Risk Factors for Retear After Arthroscopic Repair of Full-Thickness Rotator Cuff Tears Using the Suture Bridge Technique: Classification System.

Abstract

To identify factors that predict retears after arthroscopic repair of full-thickness rotator cuff tears. Factors included age, sex, diabetes, smoking, symptom duration (group I, <12 months; group II, ≥12 months), tear size according to the Kim classification (group I, A and B; group II, C; group III, D), tendon involvement (group I, supraspinatus; group II, supraspinatus and subscapularis; group III, supraspinatus and infraspinatus; group IV, all 3 tendons), and degree of fatty degeneration of the supraspinatus and infraspinatus (group I, Goutallier stages 1 and 2 for each tendon; group II, Goutallier stages 3 and 4 for each tendon). Two hundred eighty-two patients underwent arthroscopic repairs of full-thickness rotator cuff tears. The overall retear rate was 13.1%. Age, sex, diabetes, smoking, and degree of fatty degeneration of the supraspinatus and infraspinatus did not affect retear rates. However, symptom duration (P = .006), Kim classification (P < .001), and tendon involvement (P < .001) did affect retear rates. The retear rates were 8.5% (14 of 165 patients) and 19.7% (23 of 117) in symptom duration groups I and II, respectively; 8.0% (13 of 163), 15.2% (16 of 105), and 57.1% (8 of 14) in Kim classification groups I, II, and III, respectively; and 6.6% (11 of 167), 22.2% (18 of 81), 10.0% (2 of 20), and 42.9% (6 of 14) in tendon involvement groups I, II, III, and IV, respectively. In the multiple logistic regression analysis, the respective odds ratios of symptom duration group II, Kim classification group III, tendon involvement group II, and tendon involvement group IV were 2.853 (P = .011), 18.108 (P = .001), 4.184 (P = .001), and 5.727 (P = .021), respectively. To preoperatively predict retears after arthroscopic repair of full-thickness rotator cuff tears, the duration of symptoms before surgery, tear size, and tendon involvement can be used. In addition, regarding tear size, the Kim classification can be used more effectively than the modified DeOrio and Cofield classification. Level IV, prognostic case series.