Partial-Thickness Rotator Cuff Tears Treated With Full-Thickness Repair for Articular-Sided Tears and Bursal Repair for Bursal/Intrasubstance Tears Using Arthroscopic Double-Row Technique Provides Successful Clinical Outcomes at a Minimum 10-Year Follow-Up.

Abstract

To evaluate outcomes of patients who underwent arthroscopic repair for partial-thickness rotator cuff tears (PTRCTs) with a minimum 10-year follow-up. Patients who underwent arthroscopic surgery for PTRCTs between 2006 and 2014 were retrospectively analyzed. Articular-sided tears were repaired by converting to full-thickness, bursal-sided tears were repaired on the tear side, and intratendinous tears were repaired by converting to bursal-sided tears. Assessment included American Shoulder and Elbow Surgeons (ASES) score, Subjective Shoulder Value (SSV), and visual analog scale (VAS). The proportion of patients who met the minimal clinically important difference (MCID), substantial clinical benefit, and patient acceptable symptom state thresholds for ASES, SSV, and VAS was determined. Patients were classified into 3 subgroups on the basis of tear type, and demographics and patient-reported outcome measures (PROMs) were compared. Among 89 eligible patients, 72 with complete data were included. The mean age was 51.1 ± 10.8 years, and the mean follow-up period was 12 ± 2.2 years (10-19 years). Patients had significant improvements in ASES (28.6 to 87.2), SSV (35.6 to 90.3), and VAS (8.2 to 1.5) (P < .001 for all PROMs). The rates of patients achieving MCID_anchor, MCID_distribution, patient acceptable symptom state, and substantial clinical benefit were determined, respectively, ASES (89%, 98%, 92%, 90%), SSV (92%, 92%, 92%, 89%), and VAS (92%, 94%, 88%, 88%). Subgroup (bursal-sided [53%], intratendinous [19%], articular-sided [28%]) analysis revealed significant improvements in all PROMs (for bursal- and articular-sided tears, P < .001 for all PROMs; for intratendinous tears, P_ASES= .001, P_SSV= 0.002, and P_VAS= .001). At a minimum 10-year follow-up, arthroscopic double-row repair for articular (converted to full thickness and repaired), bursal (tear-side repair), and intratendinous (converted to bursal-side and repaired accordingly) PTRCTs provides significant improvements in PROMs and when considered as a single PTRCT cohort, these patients achieve satisfactory clinically meaningful outcomes. Level IV, retrospective case series.