Relevance of the association between the change of cuff integrity and the clinical outcome from 1 to 2 years postoperatively

Abstract

Few studies have evaluated the mid-term integrity of repaired rotator cuffs using magnetic resonance imaging (MRI). The purpose of this study was to evaluate the relevance of the association between the change of cuff integrity and the clinical outcome from 1 to 2 years postoperatively using MRI among 353 patients with rotator cuff tears treated with arthroscopic rotator cuff repair. Retear was detected in 53 cases (retear rate: 15.0%) in the first year after surgery, and the number of retear cases increased to 67 (19.0%) at 2 years after surgery. According to repair integrity, the retear rate between 1 and 2 years after arthroscopic rotator cuff repair was 33.3% in Sugaya type 3, which was the highest among all types. When the retear group and the successfully repaired group were compared at 2 years after surgery, the 2-year postoperative clinical scores in the retear group were significantly lower than those in the successfully repaired group, although there was no significant difference in the 1-year postoperative clinical scores between the retear group and the successfully repaired group. In addition, the improvement of fatty infiltration after repair was poor regardless of whether repair was successful or not. In conclusion, retear after 1 year postoperatively is not uncommon. Therefore, a longer follow-up of at least > 2 years is necessary after surgery, especially in patients with severe fatty infiltration preoperatively and those with insufficient thickness without discontinuity in 1-year postoperative MRI.