Ss. Burkhart et al., Arthroscopic rotator cuff repair: Analysis of results by tear size and by repair technique - Margin convergence versus direct tendon-to-bone repair, ARTHROSCOPY, 17(9), 2001, pp. 905-912
Purpose: The purpose of this article is 2-fold: To report the long-term fun
ctional results of arthroscopic rotator cuff repair (average, 3.5 years in
this study), and to analyze results by tear size and repair technique (marg
in convergence v direct tendon-to-bone repair). Type of Study: Case series.
Methods: Between September 1993 and April 1997, 62 patients had an arthros
copic rotator cuff repair performed by the senior author (S.S.B.). Of this
group, 59 patients (59 shoulders) were available for follow-up. Preoperativ
e and postoperative function were assessed by means of a modified UCLA scor
ing system. Tears were categorized according to size (greatest diameter, nu
mber of tendons involved, and pattern of tear [crescent shape v U-shape]).
Crescent-shaped tears were repaired in a direct tendon-to-bone fashion and
U-shaped tears were repaired by a margin-convergence technique. Results: Go
od and excellent results were achieved in 95% of the cases, regardless of t
ear size. The large and massive tears did as well as the small and medium-s
ized tears. That is, results were independent of tear size (P > .05). Resul
ts of tears repaired by margin convergence were not significantly different
statistically from those repaired by direct tendon-to-bone repair (P > .05
), validating the selection criteria of U-shaped tears for repair by margin
convergence. There is a rapid return to full overhead function after arthr
oscopic rotator cuff repair (average, 4 months for each tear size). Delay f
rom injury to surgery, even of several years, did not adversely affect surg
ical outcome. Conclusions: (1) Arthroscopic rotator cuff repair can achieve
good and excellent results in a large percentage of patients (95% in this
series). (2) Results of arthroscopic rotator cuff repair are independent of
tear size. (3) U-shaped tears repaired by margin convergence have results
comparable to those of crescent-shaped tears repaired directly by a tendon-
to-bone technique. (4) There is a rapid return to full overhead function af
ter arthroscopic rotator cuff repair (average, 4 months for all tear sizes)
. (5) A delay from injury to diagnosis, even of several years, is not a con
traindication to arthroscopic rotator cuff repair.