Arthroscopic rotator cuff repair: Analysis of results by tear size and by repair technique - Margin convergence versus direct tendon-to-bone repair

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.