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Tear size, fatty infiltration correlated with failure of arthroscopic rotator cuff repair
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Investigators of this retrospective, case-control study found tear size and fatty infiltration were linked with failure of arthroscopic rotator cuff repair. However, in symptomatic patients, this finding was independent of the age or gender.
Researchers reviewed information for patients who underwent arthroscopic rotator cuff repair. There were 30 failures and 60 control patients who were matched based on their gender and age. Investigators collected data that included demographics, comorbidities, repair technique, clinical examination and radiographic findings. Investigators also performed a multivariate analysis with logistic analysis.
Findings showed significant risk factors for failure included supraspinatus atrophy, tear size and the presence of an infraspinatus tear greater than 10 mm. Investigators noted single-row repairs and simple suture configuration were most common repair techniques used; however, the difference between groups was not significant.
According to researchers, diabetes mellitus and active tobacco use were not significantly correlated with an increased risk of failure. However, there was an increased number of patients in the failure group who used psychiatric medication. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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Stephen S. Burkhart, MD
This study by Gregory Gasbarro, MD, and his colleagues suggests that failure of arthroscopic rotator cuff repair is more common in large tears and in tears with higher grades of fatty infiltration. These conclusions reinforce similar conclusions from previous studies, and they suggest that rotator cuff repair might have better outcomes if performed before the tears progress to larger sizes and higher degrees of fatty infiltration. It is interesting to note that the one surgeon in this study who utilized mostly double-row repair had much lower failure rates; this keeps up with prior literature showing lower failure rates with double-row repair than with single-row repair.
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