Clinical and Radiologic Outcomes of Arthroscopic Rotator Cuff Repair in Medial Bursal-Side Fosbury Flop Tears Compared With Tendinous Avulsion Lesions

Abstract

PurposeThe purpose of this study was to determine the clinical and radiological outcomes after surgical repair of medial bursal side Fosbury Flop rotator cuff tears compared to traditional avulsion of tendinous attachments lesions. MethodsA retrospective cohort study was performed. All patients who had undergone arthroscopic posterosuperior repair were recruited. Patients with prior shoulder rotator cuff surgery were excluded. Recruited patients were divided into two groups: one presenting Fosbury flop tears and the other presenting standard avulsion lesions. Preoperative demographics such as age, gender, and arm dominance were recorded. Range of motion (ROM), visual analog scale (VAS) for pain and satisfaction, Constant score, single alpha-numeric evaluation (SANE) score, and American shoulder and elbow surgeons score (ASES) were evaluated at three points in time: preoperatively, and at six months and minimum one year postoperatively. The healing of repaired cuffs was evaluated by ultrasound at six months. ResultsTwo hundred thirty-six patients were recruited, with 27 (11.4%) Fosbury flop tears and 209 (88.6%) tendon avulsions. Although there was no significant difference in gender or arm dominance between the groups, Fosbury flop tears had significantly older patients (p<0.05) with a mean age 61.6 years (SD 9.0), compared to tendon avulsions with a mean age of 56.1 years (SD 9.1). There was no significant difference in tendon retraction between the groups.Both groups demonstrated significant improvement in ROM, VAS, ASES, SANE, and Constant score postoperatively at six months and minimum one year. The groups demonstrated no significant difference in the ROM and clinical scores. There was a non-significant difference in re-tear rate of 7.4% (2/27) in Fosbury flop tears compared to 2.8% (6/209) in tendon avulsions (p=0.361). ConclusionArthroscopic rotator cuff repair of medial bursal side Fosbury Flop rotator cuff tears results in favorable clinical and radiological outcomes at four years after surgery. These outcomes are comparable to surgically repaired avulsion lesions, with an acceptable re-tear rate after arthroscopic repair.