Functional and Structural Outcomes After Retears of Arthroscopically Repaired Large and Massive Rotator Cuff Tears

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Research

Background:

• Arthroscopic rotator cuff repair (ARCR) shows good results for large/massive tears.
• The impact of post-surgical retears on outcomes remains unclear.

Purpose of the Study:

• To assess functional and structural outcomes following retears in large/massive rotator cuff tears treated with ARCR.

Main Methods:

• A case series (Level of evidence, 4) followed 39 patients with retears after ARCR.
• Evaluated University of California, Los Angeles (UCLA) and Japanese Orthopaedic Association (JOA) scores.
• Assessed global fatty degeneration index (GFDI), tear size, and tendon attachment area via MRI.

Main Results:

• Significant improvements in UCLA and JOA scores were observed post-ARCR.
• Mediolateral tear size and residual tendon attachment area also improved significantly.
• Strong correlations found between residual tendon attachment, functional scores, and preoperative GFDI.

Conclusions:

• Residual tendon attachment area increased post-retear, correlating with improved functional outcomes.
• Preoperative fatty degeneration, tendon attachment, and functional results are significantly associated.
• These factors may explain functional improvements despite retears.