Original Article
Return to Sports After in Situ Arthroscopic Repair of Partial Rotator Cuff Tears

https://doi.org/10.1016/j.arthro.2018.07.037Get rights and content

Purpose

To evaluate return to sport, clinical outcomes, and complications in a series of athletes with painful partial-thickness rotator cuff tears treated with the arthroscopic in situ repair with a minimum 2-year follow-up.

Methods

Retrospective case series. Seventy-two patients who had undergone an arthroscopic in situ repair for partial-thickness rotator cuff tears were evaluated. We assessed return to sport and the level achieved after surgery. Clinical assessment consisted of glenohumeral range of motion measurement and the American Shoulder and Elbow Surgeons score. Pain was recorded using a visual analog scale. Postoperative complications were also assessed.

Results

The mean age was 42.2 years (range, 21-66 years), and the mean follow-up was 54 months (range, 24-113 months). Sixty-one patients (87%) were able to return to sports. Fifty-six patients (80%) returned to the same level they had previous to the injury. The mean interval between surgery and return to competition was 5.6 months. The final functional outcomes were related neither to the type of sports nor to the level of competition before the injury. All active range of motion parameters improved significantly (P < .0001). The American Shoulder and Elbow Surgeons score improved from 43.3 to 88.1, and the visual analog scale scores improved from 6.1 to 1.2 (P < .0001). No significant difference regarding return to sports or functional outcomes was found between articular and bursal-sided tears. Only 5 patients developed a postoperative adhesive capsulitis that responded to physical therapy.

Conclusions

In patients with partial-thickness rotator cuff tears, arthroscopic in situ repair resulted in excellent functional outcomes, with most of the patients returning to sport and at the same level they had before injury. The results were equally favorable in articular and bursal tears.

Level of Evidence

Level IV, therapeutic case series.

Section snippets

Methods

Athletes who underwent arthroscopic repair of partial articular- or bursal-sided rotator cuff tears (PARCTs or PBRCTs) between December 2006 and December 2015 were retrospectively identified.

The inclusion criteria were (1) patients between 20 and 60 years old, (2) with an unsuccessful minimum 3-month course of conservative treatment consisting of activity modification, anti-inflammatory medication, and a physical therapy, and (3) tears of >50% of the tendon thickness on the bursal or articular

Results

From the 87 consecutive arthroscopic partial repairs performed in patients between 20 and 60 years old who practiced sports during the study period, 17 patients were excluded. Nine patients who underwent concomitant biceps procedures (7 tenodesis and 2 tenotomies) and 3 patients who underwent subscapularis repair were excluded. Four patients did not participate in follow-up for 2 years, and 1 patient died of an unrelated disease. The final evaluation thus was carried out in 70 patients.

The mean

Discussion

The main findings of this study were that arthroscopic in situ repair of PTRCTs resulted in excellent functional outcomes, with most patients returning to sport and at the same level they had before injury. The results were equally favorable in articular- and bursal-sided tears.

We prefer in situ repair. We preserve as much of the healthy tendon as possible and repair only the avulsed flap into the footprint. The advantages of this technique are that it restores anatomically the rotator cuff

Conclusions

In patients with PTRCTs, arthroscopic in situ repair resulted in excellent functional outcomes, with most of the patients returning to sport and at the same level they had before injury. The results were equally favorable in articular and bursal tears.

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    The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.

    This study was approved by the Ethical Committee of the Italian Hospital of Buenos Aires.

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