Full thickness rotator cuff tears long-term follow-up

Background: With an increase in the treatment options available for massive rotator cuff tears, understanding the long-term outcomes of the chosen modality is important. Questions/Purpose: The purpose of this study was to systematically review the available literature on repair of massive rotator cuff repairs and learn the longevity of outcomes, the failure rate, outcomes after failure, and any contributing factors to poor outcomes or failure. Methods: We conducted a systematic review of the MEDLINE, Cochrane, and Embase databases to find studies that investigated the long-term results of repair of massive rotator cuff repairs. Studies were excluded if they did not stratify results of massive tears, provide a definition for a massive rotator cuff tear, or report isolate patients with long-term follow-up. Results: Six studies met the inclusion criteria, for a total of 472 shoulders; average patient age was 57.6 years. Follow-up ranged from 119 to 240 months. Outcome scores improved significantly following repair and were maintained throughout follow-up. The repair failure rate across studies was 39.2%. Patients who suffered retear had significantly worse outcome scores than patients with intact tendons at long-term follow-up. Conclusions: The existing literature on long-term follow-up after massive rotator cuff repair is scarce and not of high level of evidence. This review found repair of massive rotator cuff tears leads to long-term maintained improvements in outcome measures. Failure of repair is quite common, but results following failure are superior to preoperative outcomes.

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Long-term Follow-up of Extensive Peri-anchor (Poly-L/D-lactic Acid) Cyst Formation after Arthroscopic Rotator Cuff Repair: A Case Report

Clinics in Shoulder and Elbow ◽

10.5397/cise.2019.22.2.100 ◽

2019 ◽

Vol 22 (2) ◽

pp. 100-105

Author(s):

Jong-Ho Kim ◽

Jong-Ick Kim ◽

Hyo-Jin Lee ◽

Dong-Jin Kim ◽

Gwang Young Sung ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Repair ◽

Cyst Formation ◽

Arthroscopic Rotator Cuff Repair ◽

Rotator Cuff Tears ◽

Long Term Follow Up ◽

Arthroscopic Rotator Cuff ◽

Cuff Repair

Suture anchors are commonly used in shoulder surgeries, especially for rotator cuff tears. Peri-anchor cyst formation, however, is sometimes detected on follow-up radiologic image after surgery. The purpose of this report is to discuss the case of a patient who presented with regression of extensive peri-anchor cyst on postoperative 4-year follow-up magnetic resonance imaging and had good clinical outcome despite peri-anchor cyst formation after arthroscopic rotator cuff repair.

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Long-term outcome of arthroscopic debridement of massive irreparable rotator cuff tears

PLoS ONE ◽

10.1371/journal.pone.0241277 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241277

Author(s):

Tim Vogler ◽

Dimosthenis Andreou ◽

Georg Gosheger ◽

Nico Kurpiers ◽

Clara Velmans ◽

...

Keyword(s):

Rotator Cuff ◽

Shoulder Arthroplasty ◽

Reverse Shoulder Arthroplasty ◽

Rotator Cuff Tears ◽

Arthroscopic Debridement ◽

Radiographic Outcome ◽

Vas Score ◽

Long Term Follow Up

Objectives To evaluate the clinical and radiographic outcome of low-demand patients with massive rotator cuff tears undergoing arthroscopic debridement in mid- and long-term follow-up, as well as the rate of conversion to reverse shoulder arthroplasty. Methods We performed a retrospective analysis of 19 patients with a mean age at surgery of 68 years (range, 55–80 years) from a previously described consecutive cohort and after a mean follow up of 47 month (FU1) and 145 month (FU2). The functional outcome was evaluated with the VAS score, the American Shoulder and Elbow Surgeons (ASES) score, and the age- and gender-adjusted Constant (aCS) score. The radiographic outcome was classified according to the Hamada classification. Non-parametric analyses were carried out with the Mann-Whitney U for independent samples and the Wilcoxon signed-rank test for related samples. Results Five patients (26%) developed symptomatic cuff tear arthropathy and underwent reverse shoulder arthroplasty after a mean time of 63 months (range, 45–97 months). These patients were excluded from further analyses. The mean VAS score of the remaining 14 patients at FU1 was significantly lower compared to preoperatively (P = .041), while there were no significant differences between the VAS score at FU1 and FU2 (P = 1.0). The ASES score of the affected shoulder at FU1 was significantly higher compared to prior to surgery (P = .028), while there were no significant differences between the scores of the affected shoulder between FU1 and FU2 (P = .878). While the ASES score of the contralateral shoulder at FU1 was significantly higher than the score of the affected shoulder (P = .038), there were no significant differences in the ASES scores of the affected and the healthy shoulder at FU2 (P = .575). The evaluation of the aCS produced similar results. A progression of the Hamada grade was documented in 6 patients. Conclusions Arthroscopic debridement is a safe and valid option for low-demand middle-age or elderly patients with symptomatic massive rotator cuff tears, leading to a significant pain relief and significantly improved functional outcome at mid- and long-term follow up. However, about a quarter of the patients in our cohort had to undergo reverse shoulder arthroplasty due to symptomatic cuff tear arthropathy. Furthermore, some of the remaining patients continued to undergo radiographic progression. This might be due to the natural history of their disease and/or the surgical procedure, and the clinical relevance of this finding should be evaluated in further studies.

