Purpose: To evaluate clinical outcomes and revision surgery rates in primary arthroscopic repair for posterosuperior massive rotator cuff tears (MRCT) at mid-term follow-up, and to identify prognostic factors associated with outcomes.Methods: A retrospective study of patients with posterosuperior MRCT treated with primary arthroscopic repair between 2006-2023 with 2 years minimum follow-up.MRCT was defined as complete detachment of > 2 tendons or a diameter >5 cm.Baseline characteristics, surgical technique, range of motion (ROM) and patient reported outcomes (PROs) including ASES and Constant score, SST, satisfaction and VAS pain were recorded.Retear, revision surgery and survival rates were also evaluated.Univariate and multivariate analyses identified independent predictors of outcomes.Results: Fifty-seven patients with 5.4 3.6 years mean follow up were evaluated.All PROs significantly improved from pre-to postoperative (p<0.001):Constant +32.7 points (95% CI 27.2 to 38.2), ASES +51.2 points (95% CI 43.4 to 59.1), SST +5.5 points (95% CI 4.6 to 6.5) and VAS +6.2 points (95% CI 5.1 to 7.3).ROM significantly improved (p<0.001)only for flexion and abduction.Multivariate analysis showed that only revision surgery independently affected outcomes.Among 23 (40.4%) patients with postoperative MRI, the retear rate was 69.6%, with no clinical differences between retear and intact repairs.12.3% had a revision surgery with an 87.2% (95% CI 77.1-96.3) 5 year survival rate to revision.J o u r n a l P r e -p r o o f Conclusion: Arthroscopic repair of posterosuperior MRCT provides significant pain and function improvement.Despite a high retear rate, mid-term clinical results remain favorable, with low complication and revision rates.
Gallego et al. (Wed,) studied this question.