Tension-Reducing Repair Improves Rotator Cuff Healing Rates and Functional Outcomes at 2 Years

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Regenerative Medicine

Background:

• Rotator cuff tears are common injuries impacting shoulder function.
• Surgical repair aims to restore tendon integrity and shoulder function.
• Different surgical techniques exist, including full footprint covering repair (FFC-RCTR) and tension-reducing repairs (FRM-RCTR, FSP-RCTR).

Purpose of the Study:

• To compare the postoperative healing rates and shoulder function between tension-reducing rotator cuff tear repair (FRM-RCTR, FSP-RCTR) and full footprint covering rotator cuff tear repair (FFC-RCTR) in patients with full-thickness rotator cuff tears.

Main Methods:

• Retrospective analysis of 276 patients undergoing arthroscopic rotator cuff repair (July 2018-December 2022) with ≥2 years follow-up.
• Patients were grouped into FFC-RCTR, FRM-RCTR, or FSP-RCTR based on surgical technique.
• Outcomes assessed included MRI-based Sugaya grading, pain scores (VAS), and functional scores (Constant-Murley, ASES). Multivariate logistic regression and inverse probability of treatment weighting were used for analysis.

Main Results:

• Tension-reducing repair groups (FRM-RCTR, FSP-RCTR) demonstrated superior Constant-Murley/ASES scores at 6, 12, and 24 months postoperatively compared to FFC-RCTR.
• Better Sugaya grades at 24 months were observed in tension-reducing groups.
• Factors associated with repair failure included Patte type 2 retraction, large tear size, delayed postoperative exercise, and FFC-RCTR.

Conclusions:

• Tension-reducing rotator cuff repair techniques lead to increased healing rates and improved functional outcomes for full-thickness rotator cuff tears compared to full footprint covering repair.
• These findings support the use of tension-reducing strategies for enhanced patient recovery and shoulder function.