Arthroscopic rotator cuff repair: Analysis of results by tear size and by repair technique-margin convergence versus direct tendon-to-bone repair.

PURPOSE

The purpose of this article is 2-fold: To report the long-term functional results of arthroscopic rotator cuff repair (average, 3.5 years in this study), and to analyze results by tear size and repair technique (margin convergence v direct tendon-to-bone repair).

TYPE OF STUDY

Case series.

METHODS

Between September 1993 and April 1997, 62 patients had an arthroscopic rotator cuff repair performed by the senior author (S.S.B.). Of this group, 59 patients (59 shoulders) were available for follow-up. Preoperative and postoperative function were assessed by means of a modified UCLA scoring system. Tears were categorized according to size (greatest diameter, number of tendons involved, and pattern of tear [crescent shape v U-shape]). Crescent-shaped tears were repaired in a direct tendon-to-bone fashion and U-shaped tears were repaired by a margin-convergence technique.

RESULTS

Good and excellent results were achieved in 95% of the cases, regardless of tear size. The large and massive tears did as well as the small and medium-sized tears. That is, results were independent of tear size (P >.05). Results of tears repaired by margin convergence were not significantly different statistically from those repaired by direct tendon-to-bone repair (P >.05), validating the selection criteria of U-shaped tears for repair by margin convergence. There is a rapid return to full overhead function after arthroscopic rotator cuff repair (average, 4 months for each tear size). Delay from injury to surgery, even of several years, did not adversely affect surgical outcome.

CONCLUSIONS

(1) Arthroscopic rotator cuff repair can achieve good and excellent results in a large percentage of patients (95% in this series). (2) Results of arthroscopic rotator cuff repair are independent of tear size. (3) U-shaped tears repaired by margin convergence have results comparable to those of crescent-shaped tears repaired directly by a tendon-to-bone technique. (4) There is a rapid return to full overhead function after arthroscopic rotator cuff repair (average, 4 months for all tear sizes). (5) A delay from injury to diagnosis, even of several years, is not a contraindication to arthroscopic rotator cuff repair.