Good Functional Outcomes can be achieved in challenging Musculotendinous Junction Rotator Cuff Tear

Musculotendinous junction rotator cuff tears pose a challenging surgical case in the realm of arthroscopic rotator cuff repair surgery. A large focus of the repair is dependent on soft tissue-to – soft tissue fixation of medial and lateral margins of the tear. In view of the rare incidences of these tears, there is a paucity of literature on the functional outcomes and repair techniques. We seek to analyze the early post-operative outcomes in our patients with musculotendinous junction tears. A retrospective analysis of patients undergoing arthroscopic rotator cuff repair by a single-surgeon between August 2019 to December 2021 was performed. 6 patients had musculotendinous junction tears of the supraspinatus tendons, which were repaired using a suture bridging technique and double-row construct, with margin convergence sutures. Pre-operative and post-operative outcomes were evaluated using Numerical Pain Rating Scale (NPRS), University of California Los Angeles Shoulder Score (UCLASS) and Oxford shoulder Score (OSS). Pre-operatively, average VAS pain score was 5.7, which improved to 2.7 at 3 months and continued to improve for all patients, reaching a pain score of 0 by 1 year interval for 5 patients. From 3 months onwards, there were statistically significant improvements in both functional scores for UCLASS at 6 months (p = 0.0012), 1 year (p = 0.0016) and 2 years (p = 0.0011), and for OSS at 6 months (p = 0.0328), 1 year (0.0091) and 2 years (p = 0.0287). Early functional outcomes highlight improvements following arthroscopic rotator cuff repair and we recommend surgical intervention in these MTJ injuries.