Long-term survivorship of rotator cuff repairs using ultrasound and magnetic resonance imaging analysis
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Updated: Jun 1, 2026
Knotless Independent Double-Row Repair and Biceps Augmentation for Anterosuperior Rotator Cuff Tears
Published on: January 23, 2026
Rainer Kluger1, Peter Bock, Martina Mittlböck
1Department of Orthopedics, SMZOst Donauspital, Vienna, Austria. rainer.kluger@wienkav.at
Background:
Important differences in clinical outcomes likely exist between patients with healed and nonhealed rotator cuff repairs. The survival probability of rotator cuff repairs has not been published in a time-dependent manner up to now.
Hypotheses:
Recurrent tears occur more frequently in the early postoperative period. Early failures of the repair are a prognostic factor for the long-term outcome.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A series of 107 consecutive patients undergoing arthroscopically assisted mini-open repair of the rotator cuff between 1998 and 2002 were evaluated in a prospective study. Of these, 95 patients finished the study after a maximum follow-up of 11 years. The evaluation included 1 postoperative magnetic resonance imaging scan as well as multiple ultrasonographies and determinations of the American Shoulder and Elbow Surgeons (ASES) and Constant scores at 3 months, 6 months, 1 year, and then yearly with a median follow-up of 96 months.
Results:
The overall failure rate was 33% (35 of 107). The survivorship analysis revealed that 74% of all failures occurred atraumatically in the first 3 months and 11% occurred between the third and the sixth month after the repair. The remaining reruptures (14%) happened 2 to 5 years postoperatively and were related to sports activities or direct trauma. The overall clinical results did not deteriorate over time. The parameters healed tendon, rerupture of less than 2 cm(2), and rerupture of more than 2 cm(2) at 6 months were predictors of the gender- and age-adjusted (normalized) Constant score at 84 months (P < .0001).
Conclusion:
The majority of recurrent tears occurred in the first 3 months after surgical repair. The parameters "recurrent tear" as well as "healed tendon" evaluated at 6 months postoperatively appear to be predictors for the clinical outcomes at 7 years. Efforts to improve healing during the initial 3 months have long-term implications for maintenance of cuff integrity and clinical outcomes.
