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Treatment of Large and Massive Rotator Cuff Tears: Does Infraspinatus Muscle Tear Affect Repair Integrity?
Clin Should Elbow 2019;22:203-209
Published online December 1, 2019;  https://doi.org/10.5397/cise.2019.22.4.203
© 2019 Korean Shoulder and Elbow Society.

Sungwook Choi, Hyunchul Yang, Hyunseong Kang , Gyeong Min Kim

Department of Orthopedic Surgery, Jeju National University School of Medicine, Jeju, Korea
Correspondence to: Hyunseong Kang
Department of Orthopedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 63241, Korea
Tel: +82-64-717-1690, Fax: +82-64-717-1131, E-mail: oskanghs@gmail.com, ORCID: https://orcid.org/0000-0001-6764-9929
IRB approval: Jeju National University Hospital (No. JNUH 2016-06-024).
Received September 6, 2019; Revised November 2, 2019; Accepted November 3, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Clinical outcomes and prognosis of large and massive rotator cuff tears are known to be unpredictable not only in degeneration of the rotator cuff, but also due to a high rate of retear.
Methods: Totally, 81 patients who had undergone arthroscopic rotator cuff repair from May 2008 to February 2016 were evaluated in our study. Clinical and functional evaluations were performed with the Constant score and the University of California, Los Angeles (UCLA) score, as well as full physical examination of the shoulder. All patients were confirmed to have magnetic resonance imaging (MRI) of tendon healing at least 1 year postoperatively.
Results: The average age at the time of surgery was 65 years (range, 47–78 years). The average duration of postoperative time in which a follow-up MRI was performed was 36.1 months (range, 12–110 months). Large tears were present in 48 cases (59.3%) and massive tears in 33 cases (40.7%). Overall, there were 33 retear cases (40.7%). All the average clinical outcome scores were significantly improved at the last follow-up (p<0.001), although repair integrity was not maintained. Compared to type A, types C, and D of the Collin’s classification showed significantly higher retear rates (p=0.036).
Conclusions: Arthroscopic rotator cuff repair yields improved clinical outcomes and a relatively high degree of patient satisfaction, despite the repair integrity not being maintained. Involvement of the subscapularis muscle or infraspinatus muscle had no effect on the retear rate.
Keywords : Rotator cuff; Arthroscopy; Shoulder