Pre-operative factors correlated with arthroscopic reparability of large-to-massive rotator cuff tears

The purpose of this study is to determine the pre-operative factors that are associated with reparability of the large-sized and massive rotator cuff tears.

Sixty-six patients were included in this prognostic study. Demographic data, radiographic and MRI parameters were collected. Arthroscopic rotator cuff repair was performed for all included patient. Complete rotator cuff repair was achieved when the tendon covered up at least 50% of the anatomical footprint. The receiver operating characteristic (ROC) curve was analysed to define the cut-off level of each significant factor.

Eleven large-sized rotator cuff tears and fifty-five massive rotator cuff tears were defined from MRI. Fifty-four patients were in the complete repair group, and twelve patients were in the partial repair group. The mean duration between MRI and surgery of 5.5 weeks. Reparability was correlated with age, mediolateral (ML) and anteroposterior (AP) tear size, rotator cuff arthropathy, superior migration of humeral head, fatty infiltration and atrophy of the supraspinatus muscle, and fatty infiltration of infraspinatus muscle (p < 0.05). The ROC curve defined a cut-off level of each predicting factor which included age of ≥65 years, mediolateral tear size of ≥36 mm, anteroposterior tear size of ≥22 mm, Hamada's rotator cuff arthropathy of ≥class2, acromiohumeral interval of ≥6 mm, ≥stage3 supraspinatus fatty infiltration, the presence of supraspinatus muscle atrophy, and ≥ stage1 infraspinatus fatty infiltration. In multivariated regression analysis, age, acromiohumeral interval, and anteroposterior tear size were statistically associated with the reparability. The intra- and inter-observer reliabilities were moderate to excellent.

Age, ML tear size, AP tear size, rotator cuff arthropathy, superior migration of humeral head, fatty infiltration of supraspinatus and infraspinatus muscles and supraspinatus muscle atrophy all correlate with reparability of large to massive rotator cuff tear.