Comparison between partial and full coverage repair in massive rotator cuff tears. A minimum five year follow-up

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Arthroscopy

Background:

• Massive rotator cuff tears present significant surgical challenges.
• The benefit of achieving full humeral head coverage during arthroscopic repair remains debated.
• This study investigates the impact of footprint coverage on re-tear rates and clinical outcomes.

Purpose of the Study:

• To compare re-tear rates and clinical outcomes between full and partial humeral head coverage in arthroscopic repair of massive rotator cuff tears.
• To evaluate the influence of tear size, symptom duration, and fatty infiltration on surgical outcomes.

Main Methods:

• Retrospective analysis of adult patients with massive rotator cuff tears undergoing arthroscopic repair.
• Minimum five-year follow-up assessing re-tear rates, ASES Shoulder Score, and Penn Shoulder Score.
• Correlation and subgroup analyses to identify factors influencing outcomes.

Main Results:

• No significant difference in re-tear rates between full (2/27) and partial (4/27) coverage groups (p=0.64).
• Functional scores (ASES, Penn) showed no statistically significant difference between groups (p=0.20, p=0.22).
• Positive correlation between percentage of head coverage and favorable outcome (R²=0.40); negative correlation with tear size (R²=0.217) and fatty infiltration.

Conclusions:

• Arthroscopic rotator cuff repair outcomes are not significantly different between full and partial humeral head coverage.
• Achieved coverage percentage, tear size, and fatty infiltration are key factors influencing functional outcomes.
• Optimizing coverage and considering tear characteristics are crucial for successful rotator cuff repair.