this study. Mean ASES score was 46.1 ± 7.8 (95% CI, 43.9-48.3) for pain and 39.4 ± 12.1 (95% CI, 36.0-42.8) for function. Total ASES score averaged 85.5 ± 18.4 (95% CI, 80.4-90.7). PSS had a mean pain score of 26.8 ± 4.4 (95% CI, 25.4-28.1), a mean satisfaction score of 7.9 ± 2.9 (95% CI, 7.0-8.2), and a mean function score of 48.5 ± 13.5 (95% CI, 44.7-52.3). Total PSS averaged 83.2 ± 19.6 (95% CI, 77.7-87.7). No correlation was found between Goutallier grade and ASES/PSS scores or between Hamada grade and ASES/PSS scores. Three patients underwent reoperation after primary arthroscopic repair of an MRCT (5.9%).

Conclusions: Patients with MRCTs who undergo primary arthroscopic repair have postoperative outcome scores indicative of good shoulder function, low pain, and high satisfaction. The rate of reoperation for individuals who underwent primary arthroscopic repair with MRCTs was low at 6%.

Level of evidence: Level IV, retrospective case series.