Editorial Commentary: One-Year Follow-Up Does Not Determine Rotator Cuff Repair Long-Term Outcome.

Abstract

Multiple studies have recently been published justifying decreasing the routine follow-up required of clinical studies from 2 years to 1 year. Emphasis has been placed on the minimal average changes in patient-reported outcomes between 1 and 2 years. Results of joint replacements tend to fare well with this approach, whereas for other diagnoses such as shoulder instability surgery, longer follow-up is required. Where does the clinical evaluation of rotator cuff repair (RCR) fall in this continuum? Systematic reviews of RCR outcomes show small gains (below the minimal clinically important differences) between 1 and 2 years. However, these reviews obscure subgroups in which 1-year follow-up is not representative of final outcomes. For example, single-anchor repair of a small rotator cuff tear in a low-demand individual might show little clinical change between 1 and 2 years, but the same cannot be said for repair of a large, retracted tear requiring graft augmentation or for the recovery of an elite overhead athlete. In general, 1-year follow-up is not the last word for RCR outcomes. Patients must live with the long-term outcomes of our surgical procedures; we are obliged to evaluate these long-term outcomes.