Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Feb;471(2):554-61.
doi: 10.1007/s11999-012-2494-1. Epub 2012 Aug 16.

Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair

Martti Vastamäki  1 , Martina Lohman, Niclas Borgmästars
Affiliations

Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair

Martti Vastamäki et al. Clin Orthop Relat Res. 2013 Feb.

Abstract

Background: Recurrent or persistent defects in the rotator cuff after its repair are common. Short- and medium-term surveys have revealed, after open repair, patients with an intact rotator cuff have increased function and ROM. However, no long-term studies have verified cuff integrity on MR arthrography or correlated it with clinical and functional outcomes.

Questions/purposes: We evaluated long-term cuff integrity and fatty infiltration after open repair using MR arthrography and determined whether these findings correlated with clinical and functional results.

Methods: Using MR arthrography, we retrospectively evaluated 67 patients (48 men, 19 women) who underwent open rotator cuff repair between 1980 and 1989. Their mean age at surgery was 52 years. Minimum followup was 16 years (mean, 20 years; range, 16-25 years).

Results: The retear rate was 94%, and mean size of rerupture was 3.5 × 3.6 cm (ranges, 0.5-5.0 cm × 0.5-5.2 cm; median, 4 × 4 cm). The remaining four patients had a partial supraspinatus tendon tear. Fatty infiltration was marked in the supraspinatus and infraspinatus tendons. Cuff integrity correlated with clinical results: active external rotation and forward flexion, and flexion, abduction, and external rotation strengths, were better in patients with an intact rotator cuff or a small retear of 4 cm(2) or less than in patients with larger tears. Cuff integrity also correlated with functional results.

Conclusions: Rotator cuff integrity was lost in 94% of patients after a minimum followup of 16 years. Cuff integrity correlates well with clinical and functional results even several years postoperatively. A large retear seems to be the most important factor in deteriorating long-term clinical and functional results after open rotator cuff repair.

Level of evidence: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.

PubMed Disclaimer

References

    1. Bartl C, Kouloumentas P, Holzapfel K, Eichhorn S, Wörtler K, Imhoff A, Salzmann GM. Long-term outcome and structural integrity following open repair of massive rotator cuff tears. Int J Shoulder Surg. 2012;6:1–8. doi: 10.4103/0973-6042.94304. - DOI - PMC - PubMed
    1. Bartl C, Senftl M, Eichhorn S, Holzapfel K, Imhoff A, Salzmann G. Combined tears of the subscapularis and supraspinatus tendon: clinical outcome, rotator cuff strength and structural integrity following open repair. Arch Orthop Trauma Surg. 2012;132:41–50. doi: 10.1007/s00402-011-1400-8. - DOI - PubMed
    1. Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL. Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg. 2006;15:290–299. doi: 10.1016/j.jse.2005.09.017. - DOI - PubMed
    1. Borgmästars N, Paavola M, Remes V, Lohman M, Vastamäki M. Pain relief, motion, and function after rotator cuff repair or reconstruction may not persist after 16 years. Clin Orthop Relat Res. 2010;468:2678–2689. doi: 10.1007/s11999-010-1403-8. - DOI - PMC - PubMed
    1. Borgmästars N, Remes V, Lohman M, Tallroth K, Vastamäki M. [Long-term outcome after open rotator cuff surgery: an inaugural analysis of 75 patients] [in Finnish] Suomen Ortopedia ja Traumatologia. 2006;29:325–330.