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What are the Risk Factors for Rotator Cuff Retears?


Seung-Bo Shim, MD
KOREA, REPUBLIC OF

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What are the Risk Factors for Rotator Cuff Retears?

Seung-Bo Shim, MD, KOREA, REPUBLIC OF Jae-Chul Yoo, MD, KOREA, REPUBLIC OF

Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KOREA, REPUBLIC OF

2017 Congress   Paper Abstract   2017 Congress   rating (1)

 

Anatomic Location

Shoulder

Diagnosis / Condition

Tears

Diagnosis Method

MRI

Treatment / Technique

Repair / Reconstruction Sutures / Knots / Anchors

Summary: The initial tear size and fatty degeneration of the supraspinatus are independent risk factors for rotator cuff tear, whereas the type of repair based on the extent of footprint coverage was not.

Introduction

Retear is a significant clinical problem after rotator cuff repair. However, few studies have evaluated the retear rate with regard to the extent of footprint coverage (reparability). The purpose of this study was to evaluate preoperative and intraoperative factors for retear after rotator cuff repair, with particular focus on the influence of the type of repair.

Material And Methods

Data were prospectively collected from 693 patients who underwent arthroscopic rotator cuff repair between January 2006 and December 2014. All patients underwent magnetic resonance imaging (MRI) after a mean postoperative duration of 5.4 months. Patients with type IV or V tendon integrity (Sugaya et al.) were included in group A. Group A was also evaluated after adding patients with type III integrity (group B). Preoperative demographic data, functional scores, range of motion, global fatty degeneration on preoperative MRI, and intraoperative variables were evaluated.

Results

The retear rates were 7.22% and 14% for groups A and B, respectively. Univariate analysis for group A revealed that rotator cuff retear was affected by age; presence of inflammatory arthritis; type of repair; tear size; number of suture anchors; surgical duration; functional visual analog scale (FVAS) scores; Simple Shoulder Test findings; American Shoulder and Elbow Surgeons scores; and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis. Multivariate logistic regression analysis revealed age, tear size, and fatty degeneration of the supraspinatus as independent risk factors.
Univariate analysis for group B revealed that rotator cuff retear was affected by age; type of repair; tear size; number of suture anchors; surgical duration; concomitant subscapularis repair; FVAS scores; and fatty degeneration of the supraspinatus, infraspinatus, and subscapularis. Multivariate analysis revealed the presence of frozen shoulder, tear size, and fatty degeneration of the supraspinatus and infraspinatus as independent risk factors.

Conclusion

Our results suggest that the initial tear size and fatty degeneration of the supraspinatus are independent risk factors for rotator cuff retear, whereas the type of repair based on the extent of footprint coverage was not.