Summary

Arthroscopic repair of PTRCT and FTRCT followed by a suture bridge repair technique has provided similar outcomes in Oxford and WORC scores at final follow-up. However, these two different entities should be rehabilitated differently as the PTRCT has shown higher grade of stiffness at week 12 and lower re-tear rates than FTRCT at final follow-up. Therefore, with less risk of re-tear rate, starting

Abstract

Introduction

The purpose of this study was to compare the functional outcome and retear rate of arthroscopic repair of partial-thickness rotator cuff tear (PTRCT) compared with full-thickness rotator cuff tear (FTRCT) performing the same suture-bridge repair technique.

Methods

A total of 304 patients with FTRCT (242) and PTRCT (62) that required an arthroscopic rotator cuff repair between 2012 and 2020 with completed serial ultrasound examinations at weeks 6, 12 and 26 postoperatively were included. The time point for examination of cuff integrity was six months, chosen on the basis of in vivo animal studies of rotator cuff repair healing process. Functional clinical scores were assessed by Constant score, Western Ontario Rotator Cuff Index (WORC) and Oxford score. Details were retrieved from the Socrates Orthopaedic Outcomes Software database. Surgical procedures were performed by the same experienced senior surgeon (MH). All patients had undergone a suture bridge repair technique.

Results

Statistically significant difference was observed between the mean age of patients (63 years ± 8.29 for FTRCT group and 57 years ± 10.01 for PTRCT p=.001). No differences in the grade of tendinopathy were observed between both groups. Clinical outcomes were significantly improved following arthroscopic repair in both groups, preoperatively scores vs scores at week 26 of all three scores (p=<.001). No differences between preoperatively Total Oxford Score were observed between both groups. Although Oxford usual pain was statistically significantly higher in the PTRCT group (2.82 ±0.8 vs 2.64 ± 0.9 p=<0.05). No differences between total Oxford Score at week 26 were observed between both groups. However, Oxford worst pain at week 26 was statistically significant higher in the PTRCT group (1.38 ±0.79 vs 1.05 ± 0.82 p=<0.05). No differences between preoperatively Constant score were observed between both groups. The Constant score at week 26 reflected statistically significant differences with higher score for FTRCT group (66.58 ±16.34 vs 64.45 ± 17.55 p=<0.05). No differences in WORC scores preoperatively and at week 26 were observed between both groups. However, preoperatively WORC score vs WORC score at week 12 improved in the FTRCT group from 1118 (range 20-2030) to 972 (range 0-1980) and there were no
significant differences in the PTRC group (P=<0.05). Retear rates at weeks 12 and 26 were statistically significantly higher in FTRCT group than in PTRCT group. (17.77% vs 3.23% p=<0.05 at final follow-up)

Conclusion

These results suggested that patients with PTRCT are usually younger, FTRCT and PTRCT have similar preoperatively functional scores but paradoxically, our study showed that PTRCT tends to be more painful than FTRCT. Arthroscopic repair of PTRCT and FTRCT followed by a suture bridge repair technique has provided similar outcomes in Oxford and WORC scores at final follow-up. However, these two different entities should be rehabilitated differently as the PTRCT has shown a higher grade of stiffness at week 12 and lower re-tear rates than FTRCT at final follow-up. Therefore, with less risk of re-tear rate, starting at 4-week following surgery might be a reasonable time-point to begin with an early physiotherapy protocol for PTRCT.