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Early rotator cuff repair yields superior improvement in outcomes vs late repair
Patients with rotator cuff tears who underwent repair within 6 months after injury experienced statistically and clinically superior improvement in outcomes compared with patients who underwent repair after 6 months of injury, according to recently published results.
Researchers evaluated VAS for pain, American Shoulder and Elbow Surgeons (ASES) Shoulder Assessment score and Constant scores preoperatively and at 6 months, 12 months and 24 months postoperatively in 36 patients with full-thickness rotator cuff tears who underwent arthroscopic repair within 6 months of their injury (acute-on-chronic group). For comparison, researchers matched 36 patients for age, sex and tear size who underwent arthroscopic rotator cuff repair after 6 months of injury. They obtained postoperative indirect magnetic resonance arthrogram 6 months after the repair, and graded rotator cuff integrity according to the guidelines as described by Sugaya.
Results showed both groups had a clinically and statistically significant improvement after operation. While both groups had a significantly reduced VAS for pain score 2 years after surgery, researchers observed a more significant reduction in pain in the acute-on-chronic group. Patients in the acute-on-chronic group also experienced a significantly greater improvement in ASES and Constant scores after surgery, as well as a greater improvement in range of motion measurements at 2 years, according to the data. Researchers found the repair in the acute-on-chronic group appeared closer to the complete repair and had an association with a lesser incidence of retear vs. the chronic group. However, this finding was not statistically significant, researchers noted. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.
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Jeong JY, et al. J Shoulder Elbow Surg. 2017;doi:10.1016/j.jse.2016.09.032.