Long-term functional and structural outcome in patients with intact repairs 1 year after open transosseous rotator cuff repair

Hypothesis Tendon-to-bone suture and a fatty degeneration index (FDI) ≤ 2 are required to achieve an intact cuff in the mid-term. Our primary objective was to determine the structural and functional long-term outcomes of repaired cuffs that were intact after one year. Materials and methods We studied 30 cuffs with FDI ≤ 2 at surgery and no tear one year after tension-free tendon-to-bone suture. Mean follow-up was 9 ± 0.8 years. Gross tendon-stump lesions were excised prior to repair. Results Re-tear after one year was rare: only one cuff showed a recurrent tear. In the 29 intact cuffs, mean un-weighted Constant score and sub-scores improved significantly (P values, < .0001- .0002; final Constant score = 77) for two years then remained stable. FDI values increased during the first year and then remained stable. Mild osteoarthritis was noted in one shoulder at last follow-up. Conclusion Final functional outcomes correlated significantly to FDI at baseline and last follow-up. Tension free tendon-to-bone suture is effective functionally and structurally at nine years follow-up provided the FDI at surgery is ≤ 2 and the repair is intact after one year. Level of evidence Level 3; Retrospective cohort therapeutic study.