Publication:

Mid-term functional and structural analysis arthroscopic single-row repair in full thickness rotator cuff tear

Background Purpose is to analyse functional scores and structural integration of cuff in Full thickness cuff tear patients treated with single row Arthroscopic rotator cuff repair (SR-ARCR) making it cost effective surgery in developing countries. Additionally, evaluation of Fatty atrophy, Glenohumeral arthritis, importance of subscapularis repair and role of biceps tenotomy was done.

Methods 60 rotator cuff repairs with minimum 12 months follow-up and all treated by SR-ARCR. Functional Assessment by Constant Murley Score (CMS), UCLA score and structural assessment by Sugaya grading.

Results Mean follow-up 35.93± 26.24 months with post operative mean constant murley (CMS) was 94.83±7.78 (p<0.001), mean UCLA 33.82±6.7 (p<0.001). Active forward flexion (AFF) 166.5±11.62(p<0.001), External rotation 79.17±10.13 (p<0.001), Muscle strength (0-25) 22.78±3.32(p<0.001), VAS 1.2±0.75(p<0.001), restoration of Acromio-humeral-distance (AHD) to 8.8±1.79(p<0.001). Sugaya 1(85%) having CMS 97.06±5.21 (p<0.001), Sugaya 2(10%) having CMS 82.67±9.42(p<0.001), Sugaya 3 (5%) having 81.33±6.35 (p<0.001).

Conclusion Single row arthroscopic rotator cuff repair offers excellent outcomes cost effectively by reducing number of anchors and with supervised physiotherapy and rehabilitation protocols. Good structural integration of rotator cuff ensures better functional outcomes. Repair of Subscapularis to balance force couple, biceps tenotomy to decrease pain and medialised repair to decrease tension of repaired cuff improves functional scores. Restoration of acromio-humeral-distance decreases progression of gleno-humeral arthritis.