Rotator cuff repair - does healing of the tendon matter in the clinical result?

Rotator cuff tear

The JBJS just published an article entitled Repair Integrity and Functional Outcomes After Arthroscopic Suture-Bridge Rotator Cuff Repair. The re-tear rate of the medium, large, and massive tears (as classified according to the anterior-to-posterior diameter of the tear) was 12%, 21%, and 22%, respectively. Once again it is of interest that "None of the functional outcomes in this study differed significantly between the healed and unhealed groups."  The discussion section of this paper contains this very interesting paragraph:

"Frank et al.did not find any significant difference between failed and intact repairs, except with regard to the UCLA scores. During postoperative clinical evaluations, Park et al.found no difference between failed and intact repairs except with regard to abduction power at the six-month follow-up assessment. In the study by Voigt et al, neither patient satisfaction nor the Constant-Murley score, nor any subcategory, differed significantly between the unhealed/re-torn group and the group with an intact supraspinatus tendon. Sethi et al. did not find a significant difference between healed and unhealed tears with respect to outcome scores, with the exception of the strength component of the ASES."

So once again, we must wonder about the importance of cuff integrity in the improvement experienced by the patient after rotator cuff surgery.

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