Background:It is well known that rotator cuff repair is associated with an overall retear rate of 21% to 26%. However, a cuff retear may not necessarily be associated with poor clinical outcomes.Hypothesis:There would be no difference in clinical outcomes between patients with a cuff retear and those with an intact repair at a midterm follow-up of 5 years.Study Design:Cohort study; Level of evidence, 3.Methods:A retrospective study was conducted involving patients who received arthroscopic complete repair of the supraspinatus tendon between January 2009 and December 2017. Patients who did not have a postoperative magnetic resonance imaging (MRI) scan or who had a follow-up of <5 years were excluded. Clinical outcomes, including the visual analog scale (VAS) score, American Shoulder and Elbow Surgeons (ASES) score, and active forward flexion (FF) of the involved shoulder were assessed at the 2-year and 5-year follow-up points.Results:The study group included 105 patients with a mean follow-up of 85 months. MRI scans were performed at a mean of 20 months. Fourteen full-thickness cuff retears and 91 intact repairs were identified using postoperative MRI scans. Significant improvement in VAS score, ASES score, and FF were found between the preoperative assessment and the 2 designated follow-up points (2 years and 5 years) in both the cuff retear and the intact repair groups ( P < .001). The VAS and ASES scores at the 2-year follow-up for the intact repair group were 1.8 ± 2.0 and 80.7 ± 18.1, respectively. The corresponding values for the retear group were 2.3 ± 2.2 and 71.9 ± 19.5, respectively. No significant difference was found between the 2 groups in the VAS and ASES scores at the 2-year follow-up. However, patients with an intact repair had a better VAS score (1.4 ± 1.8; P = .049) and ASES score (81.7 ± 17; P = .019) than those with a cuff retear at the 5-year assessment (3.0 ± 2.8 and 67.1 ± 22.9, respectively). In the intact repair group, 91% of patients achieved the minimal clinically important difference for the 5-year VAS score, compared with 54% in the cuff retear group ( P < .001). The corresponding values for the 5-year ASES score were 80% and 54%, respectively ( P = .044). FF measurements at the 5-year follow-up in patients with intact repair and those with a cuff retear were 161°± 23° and 144°± 37°, respectively ( P = .059). Continuous improvement in VAS score and FF between the 2-year and 5-year follow-up was observed in the intact repair group ( P = .005 and P = .04, respectively).Conclusion:The patients with an intact repair had better VAS and ASES scores compared with those who had a cuff retear at a midterm follow-up of 5 years. Between the 2-year and the 5-year follow-up, some further improvement was observed in the VAS score and FF in the intact repair group.

中文翻译：

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冈上肌腱修复术后再撕裂患者与完整修复患者 5 年随访时临床结果的差异

背景：众所周知，肩袖修复与 21% 至 26% 的总体延迟率相关。然而，袖带重新撕裂不一定与不良临床结果相关。假设：在 5 年的中期随访中，袖带重新撕裂的患者与完整修复的患者之间的临床结果没有差异。研究设计：队列研究；证据级别，3.方法：对2009年1月至2017年12月期间接受关节镜下冈上肌腱完全修复术的患者进行回顾性研究。未进行术后磁共振成像（MRI）扫描或进行了随访的患者排除<5年以上的情况。在 2 年和 5 年随访点评估临床结果，包括视觉模拟量表 (VAS) 评分、美国肩肘外科医生 (ASES) 评分以及受累肩部主动前屈 (FF)。结果：研究组包括 105 名患者，平均随访时间为 85 个月。平均 20 个月进行一次 MRI 扫描。术后 MRI 扫描发现 14 处全层袖带撕裂和 91 处完整修复。在袖带重新撕裂组和完整修复组中，术前评估和 2 个指定随访点（2 年和 5 年）之间的 VAS 评分、ASES 评分和 FF 均有显着改善 (P < .001)。完整修复组2年随访时的VAS和ASES评分分别为1.8±2.0和80.7±18.1。后组的相应值分别为 2.3 ± 2.2 和 71.9 ± 19.5。2 年随访时，两组 VAS 和 ASES 评分无显着差异。然而，在 5 年评估中，修复完整的患者的 VAS 评分 (1.4 ± 1.8；P = .049) 和 ASES 评分 (81.7 ± 17；P = .019) 优于袖带重新撕裂的患者 (3.0 ±分别为 2.8 和 67.1 ± 22.9）。在完整修复组中，91% 的患者在 5 年 VAS 评分方面实现了最小的临床重要差异，而袖带再撕裂组中这一比例为 54% (P < .001)。5 年 ASES 评分的相应值分别为 80% 和 54% ( P = .044)。完整修复的患者和袖带重新撕裂的患者在 5 年随访时的 FF 测量值分别为 161°± 23° 和 144°± 37° ( P = .059)。完整修复组在 2 年和 5 年随访期间观察到 VAS 评分和 FF 持续改善（分别为 P = .005 和 P = .04）。结论：完整修复组的患者病情更好5 年中期随访时，将 VAS 和 ASES 评分与袖带重新撕裂的患者进行比较。在 2 年和 5 年随访期间，完整修复组的 VAS 评分和 FF 进一步改善。