Large Study Shows Durability of Arthroscopic Rotator Cuff Repair at 5 Years

ORTHOSuperSite—April 4, 2011

A large prospective study conducted by investigators from Hospital for Special Surgery shows that arthroscopic rotator cuff repair is effective and provides durable results 5 years after surgery, according to a Hospital for Special Surgery press release.

The study, which was presented at the American Shoulder and Elbow Surgeons 2011 Specialty Day Meeting, also revealed that rotator cuffs could heal even though early imaging studies found a defect at the site of repair.

“Our study demonstrates that arthroscopic rotator cuff repair results remain excellent when followed over 5 years, and we found that some tendons that were incompletely healed at 2 years appeared to heal fully by 5 years, suggesting that rather than deteriorating over time, results may in fact improve over time,” David W. Altchek, MD, co-chief of the Sports Medicine and Shoulder Service at Hospital for Special Surgery (HSS), stated in the release.

Healing after repair
 
The study is the largest to prospectively evaluate long-term outcomes of arthroscopic rotator cuff repair surgery, according to the press release.

“Before this study, we thought that once a rotator cuff had re-torn or failed to heal following surgery, it had no capacity to heal in the future,” lead study author, Lawrence V. Gulotta, MD, stated in the release. “Now, we know that the rotator cuff does have the capacity to heal itself, even if early radiographic studies showed there was a defect at the repair site.”

The study included 193 patients who underwent arthroscopic rotator cuff repair at HSS and were evaluated annually for 5 years. According to the release, ultrasound results after 1 year showed that 64.3% of patients had a healed rotator cuff. At 2 years postoperatively, 75.4% of patients had healed rotator cuffs. At 5 years, 81.2% had healed.

Function
 
American Shoulder and Elbow Surgeons (ASES) scores significantly improved from 52.6 points preoperatively to 92.6 points at 5 years. The investigators found no difference between ASES scores at 2 and 5 years.

“What we found is that patients continued to get better between years 1 and 2, but they stay the same between years 2 and 5,” Gulotta stated in the press release.

Although the investigators identified a slightly decreased range of motion between 2 and 5 years 2, this did not impact overall function. Passive forward elevation and external rotation also decreased in the same time period, according to the release. “While those numbers are getting worse, they are not really clinically applicable at this time point,” Gulotta stated.

Read the full sotry at orthosupersite.com.

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