Comparison of post-operative outcomes in arthroscopic repair of traumatic and atraumatic rotator cuff tears

Abstract

Background Traumatic or atraumatic etiologies are associated with different pathophysiology, and thus, may lead to different post-operative outcomes after arthroscopic rotator cuff repair (RCR). Methods Institutional records were used to identify patients who underwent arthroscopic RCR in 2019-2020. Retrospective review of medical records was performed to determine mechanism of injury, pre- and post-operative range of motion and strength measures. Results Among 100 RCR patients, 53 sustained a traumatic RC injury. Patients with traumatic rotator cuff tears (TR) presented to the clinic after onset of pain sooner than patients with atraumatic tears (aTR) (TR: 166±193 vs aTR: 595±679 days; P<0.001). Pre-operative measurements were worse among traumatic patients than atraumatic patients: forward elevation (TR: 130º±48º vs aTR: 152º±25º; P=0.036), external rotation (TR: 49º±17º vs aTR: 55º±16º; P=0.076), internal rotation (TR: L4 vs aTR: L3; P=0.033), forward elevation strength (TR: 4/5 vs aTR: 5/5; P=0.035), external rotation strength (TR: 5/5 vs aTR: 5/5; P=0.065), and internal rotation strength (TR: 5/5 vs aTR: 5/5; P=0.150). However, there was no significant difference in post-operative measurements between cohorts: forward elevation (TR: 158º±19º vs aTR: 153º±28º; P=0.433), external rotation (TR: 53º±16º vs aTR: 50º±15º, P=0.332), internal rotation (TR: L2 vs aTR: L2; P=0.703), forward elevation strength (TR: 5/5 vs aTR: 5/5; P=0.926), external rotation strength (TR: 5/5 vs aTR: 5/5; P=0.920), and internal rotation strength (TR: 5/5 vs aTR: 5/5; P=0.519). Conclusion Traumatic RCR patients had significantly worse functional measurements during pre-operative exam than atraumatic RCR patients, but there was no significant difference in post-operative outcomes.