Clinical outcomes of single-row arthroscopic revision rotator cuff repair

This article reports the authors' experience with single-row arthroscopic revision rotator cuff repairs and analyzes the variables associated with a poorer long-term outcome. A retrospective review was performed of patients who had undergone an all-arthroscopic, single-row revision rotator cuff repair for pain with a documented re-tear over a 13-year period. After exclusionary criterion was applied, 32 shoulders in 30 patients were available for follow-up. A thorough shoulder examination was performed to record postoperative motion and functional outcomes, including the University of California Los Angeles (UCLA) score, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale (VAS) pain score, and was compared with the patient's preoperative data. Analysis of variables, including patient demographics, surgical history, and functional outcomes, was performed to determine whether there was any association with a UCLA score less than 28 or an ASES score less than 65. At final follow-up, 20 men and 10 women had a mean age of 69.3 years (range, 55.1-84.1) at a mean follow-up of 70.3 months after final revision surgery. Mean UCLA score improved from 15.5 ± 3.9 preoperatively to 29.8 ± 4.6 postoperatively (P<.001); mean modified ASES score improved from 53.4 ± 12.5 preoperatively to 86.7 ± 12.7 postoperatively (P<.001); and mean VAS pain score improved from 4.6 ± 1.1 preoperatively to .91 ± 1.1 postoperatively (P<.001). A poorer functional outcome (defined as a UCLA score greater than 28) was found in 25% of patients. This was associated with female gender, age older than 70 years, dominant-arm revision, and preoperative external rotation less than 35°. In addition, preoperative active range of motion in forward flexion less than 140° (P=.039) and active range of motion in external rotation less than 35° (P=.025) were also associated with poorer ASES scores (<65). The authors believe that patients can have reliable improvements in shoulder pain and function after a revision procedure using a single-row arthroscopic technique and that patient factors can lead to poorer results with this technique.