ARTHROSCAN STUDY OF TENDON HEALING AFTER ARTHROSCOPIC REPAIR OF THE SUPRASPINATUS: ANALYSIS OF PREDICTIVE FACTORS OBSERVED IN A CONSECUTIVE SERIES OF 167 REPAIRS

Abstract

Purpose of the study: Arthroscopic repair of rotator cuff tendons is a well-described technique. Clinical outcome is good. The purpose of this work was to assess tendon healing as observed with the arthroscan after arthroscopic repair of rotator cuff tears. We search for epidemiological, anatomic, and technical factors predictive of healing.

Material and methods: This was a prospective consecutive non-randomized series of 167 shoulders. All patients were assessed preoperatively with the Constant clinical score and had a standard imaging protocol for assessing the status of the rotator cuff. Arthroscopic repair was used in all cases. Outcome was assessed with the Constant score and an arthroscan was available for 148 patients.

Results: Mean patient age was 59 years, 49% male and 77% dominant side. Mean duration of symptoms before repair was nine months. The tear resulted from trauma in 28% and was a work accident in 9%. The preoperative functional assessment was 52.48. An isolated supraspinatus tear was observed in 68% of the shoulders. Frontal retraction of the supraspinatus was distal in 74%. For 29 shoulders, reduction was difficult and the quality of the tendon was considered normal in 56. Non-anatomic repair was required in six cases. The Constant score at last follow-up (19 months) was 80. An arthroscan was available for 148 shoulders: healing was anatomic in 69, defective healing was observed in 27 and repeated tears were noted in 52. Factors predictive of healing were: demographic (lesion duration less than six months, non-dominant side, young patient, female gender, sedentary lifestyle); anatomic (isolated lesion of the supraspinatus with little extension and no retraction); technical (normal easily reduced tendon, good quality bone).

Discussion: The time before surgical management of rotator cuff tears was an important factor in this study. Tendon and muscle alterations after rotator cuff tears could explain, at least in part, healing failures.

Conclusion: This study confirmed the good functional and anatomic results obtained with arthroscopic repair of rotator cuff tears.