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Functional and Radiologic Outcomes of Degenerative Versus Traumatic Full-Thickness Rotator Cuff Tears Involving the
Cornelia Baum1,2, Laurent Audigé3,2, Thomas Stojanov4,2
1Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland.
The American Journal of Sports Medicine
|January 23, 2024
Summary
Arthroscopic rotator cuff repair (ARCR) yields good short-term functional outcomes for both degenerative and traumatic supraspinatus tears. Traumatic tears show greater improvement, achieving comparable results to degenerative tears by 12 months post-surgery.
Area of Science:
- Orthopaedic Surgery
- Biomedical Engineering
- Sports Medicine
Background:
- Arthroscopic rotator cuff repair (ARCR) is a common orthopaedic procedure with outcomes influenced by factors like age and tear severity.
- The impact of tear etiology (degenerative vs. traumatic) on functional and structural outcomes after ARCR remains debated.
- Understanding tear etiology is crucial for predicting patient recovery and optimizing treatment strategies.
Purpose of the Study:
- To compare functional and structural outcomes between degenerative and traumatic supraspinatus tendon tears following ARCR.
- To evaluate the influence of tear etiology on patient-reported scores and objective measures of shoulder function.
- To determine if tear origin affects the success and integrity of rotator cuff repairs.
Main Methods:
- A prospective cohort study involving 421 patients from 19 centers undergoing ARCR for full-thickness supraspinatus tears.
- Tears were categorized as degenerative (chronic pain, no trauma) or traumatic (acute onset, no prior pain).
- Functional outcomes (range of motion, strength, OSS, CMS) and structural integrity were assessed at baseline, 6, 12, and 24 months post-surgery.
Main Results:
- Patients with traumatic tears exhibited lower baseline scores but demonstrated significantly greater improvements in OSS and CMS at 12 months post-ARCR compared to degenerative tears.
- At 12 months, both groups achieved comparable overall functional scores (OSS and CMS).
- No significant differences were observed between degenerative and traumatic tear groups regarding repair integrity, re-tear rates, or the need for additional surgeries at 24 months.
Conclusions:
- ARCR provides satisfactory short-term functional results for both degenerative and traumatic supraspinatus tears.
- While traumatic tears start with lower scores, they show significant rehabilitation, leading to comparable clinical outcomes to degenerative tears by one year.
- Degenerative and traumatic rotator cuff tears exhibit similar structural outcomes post-repair, indicating that even degenerated tendons possess healing potential.
Keywords:
degenerative rotator cuff tearrotator cuff repairshoulder arthroscopyshoulder surgery outcometraumatic rotator cuff tearMore Related Videos
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