Long-term survivorship and outcomes after surgical repair of full-thickness rotator cuff tears

Introduction: Rotator cuff injuries are commonly diagnosed orthopaedic conditions. The purpose of this study was to determine survivorship of primary open cuff repairs, with survivorship defined as a shoulder not requiring additional surgery. Materials and methods: Between 1993 and 2004, open cuff repairs were performed in 254 patients (263 shoulders). All had a complete tear of the supraspinatus. In addition, 86 patients had tears of the infraspinatus and 50 had subscapularis tears. Survivors did not require further surgery. Survivorship was analyzed by use of the Kaplan-Meier method, and the log-rank test was used to compare survivorship between variables. Results: After surgery, 233 of 263 patients (89%) were contacted for survivorship data. Overall, 11% of patients (26 of 233) in this cohort had another surgery, with a survivorship of 94% at 5 years and 83% at 10 years. Increased survivorship was associated with single-tendon repairs (P = .02). For survivors, the mean follow-up was 6.3 years (range, 1 to 16 years), and there was a statistically significant improvement in mean American Shoulder and Elbow Surgeons (ASES) score from 56 preoperatively to 88 postoperatively. Chronic tears and tears that involved the subscapularis had lower ASES scores, and satisfaction with surgical outcome was 8 on a 10-point scale. Conclusion: Overall survivorship was 94% at 5 years after open rotator cuff surgery and 83% at 10 years. Among those patients who survived at 6.3 years, there was a mean 32-point increase in the ASES score and a rating for patient satisfaction with surgical outcomes of 8 of 10. As a consequence, most failures occurred in the first 2 years and if the cuff repairs survived the initial years, they were highly likely to survive over the 10-year period. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.