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Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association·2025
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Editorial Commentary: One-Year Follow-Up Does Not Determine Rotator Cuff Repair Long-Term Outcome.

Stephen C Weber

    Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
    |January 25, 2025
    PubMed
    Summary

    Rotator cuff repair (RCR) outcomes may not be fully represented by 1-year follow-up. Longer evaluation is crucial for complex RCR cases and specific patient groups to ensure comprehensive understanding of surgical success.

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    Area of Science:

    • Orthopedic Surgery
    • Sports Medicine
    • Clinical Outcomes Research

    Background:

    • Recent studies advocate reducing clinical study follow-up from 2 to 1 year, citing minimal patient-reported outcome changes.
    • This approach is effective for joint replacements but may be insufficient for other conditions like shoulder instability.
    • The necessity of extended follow-up for rotator cuff repair (RCR) remains under investigation.

    Discussion:

    • Systematic reviews indicate minor RCR outcome improvements between 1 and 2 years, often below minimal clinically important differences.
    • However, these aggregate results can mask crucial subgroup variations.
    • Short-term follow-up may not reflect the final recovery trajectory for all RCR patients, particularly those with large tears or high functional demands.

    Key Insights:

    • One-year follow-up may underrepresent the long-term results of rotator cuff repair (RCR) in certain patient populations.
    • Subgroups, including those with large retracted tears, graft augmentation, or elite athletes, may require longer evaluation periods.
    • Clinical decisions and patient expectations should consider the potential for continued improvement or altered outcomes beyond the first year post-RCR.

    Outlook:

    • Further research is needed to establish optimal follow-up durations for diverse rotator cuff repair (RCR) scenarios.
    • Long-term outcome assessment is essential for evaluating the true efficacy and patient satisfaction following RCR.
    • Developing evidence-based guidelines for RCR follow-up will enhance patient care and surgical practice standards.