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Current concepts in the primary management of irreparable posterosuperior rotator cuff tears without arthritis

EFORT Open Reviews ◽

10.1302/2058-5241.3.180002 ◽

2018 ◽

Vol 3 (5) ◽

pp. 200-209 ◽

Cited By ~ 9

Author(s):

Alexandre Lädermann ◽

Philippe Collin ◽

George S. Athwal ◽

Markus Scheibel ◽

Matthias A. Zumstein ◽

...

Keyword(s):

Rotator Cuff ◽

Rotator Cuff Tears ◽

Structural Failure ◽

Short Term ◽

Superior Capsular Reconstruction ◽

Long Term Follow Up ◽

Primary Management ◽

Biological Augmentation

Various procedures exist for patients with irreparable posterosuperior rotator cuff tears (IRCT). At present, no single surgical option has demonstrated clinical superiority. There is no panacea for treatment and patients must be aware, in cases of palliative or non-prosthetic options, of an alarming rate of structural failure (around 50%) in the short term. The current review does not support the initial use of complex and expensive techniques in the management of posterosuperior IRCT. Further prospective and comparative studies with large cohort populations and long-term follow-up are necessary to establish effectiveness of expensive or complicated procedures such as superior capsular reconstruction (SCR), subacromial spacers or biological augmentation as reliable and useful alternative treatments for IRCT.Cite this article: EFORT Open Rev 2018;3 DOI: 10.1302/2058-5241.3.180002

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Long-term Follow-up of Two Cases of Latissimus Dorsi Transfer for Irreparable Rotator Cuff Tears

Orthopedics & Traumatology ◽

10.5035/nishiseisai.59.704 ◽

2010 ◽

Vol 59 (4) ◽

pp. 704-707

Author(s):

Akihiko Kura ◽

Yozo Shibata ◽

Teruaki Izaki ◽

Motoyuki Fujisawa ◽

Tsuyoshi Shinoda ◽

...

Keyword(s):

Rotator Cuff ◽

Latissimus Dorsi ◽

Rotator Cuff Tears ◽

Latissimus Dorsi Transfer ◽

Long Term Follow Up

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Joint-preserving surgical treatment options for irreparable posterosuperior rotator cuff tear

Obere Extremität ◽

10.1007/s11678-021-00657-6 ◽

2021 ◽

Author(s):

Florian Grubhofer ◽

Jon JP Warner

Keyword(s):

Rotator Cuff ◽

Treatment Outcomes ◽

Treatment Options ◽

Term Treatment ◽

Therapeutic Options ◽

Rotator Cuff Tears ◽

Long Term Treatment ◽

Long Term Follow Up

AbstractTreatment of irreparable rotator cuff tears in young active patients is challenging. A variety of therapeutic options are available. Only a few joint-preserving treatment options show reliable improvements over a long-term follow-up period. However, the treatment outcomes of joint preservation procedures are not comparable to those of RTSA, as patients are typically younger and have higher expectations. It is remarkable that most of the joint-preserving therapeutic options for irreparable rotator cuff ruptures lack long-term treatment results. This article highlights the indications, technical aspects, and treatment outcomes of the most commonly performed joint-preserving surgeries for irreparable rotator cuff rupture.

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