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Ten-Year Multicenter Clinical and MRI Evaluation of Isolated Supraspinatus Repairs

Collin, Philippe, MD1,a; Kempf, Jean-François, MD, PhD2; Molé, Daniel, MD3; Meyer, Nicolas, PhD4; Agout, Charles, MD5; Saffarini, Mo, MEng6; Godenèche, Arnaud, MD7; ; the Société Française de Chirurgie Orthopédique et Traumatologique (SoFCOT)

doi: 10.2106/JBJS.16.01267
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Background: Early repair of isolated supraspinatus tears could prevent further deterioration of the rotator cuff; however, there is no consensus on the management of such tears because of a lack of long-term outcome studies. The purposes of this study were to report the 10-year outcomes of isolated supraspinatus repairs and to investigate the factors that favor healing and recovery.

Methods: We retrieved the records of all 511 patients who, in 2003, underwent repair of full-thickness isolated supraspinatus tears, performed by 15 surgeons at 15 centers. In 2014, the patients were asked to return for evaluation at a minimum follow-up of 10 years. One hundred and eighty-eight patients could not be reached, and 35 were excluded because they had a reoperation (17 had a retear, 7 had conversion to an arthroplasty, and 11 had other causes). A total of 288 patients (50% were men) who had a mean age (and standard deviation) at index surgery of 56.5 ± 8.3 years (range, 32 to 77 years) were evaluated clinically, and 210 of them were also evaluated using magnetic resonance imaging (MRI).

Results: Thirty shoulders (10.4%) had complications, including stiffness (20 shoulders), infection (1 shoulder), and other complications (9 shoulders). The total Constant score improved from a mean of 51.8 ± 13.6 points (range, 19 to 87 points) preoperatively to 77.7 ± 12.1 points (range, 37 to 100 points) at 10 years. At the 10-year follow-up evaluation, the mean Subjective Shoulder Value (SSV) was 84.9 ± 14.8 (range, 20 to 100), and the mean Simple Shoulder Test (SST) was 10.1 ± 2.2 (range, 3 to 12). Of the 210 shoulders evaluated using MRI, the repair integrity was Sugaya type I in 26 shoulders (12%), type II in 85 (41%), type III in 59 (28%), type IV in 27 (13%), and type V in 13 (6%). The total Constant score at the final follow-up was significantly associated with tendon healing (p < 0.005) and was inversely associated with preoperative fatty infiltration (p < 0.001). Neither the surgical approach nor the preoperative retraction influenced the outcomes.

Conclusions: Repairs of isolated supraspinatus tears maintained considerable improvement in clinical and radiographic outcomes at 10 years. Preoperative fatty infiltration and postoperative retear have a significantly detrimental effect on the long-term functional outcome of rotator cuff repair.

Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

1CHP Saint Grégoire VIVALTO Santé, Saint Grégoire, France

2Centre Chirurgical Émile Gallé, Nancy, France

3Centre de Traumatologie, Hôpitaux Universitaires de Strasbourg, Illkirch-Graffenstaden, France

4Laboratoire de Bio Statistiques, Faculté de Médecine de l’Université de Strasbourg, Strasbourg CEDEX, France

5Service de Chirurgie Orthopédique et Traumatologique Hôpital Trousseau CHRU, Tours, France

6ReSurg SA, Nyon, Switzerland

7Centre Orthopédique Santy, Hôpital Privé Jean Mermoz (Ramsay Genérale de Santé), Lyon, France

8SoFCOT, Paris, France

aE-mail address for P. Collin: collin.ph@wanadoo.fr

Copyright © 2017 by The Journal of Bone and Joint Surgery, Incorporated
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