These authors investigated factors associated with retear of rotator cuff repairs in 286 patients having magnetic resonance (MR) imaging at 6 months after arthroscopic cuff repair. 254 of the repairs were intact at 6 months and 32 (11%) had failed.
The mean patient age was 65 years, and the mean symptom duration was 10 months. The tear was of small/medium size in 177 patients and large/massive in 109 patients. The technique for surgical repair was single row in 42 patients, double row in 60 patients, and suture bridging in 216 patients.
On univariate analysis there were significant differences between the patients with healed and failed repairs in the anteroposterior (AP) tear size, mediolateral tear size, hyperlipidemia, global fatty degeneration index, supraspinatus fatty degeneration stage, and critical shoulder angle (CSA).
Comment: These data confirm that repairs of bigger tears in tendons with poorer muscle quality have a higher risk of failing. While the difference in average CSA between the healed and failed repairs was statistically significant, this average difference was only of two degrees while the standard deviations of the averages where almost twice as large. Thus it is difficult to attach clinical significance to this difference in the average CSA.
It is of interest that the clinical scores were not significantly different between the healed and failed groups. How important is integrity of the repair to the clinical outcome? Does it benefit the patient to repair large tears of higher Goutalier grade?