Purpose: The purpose of this study was to evaluate the integrity of the repaired rotator cuff between 1 and 2 years postoperatively after arthroscopic rotator cuff repair (ARCR) using magnetic resonance imaging (MRI), investigate the factors affecting its change, and assess the association between the change and postoperative clinical outcomes.
Methods: Rotator cuff tear patients who underwent ARCR and were evaluated by MRI before surgery, and 1 and 2 years after ARCR with a minimum of 2-year follow-up were included in this study. Repair integrity was evaluated using Sugaya's classification, and according to the classification types IV and V were defined as re-tears. In addition, fatty degeneration of the rotator cuff muscles was evaluated using Goutallier's classification. Furthermore, the clinical scores were also assessed.
Results: In total, 346 patients were evaluated. Re-tears were detected in 51 cases one year postoperatively, and the number of re-tear cases increased to 65 2 years postoperatively. The re-tear rate 1 to 2 years postoperatively was 33.3% of patients classified as Sugaya type III one year postoperatively, the highest among all types. The incidence of re-tears was significantly associated with preoperative tear size (p < 0.01) and fatty degeneration (p < 0.01) among these patients. The 2-year postoperative clinical scores of the re-tear group were significantly lower than those of the repaired group, although there was no significant difference 1 year postoperatively. Fatty degeneration after repair did not improve regardless of whether the repair was successful or not.
Conclusions: Re-tears between 1 and 2 years postoperatively are not uncommon. A follow-up of at least 2 years is necessary to determine short-term outcome after surgery, especially in patients with severe fatty degeneration preoperatively and those with diminished muscle thickness without discontinuity seen on MRI 1-year postoperatively.
Level Of Evidence: Level IV, therapeutic case series.
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| http://dx.doi.org/10.1016/j.arthro.2024.12.029 | DOI Listing |
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