Abstract
Objectives:
Rotator cuff tears may occur due to a traumatic event that causes acute tearing of the rotator cuff tendons or secondary to chronic tendon degeneration and subsequent atraumatic tearing. The role that tear etiology plays in outcomes after repair is not well understood. The purpose of this study is to determine if a difference exists in outcomes after rotator cuff repair based on tear etiology.
Methods:
221 consecutive patients who underwent arthroscopic rotator cuff repair were evaluated with prospectively collected preoperative and at least 2-year postoperative data via chart review. Shoulder range-of-motion, strength and standard shoulder physical exam findings were recorded both preoperatively and postoperatively. Outcome measures including visual acuity scale pain score (VAS), subjective shoulder value (SSV), Patient-Reported Outcomes Measurement Information System (PROMIS) scores (both mental and physical components), and American Shoulder and Elbow Surgeons Scores (ASES) were examined.
Results:
Of the 221 patients, 73 had traumatic tears and 148 had atraumatic/degenerative tears. There were no differences in age, body-mass-index, or Charlson comorbidity index between groups. Patients in the atraumatic cohort had significantly longer duration of symptoms prior to presentation (17.9 months vs 6.5 months, p<0.05). Preoperatively, the traumatic cohort had less motion to forward elevation (138.0° vs 151.7°, p<0.05). Postoperatively, both groups experienced significant improvements in VAS and SSV scores (p<0.05). However, only the traumatic cohort demonstrated improvements in ASES and the physical PROMIS scores. Patients with traumatic rotator cuff tears had greater improvements in SSV (40.6% vs 29.2%, p<0.05), forward elevation (21.6° vs 2.3°, p<0.05), and strength to forward elevation, external rotation, and internal rotation compared to those with atraumatic tears (p<0.05).
Conclusions:
Patients with traumatic rotator cuff tears experience greater improvements in range-of-motion, strength, and perceived shoulder function than those with degenerative/atraumatic tears.