Timing of surgical repair for traumatic rotator cuff tears

Traumatic full-thickness rotator cuff tears (FT-RCTs) are often treated surgically due to the acute nature of the tear. Presently, there is not a clear consensus on the appropriate timing for repair of FT-RCTs following injury. This study aims to evaluate functional outcomes based on timing of surgical repair.

In total, 141 patients who underwent RCT repair for a tear caused by a traumatic injury from 2014 to 2021 were retrospectively reviewed. Patients were stratified based on time to surgical repair from the date of injury. Patient reported outcomes (PROMs), complication rates and range of motion (ROM) were compared. Multivariate regression was also performed using postoperative ASES as the dependent outcome.

Larger tears were repaired earlier, and the preoperative ROM was worse for the patients undergoing earlier repair at all time points up to three months. There were no differences in postoperative SANE score, ASES score as well as ROM or strength assessed at 12 months. Multivariate regression determined male sex (p = 0.035) and longer time to surgery (p = 0.043) were independently associated with worse postoperative ASES scores.

While there no differences in between treatment groups regarding complications and PROMs, multivariate regression demonstrated longer time to surgery following injury was associated with lower postoperative ASES scores. Similar studies have shown inconsistent outcomes following early surgical repair, utilizing varying sample populations (range = 4-358) and times to surgical intervention (range = < 3 weeks to 12 months). Multi-center collaboration is needed to better determine the impact of early surgical intervention for traumatic FT-RCTs.