Outcome of open massive rotator cuff repairs with double-row suture knotless anchors: case series.

Purpose: The aim of the present study was to evaluate functional and quality of life outcomes after transosseous equivalent (TOE) double row suture technique for massive rotator cuff (RTC) tear repair using validated subjective and objective measures. This technique has shown promising preliminary results in RTC repair; however, a paucity of evidence regarding these outcomes in massive RTC (MRTC) tear repair exists.

Methods: Patients were identified using the Hospital Inpatient Enquiry Scheme. Pre-operative MRI and medical records were reviewed. A massive RTC tear was defined as the detachment of two or more tendons from their point of insertion on the humeral head. The Constant and Oxford Shoulder Scores (OSS) and SF-12 questionnaire were used for evaluation.

Results: Twenty-two patients were studied (72.7 % male; mean age at surgery, 62.6 years). Mean follow up was 14 (range six to 30) months. At six weeks postoperatively, 68 % achieved good or excellent shoulder function as measured by the OSS and Constant score. The cohort's mean SF-12 physical and emotional scores were significantly lower (p = 0.0002 and 0.037) and the vitality and mental health scores were higher (p = 0.005 and 0.006) than the reference norm scores.

Conclusions: The TOE double row surgical repair for MRTC tears provides good to excellent functional outcomes and is associated with high vitality and mental health scores at a mean of 14 months. Physical and emotional scores were lower than reference norm. These results suggest this repair technique is appropriate for massive rotator cuff tears, and future randomised control studies are warranted.