Medialized repair for retracted rotator cuff tears

Abstract

Background: The purpose of this study was to evaluate the functional outcomes of medialized rotator cuff repair and the continuity of repaired tendon in chronic retracted rotator cuff tears. Methods: Thirty-five consecutive patients were selected from 153 cases that underwent arthroscopic rotator cuff repair for more than medium-sized posterosuperior rotator cuff tears between July 2009 and July 2012 performed with the medialized repair. All cases were available for at least 2 years of postoperative follow-up. The visual analog scale of pain, muscle strength, Constant score, American Shoulder and Elbow Surgeons (ASES) score, and University of California-Los Angeles score were evaluated. Results: At the final follow-up, all clinical outcomes were significantly improved. The visual analog scale score for pain improved from 6 +/- 1 preoperatively to 2 +/- 1 postoperatively. The range of motion increased from preoperatively to postoperatively: active forward elevation, from 134 degrees +/- 49 degrees to 150 degrees +/- 16 degrees; active external rotation at the side, from 47 degrees +/- 15 degrees to 55 degrees +/- 10 degrees; and active internal rotation, from L3 to L1. The shoulder score also improved: Constant score, from 53.5 +/- 16.7 to 79 +/- 10; American Shoulder and Elbow Surgeons score, from 51 +/- 15 to 82 +/- 8; and University of California- Los Angeles score, from 14 +/- 4 to 28 +/- 4. The retear cases at the final follow-up were 6 (17%). Conclusions: Medialized repair may be useful in cases in which anatomic bone-o-tendo repair would be difficult because of the excessive tension of the repaired tendon and a torn tendon that does not reach the anatomic insertion. (C) 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.